• Title/Summary/Keyword: National health insurance service

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The Recognition of Groups between the Korean National Health Insurance and the Private Health Insurance (국민건강보험과 민영의료보험에 대한 집단 간의 인식도 분석)

  • Im, Bock-Hee;Lim, Jeong-Do
    • The Korean Journal of Health Service Management
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    • v.5 no.2
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    • pp.157-172
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    • 2011
  • The purpose of this study is to provide basic information for improving medical security between the Korean National Health Insurance Corporation and the private health insurance in Pusan Metropolitan area by investigating of the recognition with the benefit groups. Questionnaires of 431 were taken between Feb. 11th and Feb. 25th 2008. The survey was carried out to gather information about SES and contents of insurance and recognition between the benefit group of the Korean National Health Insurance and the private health insurance on the financial conditions and the stability. The result of survey is as follows. First, there is a difference between the National Health Insurance and the private health insurance on the financial conditions and the stability of the Korean National Health Insurance. Second, there is a high score at the private health insurance on the financial conditions and the stability of the private health insurance. Third, privatizing of a National Health Insurance is high score at increase of the premium, medical payments of the National Health Insurance group and is high score at enhance of quality of medical service and decrease of loss of medical payment of the private health insurance group. Therefore, to provides more information and improved medical security with the benefit group. it is necessary for concerns to put more efforts in creating Conflicting vs. Complementing of systemic base.

Factors Related to Family Caregivers' Burden with the Community-Dwelling Disabled Elderly under the Long-Term Care Insurance System (장기요양 재가서비스 이용자를 돌보는 가족주부양자의 부양부담감에 영향을 미치는 요인)

  • Han, Eun-Jeong;Lee, Jung-Myun;Kwon, Jin-Hee;Shin, Seul-Bi;Lee, Jung-Suk
    • Health Policy and Management
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    • v.24 no.1
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    • pp.71-84
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    • 2014
  • Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.

An Analysis of the Trends of Korean National Health Insurance Administrative Cost (건강보험 관리운영비 추이 분석)

  • Park, Chong Yon;Suh, Nam Kyu;Um, Eui Hyeon
    • Health Policy and Management
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    • v.15 no.3
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    • pp.17-39
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    • 2005
  • Social solidarity, equity in financing, and efficiency in administration have been core issues in the development of Korean health insurance reformation since 1988. This study is to investigate the trend of administrative cost in Korean National Health Insurance from various aspects. For the analysis of administrative cost, the expenditures of each insurance society and the National Health Insurance Corporation are divided into 4 items of (1) insurance benefit, (2) administrative cost, (3) an agency provision accounts, (4) other expenses, and then they are reorganized. The analyses based on 5 types of the health insurance administrative cost showed that efficiency in administration has been improved generally. We, however, should consider qualitative aspects such as customer's satisfaction with health insurance administration, prompt service, control of unjust expenditure (unjust claims), and provision of medical service including health consultation in assessing efficiency of administration. And, in order to connect the administrative costs of health insurance with efficiency, we need to give a fundamentally new definition, which can contain elaborateness of expenditure in details including the structure and evaluation method of administrative costs. It may be necessary to develop new indicators or analyzing methods hereafter.

Evaluation of national health insurance coverage of periodontal scaling: A nationwide cohort study in Korea (국민건강보험공단 표본코호트 DB를 이용한 스케일링 보험급여화 전후 실태조사)

  • Kim, Young-Taek;Lee, Jae-Hong;Kweon, Helen Hye-In;Lee, Jung-Seok;Choi, Jung-Kyu;Kim, Dong-Wook;Choi, Seong-Ho
    • The Journal of the Korean dental association
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    • v.54 no.8
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    • pp.604-612
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    • 2016
  • The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.

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Differences in Family Caregivers' Opinions about Out-of-Pocket Payment for Long-Term Care Facilities by Income Levels (장기요양 시설서비스 이용자의 소득수준별 본인부담금에 대한 인식 차이)

  • Kwon, Jinhee;Moon, Yongpil;Lee, Jung-Suk;Han, Eun-Jeong
    • Health Policy and Management
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    • v.27 no.2
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    • pp.139-148
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    • 2017
  • Background: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. Methods: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. Results: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. Conclusion: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.

The Development and Application of Core Fundamental Nursing Skills Improvement Education Program for New Nurses in Comprehensive Nursing Care Ward (간호·간병통합서비스 병동 신규간호사 대상 핵심기본간호술기향상 교육프로그램 개발 및 적용)

  • Choi, Eun Young;An, Kum Hee;Oh, In Ohg;Park, Ai Hee;Park, Min Hyun;Son, Jae Lee;Hong, Na Suk;Yoon, Ho Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.23 no.4
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    • pp.419-429
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    • 2017
  • Purpose: The purpose of this study was to investigate the effect of the development and application of the new nurses' core skill program on the clinical skill, confidence, knowledge and performance of new nurses. Methods: This study was a nonequivalent control group post-test design on 46 new nurses with 3 to 6 months work experience in a general hospital. Data were collected from August 2015 to August 2016. A training program of core fundamental nursing skills was applied on 23 new nurses from 2016 in the experiment group, and an existing training method was applied on 23 new nurses from 2015 in the comparison group. The collected data were analyzed using SPSS/WIN 23.0. Results: The experimental group ($89{\pm}4.29$) showed higher score in practical skill assessment compared to the control group ($85.09{\pm}3.99$) and showed a statistically significant difference (p<001). Conclusion: A training program of core fundamental nursing skills for new nurses proved effective in improving practical skills. Further research on the development of a systemic training program that can improve clinical nursing knowledge and work ability for new nurses according to the extended enforcement of a Nursing Care Integrated Service ward is needed.

