• Title/Summary/Keyword: Korea Health Insurance Cooperation

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Depression Symptoms and its Related Factors among the Elderly People Affiliated with Long-term Care Insurance Services in Urban Areas (일부 도시지역 장기요양급여 인정 노인들의 우울수준과 관련 요인)

  • Yoon, Hyun-Suk;Ji, Eun-Mi;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2674-2683
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    • 2015
  • This study was performed to determine the levels of depression(CES-D) and its related factors among the elderly people affiliated with long-term care insurance services in urban areas. The interviews were performed, during the period from March 1st, to May 31th, 2012, to 388 elderlies. As a result, the levels of depression among all subjects were 21.6% of normal group, and 78.4% of depression group. The distribution of depression according to the grade of long-term care insurance were 83.6% in Grade I, 82.1% in Grade II and 67.0% in Grade III, and the level of distribution were significantly higher according to the higher grade of long-term care insurance. For the results of multiple logistic regression analysis, the odds ratio was increased in older age group, in the poor health status group, and in the group of seldom in activity of hobbies than their counterparts, but it was decreased in the higher monthly income group than lower group. Above results suggested that the depression was significantly related with the variables such as sociodemographic characteristics, economic status, health related factors and health status.

Comparison of Factors Affecting According to the Quality of Life Level in Korean Adults with Diabetes Mellitus (한국 당뇨병 성인의 삶의 질 수준에 따른 영향요인 비교)

  • Bang, So-Youn
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.607-614
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    • 2020
  • This secondary analysis study used the 2015 Korea Health Panel data to identify the difference of factors affecting the quality of life (QoL) of Korean adults with diabetes mellitus (DM). The data from 1,343 subjects who met the criteria for screening was analyzed by multiple linear regression and quantile regression analyses. As a result, the average QoL of the subjects was .86 (±.14). The factors affecting the QoL of the subjects were age, gender, education level, spouse, economic activity, type of health insurance, and regular physical activity (all p<.05). However, there were differences of the results when dividing the subjects into three groups according to their QoL level. The factors for the lower 25% group were age, gender, education level, spouse, economic activity, type of health insurance, and regular physical activity, and those factors for the middle 50% group were age, gender, education level, spouse, type of health insurance, and regular physical activity, and those factors for the top 75% group were spouse, economic activity, household income, type of health insurance, and duration of DM. Based on these results, it is important to develop and provide a differentiated intervention strategy that considers the influential factors in order to improve the QoL of Korean adults with DM.

Public Perception on Coinsurance Rate of the National Health Insurance in Korea (건강보험 본인일부부담률 적정성에 대한 대중의 인식)

  • Cho, Ha Hyeon;Kim, Ji Eun;Hahm, Myung-Il;Kang, Eun Jung;Kim, Sun Jung
    • Health Policy and Management
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    • v.30 no.4
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    • pp.451-459
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    • 2020
  • Background: Although Korean government have been adopting several policies to expand coverage of National Health Insurance (NHI) program, the coverage rate is still below average across Organization for Economic Cooperation and Development countries. This study was to identify public perception on appropriateness of coinsurance rate and factors associated with coinsurance rate in National Health Insurance. Methods: For this cross-sectional study, 507 participants over aged 20 years were recruited from telephone surveys. Respondents experienced at least one and more visiting medical facilities due to medical problems in last 12 months. Demographic factors, socioeconomic positions, and experiences on medical utilization were measured in order to identify factors associated with perception appropriateness of coinsurance rate. Results: The 49.9% (n=209) of the public responded that the coinsurance rate of NHI program was appropriate. There were no differences in positive perception according to socio-demographic factors and experiences on medical utilization except for gender, residential area, and felt expensive when using medical services. People who felt burden of medical expenditure were more likely to perceive coinsurance rate inappropriate (odds ratio, 2.33; 95% confidence interval, 1.52-3.58) Conclusion: In spite of the relatively low coverage rate of NHI, this study identified that 49.9% of the public perceived the current coinsurance rate was adequate. However, people who felt the burden of medical expenditure were still had a negative perception of the coinsurance rate needed to decrease the coinsurance rate.

Workability and Life Satisfaction: Effects of Workers' Positive Perceptions on Their Return to Jobs

  • Kang, Dongsuk
    • Safety and Health at Work
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    • v.13 no.3
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    • pp.286-293
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    • 2022
  • Background: The death rate of workers due to industrial accidents in South Korea (3.61 persons in 2017) is higher than the Organization for Economic Cooperation and Development average (2.43) and the fifth highest among Organization for Economic Cooperation and Development member countries. Although the pandemic of novel coronavirus (COVID-19) has changed, the socioeconomic aspects of Korean society, the number of Koreans suffering accidents and the number of deaths in 2020 have increased. It is necessary to take measures to prevent accidents and make comprehensive efforts to return to work. This study proposes research questions about the effect of workers' positive perception on whether to work after accidents and the impact of the experience of rehabilitation services on the return to work. Methods: This research performed a panel logistic regression analysis using data on workers' compensation insurance in Korea for two years (2018-2019). Results: This research finds that workers' positive perceptions of workability and life satisfaction contributed affirmatively to their re-employment. Several factors related to employment (e.g., work period, the number of job qualifications) also positively affect their return to work. However, the experience of rehabilitation services did not have a significant effect on re-employment. The variables of their health conditions (e.g., disability grade, feelings of health problems, age) negatively influenced their return to jobs. Conclusion: These results suggest the importance of workers' mental recovery and the need to innovate rehabilitation services for their employment. Positive thinking and self-rehabilitation could be critical for workers, parallel with social welfare policies.

