• Title/Summary/Keyword: National Insurance

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Measuring the resource-based relative value scale scores for physical therapies of traditional Korean medicine and estimating the insurer's expenditure in National Health Insurance (한방물리요법 상대가치 산출과 급여 확대 시 재정부담 추계)

  • Lim, Byung-Mook;Shin, Mi-Sook;Shin, Byung-Cheul;Song, Yoon-Kyung;Song, Mi-Yeon;Shin, Seung-Woo;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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    • pp.57-66
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    • 2010
  • Backgrounds : Since December 1, 2009, National Health Insurance began to reimburse for three physical therapies of Korean medicine. The extension of insurance coverage is demanded by Korean medicine societies. Objectives : This study aimed to measure the resource-based relative value scale (RBRVS) scores for thirty four physical therapies of Korean medicine and to estimate the insurer's expenditure for them in National Health Insurance. Methods : To measure the physician's work and the practice expense, the 'magnitude estimation method (MEM)' and the 'fully distributed cost - attributable cost method (FDC-ACM)' were applied respectively. We collected the frequency data of physical therapies from Korean medicine hospitals and clinics to estimate the total expenditure. Results : The resource-based relative value scale scores of physical therapies were measured from 23.44 to 160.66. Total insurer's expenditure was calculated to be 95.5 billion won as of 2009. Conclusions : Based on the result that showed minor increase of total expenditure, most physical therapies of Korean medicine need to be reimbursed in the National Health Insurance.

The Utilization of Physical Therapies in the Korean Medicine Clinics : A Survey for National Health Insurance Planning (한의원의 한방물리요법 이용 현황과 건강보험 급여화에 대한 인식)

  • Shin, Mi-Sook;Shin, Byung-Cheul;Lee, Myeong-Jong;Kim, Ho-Jun;Song, Yoon-Kyung;Song, Mi-Yeon;Shin, Seung-Woo;Lim, Byungmook
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.3
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    • pp.101-109
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    • 2009
  • Objectives : This study aimed to investigate the present status of physical therapies provided in the Korean medicine clinics, and to find out the priorities among and the estimated fees of physical therapies for the National Health Insurance plan. Methods : We administered nationwide survey to Korean medicine doctors using the on-line survey system. 16 physical therapies were listed in the Web-based questionnaires, and responders were asked to mark the therapies they used for their patients, and, for each therapy they marked, to fill in the form including the frequencies of service, service fees, target diseases, and priorities for health insurance coverage, etc. Results : Of 488 respondents, 93.7% provide more than one physical therapy for their patients, and each responder uses 5.9 physical therapies on average. 60-90% of physical therapies are being given to patients for free because they are not covered by the National Health Insurance. There is little evidence that the specialties of Korean medicine doctors are related with the use of physical therapies, but, in some therapies, the doctors with longer career years use the physical therapy more frequently. Most physical therapies are applied to the patients with musculoskeletal diseases, cardiovascular diseases, and nervous diseases, etc. Conclusions : Physical therapies are widely used among Korean medicine doctors without proper compensation. This could be the one of the main factors distorting the profit structure of Korean medicine clinics, and it encourages the National Health Insurance to cover physical therapies provided in the Korean medicine clinics.

Analysis of changes and trends in the use of sedatives in dental sedation using data from the National Health Insurance in Korea

  • Kim, Hyuk;Ryoo, Seung-Hwa;Karm, Myong-Hwan;Seo, Kwang-Suk;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.49-60
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    • 2022
  • Background: Although dental sedation helps control anxiety and pain, side effects and serious complications related to sedation are gradually increasing. Due to the introduction of new drugs and sedation methods, insurance rates, legal regulations, drugs, and methods used for dental sedation are inevitably changed. In the Republic of Korea, National Health Insurance is applied to all citizens, and this study investigated changes in the use of sedatives using this big data. Methods: This study used customized health information data provided by the Healthcare Insurance Review & Assessment Service of Korea. Among patients with a record of use of at least one of eight types of sedatives for dental sedation between January 2007 and September 2019 were selected; the data of their overall insurance claims for dental treatment were then analyzed. Results: The number of patients who received dental sedation was 786,003, and the number of dental sedation cases was 1,649,688. Inhalational sedation using nitrous oxide (N2O) accounted for 86.8% of all sedatives that could be claimed for drugs and treatment. In particular, it was confirmed that the number of requests for sedation using N2O sharply increased each year. Midazolam showed an increasing trend, and in the case of chloral hydrate, it gradually decreased. Conclusion: According to our analysis, the use of N2O and midazolam gradually increased, while the use of chloral hydrate gradually decreased.