Recognition and satisfaction of dental care customers after 1 year national health insurance coverage of dental scaling (스케일링 건강보험 급여화 시행 1년 후 치과의료소비자의 인식도 및 만족도 조사)

  • Lee, Bo-Geun;Lee, Jung-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.185-193
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    • 2016
  • Objectives: The purpose of the study was to examine the recognition and satisfaction of dental care customers after 1 year national health insurance coverage of dental scaling. Methods: A self-reported questionnaire was completed by 477 dental care customers in Gyeongbuk, Busan, Yangsan, and Gyeonggido from July 18 to September 30, 2014 after receiving informed consents. The questionnaire consisted of general characteristics of the subjects(5 items), subjective awareness of oral health(4 items), recognition of scaling(5 items), and recognition and satisfaction of scaling health insurance(5 items). Data were analyzed using SPSS version 20.0 program. Results: Those who recognized the national health insurance coverage of dental scaling accounted for 80.1 percent and 47.2 percent of them got the health insurance coverage via media advertisements. Those who received the scaling service by health insurance coverage accounted for 73.8% and 66.2% of them were very satisfied with the service. Among the customers, 91.8% were satisfied with scaling health allotment. There was a statistical significance between scaling health insurance and subjective oral condition recognition(p<0.01). Through the health insurance coverage scaling service, the oral health in Korea will improve much. Conclusions: The expansion of health insurance coverage of scaling service will provide the universal oral health care for all people. Owing to low cost service, people will actively try to come in contact with public health service in the future.

Current Status of Outsourced Food Service Operations According to the Type of Long-Term Care Institution and Plans for Improvement (장기요양기관 유형별 위탁급식 운영 실태 및 개선 방안)

  • Kwon, Jinhee;Lee, Heeseung;Jeong, Hyeonjin;Chang, Hyeja;Lee, Jungsuk
    • Journal of the Korean Dietetic Association
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    • v.28 no.2
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    • pp.67-84
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    • 2022
  • This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units. The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.

A study on the amendments of long-term care-related legislations for the introduction of part-time facility dentists (노인장기요양시설 치과촉탁의제 도입을 위한 제도 개선 방향)

  • So, Jong-Seob
    • The Journal of the Korean dental association
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    • v.53 no.10
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    • pp.696-704
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    • 2015
  • The coverage of the National Health Insurance for the elderly is expanding to denture and implants. Although the National Long-Term Care Insurance was just being settled, Oral health service was not provided to the Elderly in Long-Term Care Facilities. The long-term care facilities had part-time facility doctors. However, there is no dentist in the long-term care facility because of lack of long-term care insurance-related legislations. The amendments of long-term care insurance-related legislations for the introduction of part-time facility dentists are needed because the elderly in long-term care facility are vulnerable to oral health. For the substantial management of the National Long-Term Care Insurance, the development of oral health service model for the elderly and education materials for the dental team will be needed. Also, adequate dental service fee of the National longterm care insurance will be needed.

The Effect of Converting Health Insurance Qualification on Medical Use (건강보험가입자의 의료급여 자격변동에 따른 의료이용행태 변화 연구)

  • Na, Young-Kyoon;Cha, Yerin;Kim, Nayoung;Lee, Youngjae;Lee, Yong-Gab;Lim, Seungji
    • Health Policy and Management
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    • v.30 no.4
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    • pp.460-466
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    • 2020
  • Background: The purpose of this study is to analyze whether there is a change in patterns of medical use among those likely to be converted their health insurance qualifications when the family support rule is alleviated. There is no empirical analysis that converting health insurance qualification will affect the increase in medical use. Methods: For analysis, data were extracted from the national health insurance eligibility and medical care database. To identify analysis targets similar to that of medical aids' characteristics among health insurance coverage, we compared income, property level, and medical use patterns through basic statistical analysis and used a difference-in-difference (DID) analysis to estimate the net effect of changes in medical use following the change of qualifications. Results: The main results are as follows. The results show that those who are under the 5% income group (1st income group) of health insurance coverage are the most similar to the medical aids group. DID analysis shows that changes in the medical use of people who maintain their national insurance qualification and who are not. As a results, the number of hospitalized days of converting group was reduced by 3.5 days while outpatient days were increased by 1.8 days. Conclusion: As a result, there was not much difference in the patterns of medical use for the under 5% income group who are likely to be eligible for expanded medical aids when the family support rule is alleviated. In addition, more than 30% of them are in arrears with their health insurance premiums, causing inconvenience in using medical services. These findings suggest the need of abolishing the criteria obligated to support family, and great efforts should be made to contribute to non-paid poor and remove their medical blind spot.