• Health Policy and Management
• /
• v.33 no.3
• /
• pp.295-310
• /
• 2023

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.2
• /
• pp.247-260
• /
• 2018

This study examined the mental health status (depression, cognitive impairment and dementia) and its association with the related factors in the elderly people who were admitted from long-term care insurance. The study subjects were 1,488 people (male 740, female 748) aged over 70 years of age who had been recognized for long-term care insurance services in the years 2011~2014 from the National Health Insurance Corporation. The data collected from the National Health Insurance Corporation set forth a lifestyle questionnaire, itemized health screening tests, and long-term care as recognition data for research purposes. As a result, depression, cognitive impairment, and dementia of subjects increased significantly with age. As a multiple logistic regression result, the risk ratios of depression, cognitive impairment, and dementia, which indicated the mental health status, were significantly higher in women than in men, in the lower body weight group than in the overweight group, in the smoking group than in the non-smoking group, and in the drinking group than in the non-drinking group. These results suggest that the mental health status (depression, cognitive impairment, and dementia) of subjects decreased with increasing age, particularly the group with poor health related behaviors, such as smoking, drinking, and regular exercise, indicating that the mental health condition is lower than in the good group.

• Journal of Oral Medicine and Pain
• /
• v.30 no.2
• /
• pp.215-230
• /
• 2005

The study was intended to investigate how dentists in private dental clinic thought on the present claim and review of dental insurance to reflect it in future establishing dental insurance policies. 1,465 dentists who were running own dental clinic in Pusan Metropolitan City and the south part of Kyungsang province were surveyed in February, 2004. A total of 406 copies of finished questionnaire were finally retrieved and analyzed. The findings are as follows. 1. About insurance claim affairs : Most of the subject of insurance claim was by dentist himself or dental hygienist(nurse). Agency claiming was carried under 20% of total insurance claim. 2. The degree of attendance on insurance lecture : The degree of attendance on insurance lecture was relatively low. 3. Filing a protest against insurance claim : Filing a protest against insurance claim was reavealed about half-and-half for "have been" or "have not been". 4. Private clinic dentist,s opinion about the regulations affecting review of dental insurance : Private clinic dentists opinion about current guide for insurance review of dental fee was“the guidance is difficult and unfair cutback of claim fee may be carried”. 5. The affairs about health insurance review agency : About 70% of private clinic dentists have dissatisfaction on health insurance review agency. 6. Standpoint of private clinic dentists about issuance of receipt for dental fee : About 70% of private clinic dentist have an difficulty in issuance of receipt for dental fee. 7. The affairs about change insurance noncoverage treatment to insurance coverage treatment : Most of private clinic dentists hoped that insurance coverage about full mouth scaling, pit and fissure sealant, fluoride application. But they do not hoped that insurance coverage about geriatric denture, prothodontic treatment except precious metal, photopolymerization resin treatment.

• Korean Journal of Social Welfare Studies
• /
• no.36
• /
• pp.29-53
• /
• 2008

Being the most populated country in the world, China's one-child policy is its basic national policy. This basic national policy is implemented together with the Maternity Insurance, which is one of the five main social insurances in the Chinese society. The Maternity Insurance is society's way of recognizing women's contribution towards child- bearing and is of utmost important significance. However, with regard to women who are not living within the city or are not working, not only are they not the target for one-child policy, they are also unable to receive the social benefit from the Maternity Insurance. Among the conditions for payment of the Maternity Insurance is the adherence to the one-child policy. Ultimately, working women living in towns and cities adhering to the one-child policy will have a positive influence on the Maternity Insurance. However this places a restriction on reducing the discrepancies to benefit from the Maternity Insurance. On the contrary, women from the villages and those moving between towns and cities are those who really need the Maternity Insurance and yet are unable to benefit from it. While we improve on the Maternity Insurance to include this group of women, we have to at the same time consider the effect it has on the one-child policy. The reformation of the Maternity Insurance has to embody the principle of a harmonious society. It has to have a certain order in the country's national policies, so as to be included in the economic policies of towns and villages.

• Journal of Fisheries and Marine Sciences Education
• /
• v.5 no.2
• /
• pp.98-109
• /
• 1993

By the Article 28 of the Korean Fishing Vessels Act and the Article 47-1 of the Enforcement Ordinance of the Act, fishing vessels over 5 gross tone must be insured the fishing vessels mutual insurance or marine insurance. Therefore the distant-water fishing vessels and vessels registered with Classification Society can be insured to the marine insurance, and non-registered vessels and the small fishing vessels can be insured to the fishing vessels mutual insurance of Fisheries Co-operatives. Moreover, the shipowners of fishing vessels over 5 gross tons to be insured a liability insurance for their crew, and it is to compensate effectively the crewman's accidents prescribed in the Seaman's Act. The shipowner's Liability Insurance to be insured the seaman's Compensation Insurance or the seaman's mutual insurance of the Fisheries Co-operatives and the Protection and Indemnity but they still involve lots of problems to cover the crewman's accidents reasonably. The author's views on the improvement way of the fisheries mutual insurance system are as follows. 1. The size of fishing vessels over 5 gross tons prescribed by the Article 28 of the Fishing Vessels Act must be revised into over 1 gross tons. And the regulations concerning penalties against nonfulfilment of the regulation must be strengthened in order to have legal effectiveness. 2. The level of the government subsidy for the fisheries mutual insurance must be raised up from the large point of view for protection of fishermen. It is concluded that the Government have to take charge of the remutual insurance in order to develop the fisheries mutual insurance system. 3. The mutual insurance system of fish catch have to be executed in order to guarantee the stable income for fishermen on the base of the amount of money by fish catch in the previous year.

