• 한국콘텐츠학회논문지
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• 제15권10호
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• pp.374-386
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• 2015

이 연구에서는 기록영화 <식코>를 활용한 교양수업이 수강생의 국민건강보험제도에 대한 인식과 태도에 미치는 영향을 분석하였다. 우리나라는 전 국민을 대상으로 공적 건강보험제도를 운영하고 있으나 선진국보다 상대적으로 낮은 보장성과 의료공급자의 저수가에 대한 불만, 그리고 민간의료보험 가입 확대로 인해 공보험의 역할 강화 노력에 대한 국민의 지지를 당연하게 기대하기 어려워 보인다. 국민건강보험제도는 전 국민의 의료서비스에 대한 접근성 강화 뿐 아니라 보험료에 따른 급여서비스 차별이 없어 민간보험에 비해 저소득층에 대한 의료보장에 있어 중요한 기능을 한다. 노인인구가 급격하게 증가하고 건강에 대한 국민적 관심이 높은 만큼 공적 건강보험제도의 지속과 역할 강화는 중요한 사안이며, 이는 국민적 지지를 바탕으로 이루어져야 할 것이다. 이에 일개 대학의 교양과목 수강생을 대상으로 민간보험의 부정적인 측면을 지적한 <식코>의 내용을 수업 콘텐츠로 학습하고, 학습 전후의 국민건강보험에 대한 태도를 비교하였다. 실증분석 결과를 바탕으로 제도에 대한 이해를 도모하는 데에 활용할 수 있는 교육콘텐츠 개발에 대하여 논하였다.

• 보건행정학회지
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• 제18권4호
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• pp.23-48
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• 2008

Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.

• 보건행정학회지
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• 제26권1호
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• pp.63-70
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• 2016

Background: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery (ultrasonic shears, electrothermal bipolar vessel sealers) for gastric cancer patients covered since December 2014. Methods: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. Results: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. Conclusion: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.

• 보건행정학회지
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• 제22권3호
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• pp.451-465
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• 2012

In order to strengthen assurance of National Health Insurance, co-payment should be reduced. This can happen with collaborative efforts of patients, medical institutes, and government altogether at the same time. This research applied Dutton(1986)'s medical service research model with high R-square, and analyzed 2008 Korea Health Panel Data (Beta Version 1), that was examined by Korea Institute for Health and Social Affairs and National Health Insurance, in order to figure out influential variables on co-payment. In result of Multiple Linear Regression Analysis, R-square was 46.7%, the older the age, the patients who had surgery, the longer days of hospital treatment are, the higher gross income of a household is, the more hospitalized in upper grade general hospitals, and the more upper grade rooms and selecting a doctor are used. The results have statistical significance. When conducting research applying medical service research model, there is a need to apply Dutton(1986)'s medical service research model with high R-square. In order to strengthen assurance of National Health Insurance, first conditions should be that patients are hospitalized in upper grade general hospital, and at the same time, are patients who had surgery with long stay of hospitalization. In addition, if proven that patients used upper grade rooms and selecting a doctor due to lack of regular treatment and rooms, for certain number of days of such hospitalization, it is suggested to be provided with health care insurance in upper grade rooms and selecting a doctor in calculating co-payment limit.

• 대한한의학회지
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• 제43권4호
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• pp.145-158
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• 2022

Objectives: To identify changes in the subjects and methods of Herbal Medicine Consumption Survey, and analyze trend of the key results Methods: The population, methods, and items of the basic reports of all Surveys on Consumption of Herbal Medicine(HM) were organized in a time-series manner. The analysis items were trend in the purchase of standardized HM; consumption value share, and price of prepared HM; type of herbal dispensary; and awareness of HM policy in Koran Medicine(KM) institutions. Results: The price of HM preparations showed an upward trend in 2011, 2014, and 2017 surveys, and decreased in the 2020 survey. However, despite this recent decrease, the 2021 survey also saw the highest proportion of HM users reporting that price of herbal decoction is expensive. Furthermore, the demand for expanded coverage of herbal decoction was the greatest for the expansion of health insurance benefits. Efforts such as adjusting the number of covered diseases and the cost of health insurance coverage would be necessary. Regarding decoction dispensaries the proportion of HM hospitals using only extramural herbal dispensaries increased. Finally, the consumption of HM and the size of the HM industry has continued to expand due to the large-scale branding of KM institutions and the expansion of health insurance coverage. Conclusion: Future surveys must standardize and unify the items for the time-series continuity and compare the results with government statistics reports on HM to increase reliability. Moreover, specialized survey items may be developed for KM, to establish a better and efficient distribution system for domestic HMs.