An Analysis of Health Care Services for the Elderly in Rural Areas: Its Demand in Projection and Policy Implications (우리나라 농촌지역(시.군 통합모형)의 노인보건의료 자원 수급계획에 관한 연구)

  • 정영일;정문호;강성홍;이창은
    • Korean Journal of Health Education and Promotion
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    • v.12 no.1
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    • pp.22-46
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    • 1995
  • This is an effort to project health care resources in need for the elderly in the future when advanced transportation systems would greatly reduce geographical accessibility to health care services for the rural elderly. Two areas, Kimhae and Chuncheon, were selected for the study. Projection of health professionals and health care institutions for the elderly were made based on the analysis for the morbidity and illness behavior reported to two data sources, National Survey for the Elderly in 1992 by Korea Institute for Health and Social Affairs and beneficiary data by Korea Medical Insurance Cooperation for those living in the study areas in 1992. Projected number of health professionals and health care institutions were estimated for each area under study in years of 2010 and 2030, with those in a Japanese being used as a standard. Policy implications were discussed.

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A Study on the Analysis of Factors for the Increase of Oriental Medicine Expenditure in the Automobile Insurance (자동차보험 한방진료비 증가요인 분석)

  • Lee, ChangSoo;Lee, Hyeon Ju;Chae, JungMi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.121-130
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    • 2019
  • Automobile insurance medical expenses increased by 12% in year 2015 compared to year 2014. But the oriental medical service expenses in automobile insurance increased by 36% during the same period. In this paper the reason for the rapid increase of expenses for oriental medical service was analyzed using the method of decomposing medical expenses. As a result of analyzing 34,351,120 cases that were examined and completed during the period of 2014~2015, the number of oriental medicine patients increased by 27% and the medical expense per patient increased by 7%. The result of analysis showed that there was no significant change in service period per patient but medical expense per day increased by 7%. The increase in the number of patients receiving only oriental medical services was 32%. Increase in the number of patients receiving medical treatment and oriental medical services was 24% and the number of patients receiving medical treatment only decreased by 4%. There was significant increase in non standardized cost of oriental physical therapy which was one reason of the increase of the expenses. However, the most influential factor of the increase in the expenses of oriental medical services was the increase of the number of patients.

Relationship between Medical Service Specialization and Operational Performance in Hospitals: Focusing on Length of Stay and Medical Expense (병원 진료의 전문화와 운영 성과 간의 관계: 재원일수와 급여비용을 중심으로)

  • Yoo, Hai-Won;Kim, Kyoung-Hoon
    • The Korean Journal of Health Service Management
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    • v.10 no.1
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    • pp.1-11
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    • 2016
  • Objectives : Medical service specialization could have positive effects on their profits and medical service quality. This study was to examine the relationship between medical service specializations and operational performance in hospitals. Methods : We used the National Inpatient Sample data provided by the Health Insurance Review and Assessment Service from 2010 to 2013. The hospital operational performance was determined by measuring the specialization level of the hospital based on DRGs. Results : The information theory index was 2.38 in 2010, 2.38 in 2011, 2.37 in 2012, and 2.37 in 2013. A multiple regression model was constructed which showed that if the specialization level becomes higher, it decreases the length of stay per case with an increase in medical expense. Conclusions : Differentiation and concentrated medical service specialization strategy have had a positive effect on the operational performance of hospitals.

Key Issues on Long-Term Care Hospitals in Korea (요양병원의 성장과 운영상의 주요 이슈)

  • Oh, Eun-Hwan
    • Health Policy and Management
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    • v.28 no.3
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    • pp.257-262
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    • 2018
  • This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

Age-Related Physical Function(ADL, IADL) and its Related Factors of Elderly People in Korea (우리나라 고령자의 연령에 따른 신체적 기능(ADL, IADL)과 관련요인)

  • Song, Young-Su;Bae, Nam-Kyou;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.2002-2011
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    • 2015
  • This study was performed to determine the levels of physical function (ADL, IADL) and to reveal its association with the related factors in the elderly people. The study subjects were 1,756 (male 872, female 884) people aged over 70 who received medical check-ups and long-term care services between 2009 and 2012 from the National Health Insurance Corporation. As a result, the distribution of impaired ADL and IADL increased significantly with age. Logistic regression showed that the risk ratio of impaired ADL was increased significantly in the following groups: female, urban, low weight, stroke history group, smoking, alcohol drinking, and not regular exercise group. The risk ratio of an impaired IADL were increased significantly in the group of females, low weight, smoking, alcohol drinking. On the other hand the risk ratio of an impaired ADL and IADL was similar in each age group. As above results, the levels of ADL and IADL in the study subjects are closely related to the socio-demographic characteristics and health related behaviors. In particular, they suggested that the levels of ADL and IADL were lower in the poor group of the health-related behaviors, such as smoking, alcohol drinking, and regular exercise.

Designing the Sickness Benefit Scheme in South Korea: Using the Implication from Schemes of Advanced Nations (한국 상병수당제도 및 전달체계 설계연구: 주요 선진국과의 제도 비교를 중심으로)

  • Jung, Hyun Woo;Sohn, Minsung;Chung, Haejoo
    • Health Policy and Management
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    • v.29 no.2
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    • pp.112-129
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    • 2019
  • Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.