• Tuberculosis and Respiratory Diseases
• /
• v.64 no.1
• /
• pp.33-38
• /
• 2008

Alcaligenes xylosoxidans is a catalase and oxidase positive, motile, nonfermentative and gram-negative rod bacterium. A. xylosoxidans infection is a rare cause of pulmonary infection and little information concerning treatment is available. The majority of patients that develop A. xylosoxidans infection belong to a high-risk group due to an immunocompromised condition or due to pulmonary cystic fibrosis. We report two rare cases of immunocompentent patients that developed a pulmonary infection due to A. xylosoxidans. A 77-year-old man was admitted with a lung abscess. The patient denied having any prior medical illness. A culture of bronchial washing fluid showed the presence of A. xylosoxidans. Despite appropriate antibiotic treatment, the patient died from acute respiratory distress syndrome (ARDS). Another patient, a 61-year-old man without an underlying disease, was admitted with empyema. Under the condition of a closed thoracostomy, a high fever persisted and the empyema was also aggravated. A. xylosoxidans was detected from a culture of pleural fluid. Susceptible antibiotic treatment was provided and surgical intervention was performed. We report these cases with a review of the literature.

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.3
• /
• pp.193-200
• /
• 2020

Purpose: To investigate the relationship between dementia and complete tooth loss on both sides or one side using large demographic data. Materials and methods: A retrospective cohort study was designed using the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD) which was established for people over the age of 60. The experimental group was the complete edentulous cohort, which had a history of treatment for national health insurance covered complete denture on both sides or one side from July 1, 2012 to December 31, 2013. And the control group was the dentulous cohort, which had a history of conservative dental treatment for the same period. All subjects had no history of diagnosis or treatment of dementia during this time. These cohorts were matched 1:1 by age, gender, and place of residence according to the propensity score matching method. Then the incidence of dementia was compared between these cohorts. Results: Compared with those groups, the incidence of dementia was significantly higher in the experimental group (12.13%) than in the control group (9.74%) (P<.05). No clear association between other factors has been identified. Conclusion: The analysis of large-scale demographic data shows that the incidence of dementia is high in complete edentulous patients on both sides or one side.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.8
• /
• pp.3767-3772
• /
• 2012

Objective: We estimated the total medical costs incurred during the 5 years following a cancer diagnosis and annual medical use status for the six most prevalent cancers in Korea. Methods: From January 1 to December 31, 2006, new patients registered with the six most prevalent cancers (stomach, liver, lung, breast, colon, and thyroid) were randomly selected from the Korea Central Cancer Registry, with 30% of patients being drawn from each cancer group. For the selected patients, cost data were generated using National Health Insurance claims data from the time of cancer diagnosis in 2006 to December 31, 2010. The total number of patients selected was 28,509. Five-year total medical costs by tumor site and Surveillance, Epidemiology, and End Results (SEER) stage at the time of diagnosis, and annual total medical costs from diagnosis, were estimated. All costs were calculated as per-patient net costs. Results: Mean 5-year net costs per patient varied widely, from $5,647 for thyroid cancer to $20,217 for lung cancer. Advanced stage at diagnosis was associated with a 1.8-2.5-fold higher total cost, and the total medical cost was highest during the first year following diagnosis and decreased by the third or fourth year. Conclusions: The costs of cancer care were substantial and varied by tumor site, annual phase, and stage at diagnosis. This indicates the need for increased prevention, earlier diagnosis, and new therapies that may assist in reducing medical costs.

• The Journal of Korean Medicine
• /
• v.26 no.2 s.62
• /
• pp.105-125
• /
• 2005

Objectives: The purpose of this study was to identify resources put into clinical. activities and identify a new RBRVS for oriental medical services in the Korean National Health Insurance. Methods: Based on a survey of physician's time, physical effort & technical skill, mental effort & judgment, and stress that were used for patient treatments, relative input values for the relevant clinical activities were estimated and rearranged in a way to be compared. with the current values in health insurance. Results: We found the actual resource-based relative values for oriental medical services statistically different from the current values, with a narrower variation in value distribution. Conclusions: The findings suggest the C\lrrent RBRVS should be revised to reflect the actual input resources into physicians activities and to avoid a distortion of physicians behavior.

• The Journal of the Korean dental association
• /
• v.57 no.9
• /
• pp.496-503
• /
• 2019

A dental implant has been covered by National Health Insurance (NHI) in Korea since 2014. Every year the age group covered was extended and the out-of-pocket payment was decreased. This study analyzed the dental implant utilization rate by the National Health Insurance customized DB during the last 5 years. As a result, the utilization rate has been rapidly increasing steeply. The differences by age and sex in the utilization rate of dental implants were explored. The inclusion of a dental implant in the NHI system contributed to improving the dental accessibility of the elderly in Korea. However, a deep discussion is needed whether it is appropriately provided to necessary patients. The utilization rate will increase further in the future. Therefore, continuous monitoring and critical policy review should be continued.