• 한국치위생학회지
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• 제13권4호
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• pp.561-568
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• 2013

Objectives : The purpose of this study is to examine the recognition and needs on the national health insurance coverage of scaling in industry accident injury patients. National health insurance coverage of dental scaling will start in September, 2013. Methods : Subjects were 649 industrial injury patients and they completed self-reported questionnaire. Data were analysed using SPSS version 20.0 for percentage, chi-square test, t-test, ANOVA, post-hoc Scheffe test, and Pearson's correlation coefficient. Results : Recognition on national health insurance coverage of dental scaling was not fully known to industrial injury patients (24.5%). Highly educated and high income workers seemed to recognize national health insurance coverage of dental scaling (p<.001). Recognition for national health insurance coverage of dental scaling revealed a significance (r=.576, p<.001). Most of the industrial injury workers thought that 50,000 to 100,000 Korean Won of dental scaling fee is reasonable. The coverage of dental scaling should be more than twice over 20 years old. Conclusions : It is necessary to encourage the patients to take regular dental scaling checkup and make them know the health insurance coverage of scaling. The preventive oral health care may improve oral health care and quality of life.

• 한국IT서비스학회지
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• 제19권1호
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• pp.37-53
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• 2020

Today, our society is exposed to cyber threats, such as the leakage of personal information, as various systems are connected and operated organically with the development of information and communication technology. With the impact of these cyber risks, we are experiencing damage from the virtual world to the physical world. As the number of cases of damage caused by cyber attacks has continued to rise, social voices have risen that the government needs to manage cyber risks. Thus, information and telecommunication service providers are now mandatory to have insurance against personal information protection due to amendment of "the Act on Promotion of Information and Communication Network Utilization and Information Protection". However, the insurance management system has not been properly prepared, with information and communication service providers selecting the service operators based on sales volume rather than selecting them based on the type and amount of personal information they store and manage. In order for the personal information protection liability insurance system to be used more effectively in line with the legislative purpose, effective countermeasures such as cooperation with the government and related organizations and provision of benefits for insured companies should be prepared. Thus, the author of this study discuss the current status of personal information protection liability insurance system and the issues raised in the operation of the system. Based on the results of this analysis, the authors propsoe tasks and plans to establish an effective personal information protection liability insurance system.

• 한국보건간호학회지
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• 제31권1호
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• pp.5-18
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• 2017

Purpose: This study was conducted to suggest a method for financial projection of health insurance expenditures that reflects future changes in demographic structure. Methods: Using data associated with the number of patients and health insurance cost per patient, generalized linear models (GLM) were fitted with demographic explanatory variables. Models were constructed separately for individual medical departments, types of medical service, and types of public health insurance. Goodness-of-fit of most of the applied GLM models was quite satisfactory. By combining estimates of frequency and severity from the constructed models and results of the population projection, total annual health insurance expenditures were projected through year 2060. Results: Expenditures for medical departments associated with diseases that are more frequent in elderly peoples are expected to increase steeply, leading to considerable increases in overall health insurance expenditures. The suggested method can contribute to improvement of the accuracy of financial projection. Conclusion: The overall demands for medical service, medical personnel, and relevant facilities in the future are expected to increase as the proportion of elderly people increases. Application of a more reasonable estimation method reflecting changes in demographic structure will help develop health policies relevant to above mentioned resources.

• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.148-155
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• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• 한국병원경영학회지
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• 제19권2호
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• pp.1-11
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• 2014

The purpose of this study is to investigate awareness on medical insurance on the caregivers cost for hospital administrative staff and to provide the basic data for realization of legislation. The subjects were caregivers living in Busan, the survey was conducted from February 18 to March 9, 2013, 283 except for 17 copies of non-response and error response among a total of 300 questionnaires were analyzed. As a result, To improve the quality of care services, there were 51.8% of refresher training needs in refresher training items, 72.7% in favor of premiums increases in health insurance details, as for health insurance coverage subjects, patients' income were 32.0%, copayment for caregivers cost was 20.0%, which was 42.3%. Refresher training item, premiums increases, health insurance applied subjects, variables for copayment for care fee were related to medical insurance on the caregivers cost. On legislation on the medical insurance, systematic and standardized criteria should be provided to provide standardized curriculum for caregivers, to relieve patients and guardians of economic burden for caregivers cost and offer the stability of the cost.

• 유통과학연구
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• 제14권3호
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• pp.5-10
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• 2016

Purpose - This paper analyzed the accident of drone and related insurance goods which can be coverable with regard to drone accident. The study range is limited in the owner's care, custody, and the control of drone in South Korea, but military area and law and regulation of the drone would be exceptional. Research design, data, and methodology - With regard to drone's flight, drone can make possible risks and can give severe damage to the people. To carry out this research, literature survey and review such as journal, thesis and publications were adopted. Results - As for the insurance coverage from drone's accident involved in the purpose of business, insurance coverage depends on 'commercial general liability insurance'. However, in case of personal hobby including leasure intention, insurance coverage depends on 'living liability insurance'. Conclusions - From a drone's accident, operator and owner of the drone may face the property damage to the drone itself, and then can give severe damage or loss to the people such as physical injuries and property damage. Peoples should be concerned about having the awareness of drone's accident with insurance coverage.

• 한국임상약학회지
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• 제28권2호
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• pp.124-130
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• 2018

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

• 보건행정학회지
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• 제11권2호
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.

• 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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• 제20권2호
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• pp.104-127
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• 2010

To vitalize the link program of Korean long-term care insurance system to community-based services for non-eligible people, we analysed the claim data from the Korean National Health Insurance Corporation (NHIC), and conducted a questionnaire survey to charging employees of elderly service department at local governments. The subjects were all 81,377 people, 57,454 of them were arranged to community-based services. The link program was more necessary among the missed subjects rather than the arranged people due to the need for physical or psychological assistance. By the result of the survey to the local government employees, 59.5% of subjects responded their proportion of link service was over 10% and under 20%, and 54.3% of them responded their job boundary are not clear. Major type of linking was notification the subject list to local government, 91.4%; proportion of periodical notification on the status of their service link were 57.1%, only 7.1% were followed to manage after the link. Difficult factors at the link process were pointed out the overload by other side work, deficiency of resources, rigidity of priority of link, and so on. Considering these results, to vitalize the community-based services to the non-eligible people, it may be essential the active participation of the subjects, construction of parts working in coordination among the institutions including NHIC, local governments, and service providers; development of various services for maintenance or promotion of the non-eligible peoples' health and functional status; and active participation of institutions from the third sector, and so on.