• 한국병원경영학회지
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• 제17권3호
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• pp.23-36
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• 2012

Objectives : The coverage of Korean National Health Insurance is limited to basic level. Korean government encourages private health insurance for covering medical securities. So, many studies examined the determinants of purchasing private health insurance. However, 11% of Korean population is older than 65 in 2011. Considering the elderly is important to establish a health policy. The aim of this study is to examine factors determining the purchase of private health insurance among middle-aged and elderly Korean adults. Methods : We used the second Korean Longitudinal Study of Ageing (KLoSA), selected 8,688 sample of the aged 47 or older for the analysis. KLoSA collected information on demographic characteristics, income, health- related factors. KLoSA data include in the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Logistic regression was used to examine the relationship between the determinants of purchasing private health insurance and the factors which include age, gender, education, residential district, marital status, smoking, drinking, physical exercise, economic activity status, national health insurance type, income, the number of chronic disease, and the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Results : People who were older, did not live in a city, had higher IADL, currently drunk alcohol, did exercise regularly and had chronic diseases more than three were inclined not to purchase private health insurance. Females, the married, well-educated, past & currently smokers, the employed, high income earners, national health insurers, metropolitan citizens and someone who got high MMSE were more likely to purchase private health insurance. The more people experienced outpatients, inpatients, dental clinics and Chinese medicine clinics, the more private health insurance was purchased. The elderly people over 75 had more private health insurance than the aged 65-74. The strongest factors for private health insurance is gender, and economic status such as income. Conclusion : In this study, we found healthy-high income people were more likely to purchase private health insurance. In contrast, unhealthy-low income and older people did not. The economic factors were strongly related with private health insurance in aged over 75. These mean inequality exists in the using private health insurance. Therefore, the government should consider vulnerable social group before expanding private health insurance.

• Journal of Preventive Medicine and Public Health
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• 제54권1호
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• pp.17-21
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• 2021

In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.

• 대한치과의사협회지
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• 제54권6호
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• pp.448-456
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• 2016

Dental care is becoming more available on the NHI(National Health Insurance) in Korea. Especially, complete denture, partial denture, dental scaling, and dental implant has been applied by NHI from 2012 to 2014. Although, the entire nation is not eligible for the benefit now, the more dental coverage of NHI is extended, the more regulaition is tightened. Essential documents for proof of correctness of dental treatment covered by NHI are dental records and the receipt book. Summary of regal regulation about them is as follows 1. Chief complaints of patients, diagnosis, progress, and act of treatment, drugs and materials of treatment, doctor's sign, date and hour should be placed accurately on dental record 2. Dental clinic should collect patients sharing of the dental cost covered by NHI. 3. Dental clinic should keep the receipt as proof of purchase of dental drugs or materials.

• Journal of Preventive Medicine and Public Health
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• 제48권6호
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• pp.319-329
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• 2015

Objectives: Parental socioeconomic status (SES) exerts a substantial influence on children's health. The purpose of this study was to examine factors determining children's private health insurance (PHI) enrolment and children's healthcare utilization according to PHI coverage. Methods: Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084). Results: The factors determining children's PHI enrolment included children's age and sex and parents' educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly. Conclusions: Children's PHI enrolment was influenced by parents' SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

• 대한치과보철학회지
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• 제60권3호
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• pp.239-245
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• 2022

목적: 총의치를 장착한 환자에서 연령, 성별, 총의치를 장착한 악궁, 틀니 보험 적용 여부, 대합치의 종류, 의치 사용 경험, 무치악 기간, 의치상 종류 등에 따라 의치 장착 후 의치를 조정하는 횟수 및 기간에 차이가 있는지를 분석하고자 한다. 대상 및 방법: 5년 간 국민건강보험 일산병원 치과보철과에서 총의치 장착을 시행한 만 65세 이상 환자의 의무기록을 대상으로, 총의치 장착 후 사후 점검의 횟수 및 기간을 평가하였다. 성별, 보험 적용 여부, 총의치를 장착한 악궁, 의치상 종류, 대합치의 종류, 의치 사용 경험, 연령 및 발치 후 의치를 장착하기 전 치유기간에 따른 총의치의 사후 점검 횟수 및 기간의 상관 관계를 분석하기 위해서 5%의 유의수준에서 통계 분석을 시행하였다. 결과: 총 247개의 의치가 포함되었다. 평균 사후 점검 횟수의 중위수는 3회였으며, 사후 점검 기간의 중위수는 36일이었다. 의치를 하악에 장착한 경우가 상악에 장착한 경우보다 사후 점검 횟수가 통계적으로 유의하게 많은 것으로 나타났으며(P = .036) 대합치가 총의치인 경우가 국소의치인 경우에 비해 사후 점검 횟수가 많은 것으로 나타났다(P = .016). 연령, 성별, 보험 적용 여부, 의치 사용 경험, 무치악 기간, 의치상 종류에 따른 사후 점검 횟수는 유의미한 차이가 없었다. 결론: 이번 연구의 한계 내에서, 의치의 조정 횟수는 의치를 장착한 악궁이 하악일 때 및 대합치가 총의치인 경우에서 증가하였다.