• Health Policy and Management
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• v.18 no.2
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• pp.1-18
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• 2008

As medical insurance had been implemented for Magnetic Resonance Imaging (MRI) from January 1, 2005, this study investigated whether there had been any change in the amount of the medical care utilization of patients who undertook MRI before and after the insurance coverage, and was to examine factors affecting the amount of medical care utilization of MRI. Data were collected from patients who undertook MRI before and after the insurance coverage for a year at a general hospital in Kyeanggi-do. $X^2$ and t-test were used for the analysis of their general characteristics, the number of MRI, and its medical costs before and after the insurance coverage, and hierarchical multiple regression analysis for the factors affecting the amount of the medical care utilization of MRI. The results of this study were as follows. First, the number of MRI after the insurance coverage was significantly decreased. Second, there was no significant difference in the total medical costs of MRI after the insurance coverage, but a significant difference was found in patient's share of medical costs. Third, six variables were found to be affecting the amount of the medical care utilization of MRI, and the variables showed to lead the number of MRI decrease after the insurance coverage. These six factors explained 21.4% of the total number of MRI. As MRI had been covered by insurance, the use of MRI and patient's share of the costs were deceased, but the total medical costs were not affected. Reasons for that could be found in that MRI insurance, different from the case of CT insurance coverage, was allowed not to cover some items and the kinds of diseases subjected to the insurance coverage were extremely limited, lowering insurance prescription rate. In addition to that, the average medical cost of MRI was not changed after the insurance coverage. Therefore, as future measures for the MRI insurance, coverage, it should be considered to allow insurance coverage to no coverage items and to expand the scope of benefit coverage, or to lower patient's share of the costs. Furthermore, researches should be done to explore how recipients will act and how suppliers will react if the coverage is expanded, including expanding the scope of coverage and reducing patient's share of the costs, as well as to conduct research on its economic analysis according to case mix.

• The Journal of the Korean life insurance medical association
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• v.29 no.1
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• pp.12-15
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• 2010

Global prevalence of chronic obstructive pulmonary disease(COPD) is known to 5.6 ~ 9.8%. Then life insurance applicants from persons with COPD are frequently encountered, and the underwriter and insurance medical doctors are called on with some regularity to render assessments of the mortality risk associated with COPD. According to previous article which contains long-term follow up of COPD, mortality ratio and excess death rate were 230% and 29 per 1000, respectively. Nowadays molecular genetic methodology such as GWAS has been developed. So it might be possible that molecular diagnostic methods may be one of useful underwriting tools in the life insurance risk selection of COPD applicants.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.3-16
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• 1985

Necessity of life insurance is stronger for people who feel some anxiety of their health. However, in fact, it is not permitted for them to get a contract, because life insurance stands on the mutual benefit system. Life insurance must be impartial to all applicants. However, it is very reasonable that an applicant, who has high medical impairment like heart infarction or cancer, is rejected, to have a contract by underwriting decision. On the other hand, if his medical impairment is not so severe, we might accept his application by giving some restriction. Numericalratingsystem by hunter-rogers gave us one of solutions to this problem. We can keep impartiality by using more restrictive decision, in order that we demand additional payment to the impairment applicant according to his mortality. We call this system as substandard life insurance. In this system we need detail information about impairments of applicants in order to decide the condition of substandard risks. Therefore, medical examiners are required to have high diagnostic technique.

• The Journal of the Korean life insurance medical association
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• v.28 no.1_2
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• pp.11-14
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• 2009

It is common to find cerebral infarct and hemorrhage without definite neurologic signs but with lesions on neuroimaging. These lesions are called silent lacunar infarct and cerebral microbleed. Silent lacunar infarct are frequently seen in the elderly and are associated with clinically apparent stroke and vascular dementia. Known stroke risk factors, such as hypertension, diabetes mellitus, smoking, hypercholesterolemia and heart problems may increase the risk of silent lacunar infarct. Metabolic syndrome, homocysteinemia, renal failure and intima media thickness(IMT) are also other risk factors of the silent lacunar infarct. Cerebral microbleed, lacunar infarct and intracerebral hemorrhage(ICH) have similar pathology and pathogenesis. So, cerebral microbleed are coexisted with lacunar infarct, leukoaraiosis, hypertensive ICH and vascular dementia. Cerebral microbleed are associated with volume and recurrence of ICH. Also cerebral microbleed may reflect baseline status of blood brain barrior disruption. Silent lacunar infarct and cerebral microbleed are very important to clinical management, but in the aspect of insurance medicine and independent medical examiners, these lesions are not subject of evaluation for handicap.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.221-225
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• 2017

Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.

• The Journal of the Korean life insurance medical association
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• v.16
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• pp.83-86
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• 1997

• The Journal of the Korean life insurance medical association
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• v.16
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• pp.99-107
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• 1997

• The Journal of the Korean life insurance medical association
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• v.16
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• pp.59-72
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• 1997

• The Journal of the Korean life insurance medical association
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• v.16
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• pp.37-48
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• 1997

• The Journal of the Korean life insurance medical association
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• v.17
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• pp.3-8
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• 1998