• Health Policy and Management
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• v.31 no.4
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• pp.409-422
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• 2021

The growing use of prescription analgesic opioids has rapidly escalated the treatment of chronic pain since the 1990s; however, it is also highly needed to control opioid-related issues, including opioids misuse, abuse, and addiction. In 2018, Organization for Economic Cooperation and Development (OECD) secretariat administered the survey on opioids use and policies to OECD countries and presented it at the Health Committee meeting of December 2018. This study aimed to review the opioids use in OECD countries and their policies to prevent and reduce associated harms, also seek the available policy lessons from OECD countries. More recently, opioids prescribing rate have been increased 14.7% between 2011-2013 and 2014-2016 and steadily focused on the main substance misused and abused in Korea. In addition, policy efforts have contributed to developing a guideline for prescribing opioids to steer the appropriate use of prescription analgesic opioids since 2000 in Korea, so it is not enough to control opioids compared with other OECD countries. Therefore, taking a people-centered and public health perspective, it will consider the health system policies and interventions at a national level to improve their preparation and approach to control opioid-related issues.

• Health Policy and Management
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• v.29 no.2
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• pp.206-219
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• 2019

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.75-82
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• 2021

The purpose of this study was to review literature about private health insurance (PHI) schemes for Korean older adults published in Korea and abroad from 2015 to 2019, and to present the implications of the study and provide an overview of PHI utilization by Korean older adults. Nineteen quantitative academic research papers were selected and analyzed with respect to presentation time, research purpose, data source, and study design. Old age, low income, low education, and chronic disease were found to hinder enrollment in PHI schemes. Although the relationship between PHI and medical usage was not consistent, it was positively related to health outcomes such as subjective health status and health-related quality of life. Therefore, for PHI to fulfill the role of providing supplementary medical care for older adults with high medical demands, a national improvement policy should be developed to address the barriers that prevent older adults adopting PHI schemes, and empirical studies related to medical usages by and the health outcomes of older adults should be conducted in order to generate a basis for the use of PHI.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2338-2348
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• 2013

This study was performed to determine the levels of physical functioning and to reveal its association with socio-demographic characteristics, health status and health related behaviors in the elderly people admitted long-term home care insurance. The interviews were performed, during the period from December 1, 2011 to March 31, 2012, to 618 home care elderlies admitted long-term care insurance dwelling in Daejeon city. As a results, the distribution of impaired ADL and IADL group of all subjects were 45.6% in ADL, and 48.4% in IADL. in consequently, the rate of impaired IADL group was higher than that of impaired ADL group. In logistic regression analysis, the adjusted odds ratio of the impaired ADL and IADL group were significantly increased in the group of male, living with spouse or family, bear for living expenses with son and daughter, health insurance, irregular exercise, seldom with frequency of going out, seldom with activity of hobbies, Subjective health status is good, and disability of body, visual acuity, hearing ability and mastication ability is good, and without urinary incontinence and amnesia. In conclusion, the level of physical functioning in the elderly people admitted long-term home care insurance was decreased in IADL than ADL. And the level of ADL and IADL were related with the various variables of socio-demographic characteristics, health status and health related behaviors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.392-399
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• 2016

This study examined the distribution of metabolic syndrome according to the age groups among the elderly people to reveal the sociodemographic and health related factors. The survey in 2011~2014 from the National Health Insurance Corporation under regular medical check-ups, which received a recognition survey targeted 1,756 people aged over 70. Multiple logistic regression was performed on the relation metabolic syndrome and its related factors. As a result, the risk ratio for metabolic syndrome increased significantly in females than in males, living with a family than living alone, high economic status than in the low group, obese than in the normal weight group, have a history of stroke group than the no history group, smoking group than the non-smoking group, and drinking group than the non-drinking group. The distribution of metabolic syndrome differed significantly according to the sociodemographic characteristics and health-related variables.

• The Journal of the Korean life insurance medical association
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• v.27 no.2
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• pp.85-95
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• 2008

When an insurance company receives an application for life or health insurance, the company must evaluate the degree of risk the individual for insurance coverage presents before the company agrees to issue the policy. A medical factor is a physical or psychological characteristic that may increases a hazard. A financial factor is financial information that is taken into account by underwriter to determine if a person is applying for more than he/she reasonably needs or can afford. A personal factor is a lifestyle choice. There are several medical risk selection systems in Korean life insurance market. They are attending physician's statement, direct examination by insurance doctors, and paramedic examination. However there is some dissatisfaction of current system. It is possible that cooperation of part-time insurance doctors system may be one of useful system of medical risk selection. Improvement of medical risk selection system will be an important matter of profitability of insurance company and it will contribute to sound life insurance system.

