• 대한한방부인과학회지
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• 제21권3호
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• pp.218-230
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• 2008

Purpose: This study was performed to investigate the percentage of the oriental medical Ob & GY disease group in Korean Medical Health Insurance and to gain the basic data of enlargement and improvement of Acupuncture Benefits in the oriental medical Ob & Gy field. Methods: We requested data about the status of Insurance Benefits in 2005. 2006 to Health Insurance Review & Assessmenstatus Service(HIRA). And on the basis of this 2005. 2006 data, we analyzed the status of Insurance Benefits and Acupuncture Benefits in the oriental medical Ob & Gy disease group. Results: 1. Total health care benefit costs of Korean medical health insurance in 2005, 2006 took 4.38 percent and 4.25 percent of total health care benefit costs of Health insurance. 2. Total health care benefit costs of the oriental medical Ob & Gy disease group in 2005, 2006 took 0.38 percent and 0.40 percent of total health care benefit costs of Korean medical health insurance. 3. The percentage of Acupuncture benefits costs of the oriental medical Ob & Gy disease group in 2005, 2006 was merely 0.22 percent and 0.23 percent of total Acupuncture Benefits costs. 4. The main sick and wounded name of Ob & Gy diseases of Acupuncture Benefits was limited to Menstrual Disorder(K01)과- Uterus Abnormality(K13). Conclusion: The percentage of the oriental medical Ob & Gy disease group in Korean Medical Health Insurance was very low and the percentage of Acupuncture Benefits of he oriental medical Ob & Gy disease group was also very low. From now on, Searching ay of enlargement of Acupuncture Benefits in the oriental medical Ob & Gy field is required.

• 보건행정학회지
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• 제21권4호
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• pp.617-642
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• 2011

The purpose of our study is to analyze the determinants of the benefits of the long-term care insurance in Korea using 2008 and 2009 cross-sectional data. Per capita long-term care insurance benefits can be divided into home care services utilization rate, institutional care services utilization rate, per capita home care services benefits, and per capita institutional care services benefits, which are used as the dependent variables in our regression analysis. Admission rate and the ratio of the admitted to the applicant also used as the dependent variables. The results of our analysis show that the explanatory variables such as income level, needs for care, family type, access to the services, and regional characteristics are statistically significant to explain the dependent variables, the long-term care insurance benefits. The higher is the regional income and the more of the female residents, the more are the long-term care insurance benefits. The easier is the access to the services, the more are the insurance benefits. In the rural area, the level of the insurance benefits is relatively high. We propose that copayment rates of the long-term care insurance should be examined and monitoring on the over-use of the services should be done. Also preventive services and care by the family member should be expanded.

• 보건행정학회지
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• 제32권2호
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• pp.137-153
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• 2022

In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as 'large or small,' and the government's regulation and management policy on private health insurance was classified as 'strong or weak.' Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government's management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries' cases.

• 한국치위생학회지
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• 제22권5호
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• pp.401-410
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• 2022

Objectives: This study aims to provide data that will improve the scope of national health insurance coverage by surveying the awareness of health insurance benefits, specifically for implants and dentures, among dental workers. Methods: Information was collected through questionnaires completed by 194 dental workers at dental hospitals and clinics. The multiple logistic regression analysis was conducted to confirm influential factors in recognizing the health insurance benefits application for dentures and implants. Results: Regarding the awareness about the validity of health insurance benefits, satisfaction with the appropriateness on the subjects of the denture application and implant application are appeared to be high with each 3.369 and 3.673. Regarding satisfaction with the appropriateness of free post-maintenance for implants, the awareness level regarding the validity of health insurance benefits was indicated as high at 3.673. Conclusions: The categories and levels of appropriate insurance benefits must be restructured continuously.

• 보건행정학회지
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• 제19권2호
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• pp.36-50
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• 2009

Korean Government had performed three pilot programs to introduce the long term care insurance system. Persons aged 65 or older who are dependent on others for daily living could use long term care services in the pilot program. The long-term care insurance covered nursing home services, home care services and cash benefits. The cash benefits are included that for elderly at home and for patients in geriatric hospital. This study investigated whether there had been any change in the medical care utilization according to cash benefits for geriatric hospitalization. This study used National Health Insurance claims and Long term Care Insurance claims 2003 through 2006. Data were composed of subjects who undertook both insurance coverage. The subjects was divided into two groups. Case group included participants with the cash benefits of geriatric hospitalization. Control group included persons without the cash benefits selected by random sampling according to the distribution of case group. This study showed that the amount of medical care utilization of the case group is more significantly increased than the control group after adjusted their health condition and functional condition. This result will be helpful for making decisions on whether the cash benefit of geriatric hospitalization can be introduced into long term care insurance system.

• Journal of Periodontal and Implant Science
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• 제49권4호
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• pp.248-257
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• 2019

Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

• 의료법학
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• 제13권1호
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• pp.11-40
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• 2012

National Health Insurance Act has been enforced all over the People as part of the effort to assure the minimum constitutional human worth and dignity in the aspect of the right to pursue health for preventing misfortune that comes to death without even a chance to be received treatment for illness or injury. Meanwhile auto insurance is compulsory in certain parts in order to promote benefits of everyday life and the rapid recovery of the damage caused by traffic accident when one have negligently driven a car which has become the necessities in daily life. Any injured driver in a traffic accident can be treated by National Health Insurance without getting an auto insurance in various circumstances, but Article 3 paragraph 2 of Traffic Accident Act don't allow exception of criminal punishment when he has driven a car without license, drunken, or tresspassing the centerline, etc. When the injury occured by his own certain negligence is judged to 'when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident' of National Health Insurance Act, insurance benefits can be restricted. Such a restriction could harm the right to pursue happiness and health of People by depriving the poor, who cannot afford to pay, of chances to get treatment. Here we will see benefit restriction by 'gross negligence' of National Health Insurance Act Article 48 paragraph 1, which has largest portion of such restriction. It is desirable to delete 'gross negligence' clause from above paragraph and to interpret 'when' clause restrictively for diminishing confusion of interpreting and guaranteeing the right of health.

