• Title/Summary/Keyword: National Insurance

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Comparison of Severe Disease Incidence among Eligible Insureds to Expand Coverage for Substandard Risks (유병자 보험의 보장성 확대를 위한 유병자들의 중증질환 발생률 비교)

  • Baek, Hyeyoun;Son, Jihoon;Shin, Jimin
    • Journal of health informatics and statistics
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    • v.43 no.4
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    • pp.318-328
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    • 2018
  • Objectives: People are living longer, but often with diseases or chronic conditions. As a consequence, interest in resolving insurance blind spots is growing. This study provides substandard risk-relevant statistics to help substandard risks who are likely to fall in insurance blind spots obtain insurance coverage, such as the reimbursement of medical costs, as well as to stimulate insurance product development. Methods: This study uses National Health Insurance Service (NHIS) cohort data to determine the relevant statistics. The incidence rates of severe diseases are derived and compared against standard risks to establish a set of relative risk factors. These incidence rates of standard and substandard risks are then compared. Results: Currently, an individual's cancer history is used in the underwriting process for simplified issue insurance. However, underwriting focusing on hospitalization and procedures related to serious illnesses could lower premiums for substandard risks. Moreover, the statistical results could be used to expand the coverage of health insurance products. Conclusions: This study's relative risk factors can be used to derive simplified issue premium rates for substandard risks. They can also be used to implement discount and loading schemes for medical reimbursement insurance and help insurance companies implement proactive risk management.

Treatment of Peroneal Tendon Subluxation by Fibular Groove Deepening (비골건구를 깊게 하는 술식을 이용한 비골건 아탈구의 수술적 치료)

  • Yoo, Ju-Hyung;Lee, Yun-Tae;Ha, Joong-Won;Park, Yung;Shin, Young-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.184-187
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    • 2005
  • Purpose: To evaluate the efficiency of fibular groove deepening and superior retinacular reconstruction for peroneal tendon subluxation. Materials and Methods: Six patients who were treated by fibular groove deepening and superior retinacular reconstruction for peroneal tendon subluxation from March 2000 to August 2004 were reviewed retrospectively. Results: No recurrent subluxation of peroneal tendons had occurred. All patients were return to sports by 4 months after surgery and also gained nearly normal range of motion. Five patients were completely pain free, but one patient had mild occasional pain that limit his sports activities. Conclusion: Fibular groove deepening and superior retinacular reconstruction was believed to be a reliable procedure for peroneal tendon subluxation in spite of some minor complications.

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Two Cases of Ultrasound-Guided Angiocatheter Irrigation and Drainage of the Head and Neck Abscesses (초음파 유도하 Angiocatheter를 이용한 두경부 농양의 세척 및 배농 2예)

  • Roh, Kyung-Jin;Suh, Michelle J.;Park, Sang-Chul;Kim, Hong-Jun;Kim, Bo-Mi;Shin, Hyang-Ae
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.230-233
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    • 2011
  • Head and neck abscess usually requires hospitalization, intravenous antibiotic therapy, and surgical incision and drainage. Open surgical drainage may result in unsightly scars. We report two cases of a 56-year-old man with a facial abscess and a 47-year-old man with a parotid abscess. The patients were successfully treated with ultrasound-guided angiocatheter irrigation and drainage without scar. Ultrasound-guided angiocatheter irrigation and drainage can be a simple, safe and effective alternative procedure to open surgery in the management of the selected head and neck abscesses.

Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction

  • Im, Joon;Kang, Sang Hoon;Lee, Ji Yeon;Kim, Moon Key;Kim, Jung Hoon
    • The korean journal of orthodontics
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    • v.44 no.6
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    • pp.330-341
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    • 2014
  • A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

A Case of Nasopharyngeal Carcinoma with Metastatic Axillary Node after Concurrent Chemoradiotherapy (치료 후 액와 림프절의 전이를 보인 비인강암 1례)

  • Hong, Hyun-Jun;Lee, Won-Il;Park, Mi-Na;Chung, Eun-Ji;Kim, Yong-Tai;Choi, Eun-Chang
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.43-46
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    • 2009
  • Nasopharyngeal carcinomas are epithelial neoplasm derived from nasopharyngeal mucosa. Nasopharyngeal carcinoma involved cervical lymph nodes frequently. However, nasopharyngeal carcinoma with metastatic axillary node after concurrent chemoradiotherapy was reported rarely. We report the patients who was a 34-year-old man diagnosed as nasopharyngeal carcinoma. He was treated by concurrent chemo-radiotherapy. But axillary node metastasis was found after treatment in 2 years. After surgical resection of axillary lymph node, there is no evidence of disease.