Analysis of Source of Increase in Medical Expenditure for Medical Insurance Demonstration Area before(1982-1987) and after(1988-1990) National Health Insurance (의료보험 시범지역의 전국민 의료보험실시전후의 진료비증가 기여도 분석)

  • Cha, Byeong-Jun;Park, Jae-Yong;Kam, Sin
    • Health Policy and Management
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    • v.2 no.2
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    • pp.221-237
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    • 1992
  • The reasons for cost inflation in medical insurance expenditure are classified into demand pull inflation and cost push inflation. The former includes increase in the number of beneficiaries and utilization rate, while the latter includes increase in medical insurance fee and the charges per case. This study was conducted to analyze sources of increases of expenditure in medical insurance demonstration area by the period of 1982-1987 which was earlier than national health insurance and the period of national health insurance(1988-1990). The major findings were as follows: Medical expenditure in these areas increased by 9.4%(15.1%) annually between 1982 and 1990 on the basis of costant price(current price) and for this period, the yearly average increasing rate of expenses for outpatient care[10.5%(15.8%)] was higher than that of inpatient care [7.3%(12.6%)]. Medical expenditure increased by 6.3%(8.9%) annually between 1982 and 1987, the period of medical insurance demonstration, while it increased by 10.7%(18.9%) after implementing national health insurance(1988-1990). Medical expenditure increased by 35.9%(45.9%) between 1982 and 1987. Of this increase, 115.2%(92.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 61.0%(68.1%) was due to the increase in the charges per case, but the expenditure decreased by 76.2%(60.2%) due to the reduction in the number of beneficiaries. Beteen 1988 and 1990, the period of national health insurance, medical expenditure increased by 21.2%(41.4%). Of this increase, 87.5%(46.4%) was attributable to the increase in the frequencies of utilization per beneficiary and 52.4%(73.4%) was due to the increase in the charges per case, and of the increase in the charges per case, 69.6%(40.8%) was attributable to the increase in the days of visit per case. Medical expenses per person in these areas increased by 78.2%(89.0%) between 1982 and 1987. Of this increase, 76.6%(69.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 23.4%(30.9%) was due to the increase in the charges per case. For this period, demand-pull factor was the major cause of the increase in medical expenses and the expenses per treatment day was the major attributable factor in cost-push inflation. Betwee 1988 and 1990, medical expenditure per person increased by 31.2%(53.1%). Of this increase, 60.8%(37.2%) was attributable to the demand-pull factor and 39.2%(62.8%) was due to the increase in the charges per case which was one of cost-push factors. In current price, the attributalbe rate of the charges per case which was one of cost-push factors was higher than that of utilization rate in the period of national health insurance as compared to the period of medical insurance demonstration. In consideration of above findings, demand-pull factor led the increase in medical expenditure between 1982 and 1987, the period of medical insurance medel trial, but after implementing national health insurance, the attributable rate of cost-push factor was increasing gradually. Thus we may conclude that for medical cost containment, it is requested to examine the new reimbursement method to control cost-push factor and service-intensity factor.

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Anterior tympanic plate fracture following extraction of the lower molar

  • Kim, Yeon-Ho;Kim, Moon-Key;Kang, Sang-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.51-54
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    • 2016
  • The present case report describes an external auditory canal injury following extraction of the lower molar. The external auditory canal was torn in the same fashion that occurs in an anterior tympanic plate fracture. This case demonstrates one of the rare complications associated with dental extractions.