• 보건행정학회지
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• 제11권2호
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• pp.85-122
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• 2001

This study compared and analyzed the effect of income-redistribution, collecting data on the basis of the estimated details of insurance contribution and individual money wage lists for each one year before and after the combination of medical insurance program for industrial workers, by systematic sampling, extracting 4,160 families(14,764 people) among people applied to medical insurance program for self employees in Taegu City on the basis of Oct. 1st in 1998 with 227 associations of medical insurance program for self employees and medical insurance program for government employees and private school teachers combined, comparing the effect of income redistribution of before and after the combination of medical insurance program for self employees. The insurance contribution by household after the combination of medical insurance program for self employees showed the increase rate of average 20.9%, among them households of 68.8% increased and 31.2% decreased. The effect of income-redistribution was more positive because the degree of inequality was more deepened from 0.64 of the before-combination to 0.45 of the after-one in decile distribution ratio, from 0.26 to 0.34 in Gini -coefficient. Decile distribution ratio on the basis of insurance benefits by household was from 0.09 in the before-combination to 0.14 in the after-one, Gini-coefficient from 0.16 in the before-combination to 0.57 in the after-one was a little lowered. And decile distribution ratio of insurance benefits on the basis of insurance contribution was higher from 1.08 in the before-combination to 1.23 in the after-one, concentration index was a little lowered from 0.14 to 0.11, the effect of income-redistribution was improved in the phase of insurance benefits. The income-transfer rate of medical insurance program for self employees (the occupied rate of insurance benefits/ the occupied rate of insurance contribution) showed a lower trend in all of the before and after-combination towards upper classes, it was known that the income-transfer rate was higher from 1st degree to 7th degree in the after-combination in comparison with the before-one, but the effect of income¬redistribution was high because the income-transfer rate was lowered from 8th degree to 10th degree. The rate of medical insurance benefits (insurance benefits/ insurance contribution) increased from 0.79 in the before-combination to 1.07 in the after-one, and showed over 1.0 under 3th degree before the combination, but all of it was higher than 1.0 under 7th degree after the combination, the after-combination was more improved than the before-one in view of the rate of insurance benefits. As the result of above, on the basis of Oct. 1st in 1998 that 227 associations of medical insurance program for self employees was combined into one, we could say that the equality of imposing medical insurance contribution was more re-considered in the after-combination than in the before-one. But this study analyzed with classes divided, anyway, on the basis of insurance contribution, we have limit in explaining the correct effect of income-redistribution, because it was not analyzed according to classes of income, though it helps to analogize the effect of income-redistribution. So there must be analysis about the effect of income-redistribution, on the basis of the system, building up the system to grasp the correct income of the insureds of medical insurance program for self employees.

• 한국IT서비스학회지
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• 제17권4호
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• pp.163-189
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• 2018

In this study, we analyze the acceptance theories of insurance services using blockchain technology. Although insurance services using block-chain technology are still in discussion, specific development methods for service methods applying block-chain technology in insurance services are being studied. In this study, the following analysis was conducted to analyze the acceptance of insurance services using block chain technology, focusing on four factors of the UTAUT model. As a result of the analysis, the technology benefits of the blockchain affecting the performance expectations of UTAUT are security and reliability. In addition, the factors influencing UTAUT's effort expectations were found to be availability and economics. Therefore, it was found that performance expectation and effort expectation for technology acceptance are influenced by different technology benefits. Among the four factors of UTAUT, the factors affecting the insurance service using the blockchain technology are performance expectation and effort expectation, and social influence and promotion condition have no effect on acceptance intention. Also, the moderating effect of user innovation on acceptance intention of insurance service applying blockchain was significant only for effort expectation among UTAUT factors.

• Journal of Preventive Medicine and Public Health
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• 제13권1호
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• pp.47-51
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• 1980

This study attempts to assess the effect of the 1st class health insurance program to the income redistribution among the participants in a unit health insurance cooperative. One health insurance cooperative, located in Seoul, with 1558 members and 768 households was selected for this purpose. The relationships between amount of premium payed and benefits from the cooperative were compared. Necessary data were obtained from the bills submitted to the health insurance cooperative by the contracted medical institutions from 1st January 1977 to 30th June 1979. Households and individuals were the unit of the assessment. The indicators measuring income redistribution effect were the ratios between the benefit and expected benefit and the ratios between the benefit and the mean benefit. The major findings were: 1. The ratios between the benefits and the expected benefits were lower than 1 in the high income group and greater than 1 in the middle and lower income groups. This fact imply that the income redistribution effect was shown in the studied groups. It was shown that the middle income group received the greatest benefit, and then the lower income group. 2. The ratios between the benefit ana the mean benefit of the households in the higher standard income grade, were found to be higher. This means that the equity of the benefits of households were not achieved by the policy of the health insurance plan. 3. The health insurance utilization rates of the higher standard income group, measured by the household unit, were higher, and by the individual unit, the same rates of the middle income group were higher than other groups.