LARGE COMPLEX ODONTOMA OF MAXILLARY SINUS: A CASE REPORT AND LITERATURE REVIEW (상악동에 발생한 큰 복잡성 치아종 : 증례보고 및 문헌 고찰)

  • Kim, Byung-Wook;Jung, Jae-Hyung;Kim, Moon-Key;Lee, Hyun-Jung;Kim, Jung-Ihn;Lee, Mi-Kyung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.179-182
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    • 2006
  • The term odontoma, first introduced by Broca, was originally applied to all odontogenic tumors. Related to the clinical and histological differences, 2 groups of odontoma were defined: compound odontoma and complex odontoma. Complex odontoma is more common in the mandible than in the maxilla, usually occuring in the mandibular premolar-molar area. And this consists of small mass of irregularly arranged enamel, dentine, cementum, and connective tissue, but tooth-like structures are not found. In our case, 34 year old man was diagnosed as the complex odontoma of maxillary sinus by the physical exam, Panex, and C.T scan. We sectioned and removed it, and then confirmed the diagnosis histopathologically. Its uncommon location and size made us report that case and review the literature concerned.

Estimating the Reimbursing Price Level of Oriental Medical Services in the National Health Insurance (한방의료서비스의 건강보험수가 산출방법과 추정)

  • Kim, Jin-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.3
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    • pp.21-34
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    • 2008
  • Objectives : This paper analysed the alternative methods of calculating conversion factor for oriental medicine in the National Health Insurance and estimated the conversion factor(reimbursing price level) of the oriental medical services, based on health insurance claims data and macro economic data. Methods : Comparing cost accounting method, SGR model, and index model to estimate conversion factor in the national health insurance, six empirical models were derived depending on the scope of revenue considered in financial indicators. Classifications of data and sources used in the analysis were identified as officially released by the government. Results and Conclusion : Cost accounting analysis and SGR model showed a two digit decrease in the physician fee schedule of oriental medical services in the national health insurance, while index model indicated a positive increase in the fee reimbursed. As expected, SGR model measured an overall trend of health expenditures rather than an individual financial status of medical institutions, and index model properly estimated the level of payments to oriental medical doctors. Upon a declining share of health expenditures on oriental medicine, a global budget system fixed to a flat rate of total budget could be an opportunity as well as a challenge.

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Interactions of Behavioral Changes in Smoking, High-risk Drinking, and Weight Gain in a Population of 7.2 Million in Korea

  • Kim, Yeon-Yong;Kang, Hee-Jin;Ha, Seongjun;Park, Jong Heon
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.4
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    • pp.234-241
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    • 2019
  • Objectives: To identify simultaneous behavioral changes in alcohol consumption, smoking, and weight using a fixed-effect model and to characterize their associations with disease status. Methods: This study included 7 000 529 individuals who participated in the national biennial health-screening program every 2 years from 2009 to 2016 and were aged 40 or more. We reconstructed the data into an individual-level panel dataset with 4 waves. We used a fixed-effect model for smoking, heavy alcohol drinking, and overweight. The independent variables were sex, age, lifestyle factors, insurance contribution, employment status, and disease status. Results: Becoming a high-risk drinker and losing weight were associated with initiation or resumption of smoking. Initiation or resumption of smoking and weight gain were associated with non-high-risk drinkers becoming high-risk drinkers. Smoking cessation and becoming a high-risk drinker were associated with normal-weight participants becoming overweight. Participants with newly acquired diabetes mellitus, ischemic heart disease, stroke, and cancer tended to stop smoking, discontinue high-risk drinking, and return to a normal weight. Conclusions: These results obtained using a large-scale population-based database documented interactions among lifestyle factors over time.

Chronic Multiple Gouty Arthritis Diagnosed during Anti-Tuberculosis Treatment of Recurrent Tuberculous Arthritis: A Case Report (재발성 결핵성 관절염의 항결핵제 치료 중 진단된 만성 다발성 통풍성 관절염: 증례 보고)

  • Oh, Hyun Cheol;Choi, Yoon Jung;Ha, Joong Won;Park, Sang Hoon;Kim, Sang Hee;Yoon, Han Kook
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.116-119
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    • 2018
  • Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.

Verrucous carcinoma arising from actinic keratosis: a case report

  • Jung, Ji Hyuk;Jeon, Yeo Reum;Kim, Hyo In;Lee, Mi Kyung;Chung, Seum
    • Archives of Craniofacial Surgery
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    • v.22 no.6
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    • pp.333-336
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    • 2021
  • Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma that commonly occurs in the oral cavity. However, VC of the facial skin is relatively rare. We report a case of a 91-year-old woman with VC of the facial skin in the left zygoma area. She was diagnosed with actinic keratosis (4×3 cm) of the same site approximately 12 years previously, but declined further treatment. The mass was excised with a minimum of 0.4 cm from gross margins with the result of free from tumor of all margins by frozen section, allowing for primary closure after skin undermining. Basal resection was performed in the preplatysmal plane. The diagnosis of VC was confirmed by histopathological examination. Postoperatively, the wound healed without incident and with no signs of facial nerve injury. To our knowledge, this is the first reported case of VC of facial skin arising from actinic keratosis.