Survey on National Health Insurance Coverage for Herbal Decoctions (비급여 한약의 보험급여에 대한 한의사의 인식도 조사)

  • Lee, Eun-Kyoung;Chong, Myong-Soo;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.13 no.3
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    • pp.113-126
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    • 2009
  • Objective : This research aimed to investigate and analyze the opinions of Oriental Medical Doctors (O.M.D.) on covering herbal medicines into National Health Insurance scheme. Methods : Structured questionnaires were e-mailed to the O.M.D.s listed on member's DB of the Association of Korean Oriental Medicine. Collected data were analyzed with the SPSS 12.0 program. Results : The insurance coverage for herbal decoctions was supported by 80.8% of the responders, the median reasonable price for daily herbal decoctions was \9,517, the minimum price median of daily herbal decoctions considering its costs was \8,080, and the daily technical fee median was \4,379. On health insurance coverage for herbal decoctions, O.M.D.s were specially considering the standardization of herbal medicines. Conclusion : In this study, majority of O.M.D.s assented to health insurance coverage for herbal decoctions, but considered standardization of herbal medicines and optional prescription fee. It needs to prepare plan for insurance coverage of herbal decoctions that reflect the character of oriental medicine and oriental medical institutions.

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An Investigation of the Efficiency of Insurance Companies in Vietnam - Using Data Envelopment Analysis and Malmquist Index

  • NGUYEN, Bao Ngoc;NGUYEN, Phuong Anh
    • The Journal of Asian Finance, Economics and Business
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    • v.9 no.7
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    • pp.261-271
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    • 2022
  • Over the last 20 years, the insurance industry in Vietnam has been rapidly growing with an average annual growth rate of 21%, one of the most active markets in Southeast Asia, raising the question of efficiency to managers, investors, and regulators. This article is one of the first research works using Data Envelopment Analysis combined with the Malmquist index over the period from 2016 to 2020 for 37 insurance firms in Vietnam to investigate the efficiency of this sector. The value-added approach is employed with total equity and operating expenses as inputs, finance income, and gross written premium as outputs. The findings reveal that most of Vietnam's insurance companies are operating quite effectively, and the non-life sector is more efficient than the life sector. There is also a regression in efficiency change, while there is a progression in technological change and total factor productivity change during the period examined. The goal of this research is to give a fundamental understanding of the overall efficiency of insurance firms in Vietnam, and help managers, investors, policyholders, and government agencies make better decisions regarding self-assessment, M&A activities, deregulation... Consequently, the insurance sector could improve in terms of efficiency and develop sustainably over time.

Factors influencing awareness of dental health insurance among adults (성인의 치과건강보험 인식과 영향 요인 연구)

  • Lee, Kyeong-Hee;Lee, Sae-Bom;Jung, Eun-Young;Jo, Eun-Byeol;Jung, Eun-Seo
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.5
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    • pp.771-783
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    • 2018
  • Objectives: This study aimed to identify methods that help medical consumers to be aware of relevant information regarding changes in dental health insurance policy. Methods: The following results were obtained from a survey regarding awareness and satisfaction with dental health insurance policy among the general public aged 20 years or older in Seoul, Gyeonggi Province, and other areas from August 1, 2017 to August 23, 2017. Results: The correlation between adults' awareness of and satisfaction with dental health insurance was 0.471, where satisfaction with dental health insurance was enhanced with increasing awareness of dental health insurance (p<0.001). Factors that significantly affected awareness of dental health insurance were marriage (married p<0.05), medical service (dental university hospital, p<0.01), and satisfaction with dental health insurance (p<0.001); these factors explained 29.2% of the variance. Factors that significantly affected satisfaction with dental health insurance were final education (high school graduation, p<0.05), medical service (dental hospital, p<0.05), and awareness of dental health insurance (p<0.001); these factors explained 27.8% of the variance. Conclusions: Importantly, awareness of the government's operation of dental health insurance and the benefits of such dental health insurance were low, suggesting that the government and national health insurance agency should improve the level of transparency in dental health insurance operations and continuously promote dental health insurance benefits to the public.

A Case of Schwannoma Originated from Hypoglossal Nerve (설하신경 기원의 신경초종 1례)

  • Yang Hae-Dong;Kang Ju-Wan;Kim Seong-Soo;Jin Yoon-Mi
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.207-210
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    • 2002
  • Schwannoma is a relatively rare benign tumor which may occur from nerve sheath of the peripheral, sympathetic and cranial nerves and so on except optic and olfactory nerves which have no nerve sheath themselves. Although it occur most frequently in the head and neck region especially in the acoustic nerve, the schwannoma originated from the motor nerves including hypoglossal nerve is very rare. Recently, we have experienced a case of schwannoma originated from hypoglossal nerve in a 47-year-old female. We report this case with literature review.