• Korean Journal of Health Education and Promotion
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• v.20 no.1
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• pp.41-60
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• 2003

This study, performed to analyze the factors associated with health and cancer screening using preventive programs form health insurance among the women of a community, through a survey of about 923 women in Euijungbu-city. The subjects of the study were selected by a proportional cluster sampling method. The self-reported questionnaire was intended to fine factors associated with health screening and cancer screening. The results of this study were as follows: 1. In the case of health screening using health insurance, 14.1% of the subjects turned out to have been screened once or more in their respective life-time. Reasons given for non-participation in the screening were : 'lacking screening information', a belief that' it's not useful' and a belief that they' weren't sick'. 2. The factors associated with health screening behavior were age, educational level, number of doctor visits, BMI and health promotion behavior(p<0.01, p<0.05). Also, the factors associated with health screening behavior were cue to action and health status, and the predictors on health screening behavior were age and health promotion behavior(p<0.01, p<0.05). 3. In the case of cancer screening through the health insurance, 7.4% of the subjects turned out to have been screened once or more respectively in their life-times. Reasons given for non-participation in the screening were : 'lacking screening information', a belief they 'weren't sick' and that it's not useful'. 4. The factors associated with cancer screening behavior were age, educational level, income, alcholol intake, exercise, number of doctor visits and BMI(p<0.01, p<0.05). Aditional factors associated with cancer screening behavior were cue to action, health belief score and health status. Predictors for cancer screening behavior were: age, health belief score, screening attitude and health status(p<0.01, p<0.05). As indicated by the above results, a lack of information was an important factor for a lack of participation in screening. Age and cue to action were also important factors in promoting the cancer screening rate. Therefore, a dissemination of information about cancer screening contributes to the promotion of a screening rate, and cooperation between health insurance and local health cancer facilitates to be public the community-based cancer screening program.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.1920-1927
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• 2015

This study examined health insurance costs of occupational therapy in stroke patients. The subjects were stroke patients, who underwent occupational therapy by hospitalization or out-patient centers in 2010. The cost of occupational therapy was analyzed from the insurance claims data of Health Insurance Review and Assessment Service in 2010. The kinds of occupational therapy were divided according to the insurance fee of occupational therapy in 2010. In-patients who received occupational therapy paid the highest rehabilitation treatment fee, whereas outpatients paid the highest nervous system function test fee. The cost of occupational therapy in the special rehabilitation treatment fee was highest by 25.3 billion won. The number of uses of general hospitals was the highest by 180 thousand but the total cost of long-term care hospital was highest by 10.4 billion won. The number of uses and cost by regional groups was highest in Seoul and Gyeonggi-do province. This study is meaningful in that a cost analysis of occupational therapy in stroke patients was performed for the first time using the stroke data from the whole country. The result can be used to provide basic data to improve the insurance fee in the future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.268-277
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• 2017

This study was performed to determine the level of physical health(ADL, IADL) and mental health (cognitive impairment, dementia) among centenarians and to find the related factors. The study subjects were 268 centenarians who received medical check-ups from the National Health Insurance Corporation during 2011-2014. From the results, the factors that significantly influenced the ADL of the study subjects were gender, residential area, IADL, cognitive impairment and dementia. ADL and cognitive impairment were selected as the influencing factors of IADL, smoking status, ADL and IADL were selected as the influencing factors of cognitive impairment, and gender and ADL were selected as the influencing factors of dementia. These results suggested that the levels of physical and mental health of the centenarians were significantly affected by socio-demographic characteristics and health-related variables. Especially, the levels of physical and mental health were decreased with the poor group of health-related variables such as smoking, alcohol drinking and regular exercise.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.11
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• pp.6746-6755
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• 2014

This study examined the effect of long-term care utilization on the health care utilization of Medicaid elderly. The subjects were 5,834 long-term care insurance with the level 1 Medicaid elders, who received either service or non-service. This study examined the impact of long-term care service on the probability of health care utilization and the costs of health care utilization. The total medical cost and inpatient day between 2009-2007 were significant factors affecting long-term care utilization (${\beta}=.29$, p< .001, ${\beta}=.33$, p< .001 ) and this variable explained 22.6% of the total medical cost and 22.4% of the inpatient day. The results showed that non-service in long-term care was associated with an increase in health care utilization. The current long-term care insurance system should place higher priority and more resource allocation on long-term care utilization to increase the efficiency of the insurance system.