• 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.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.56-62
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• 2017

Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.37-82
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• 2009

Korea has gained the much more performances in the fields of pubic health laws and related policies on the basis of the substantial economic achievements. In 1977, the social medical insurance was established for companies with more than 500 employees, and in 1989, Korea successfully achieved the national medical insurance system covering the total population within only 12 years beginning with multiple insurers. There remained some problems, however, to be improved such as both the low level of contribution rates and benefit packages due to the inefficiency in utilizing limited medical resources. In 2000, all insurers were unified into a single insurer (National Health Insurance Corporation), and special independent Health Insurance Review & Assessment Service (HIRA) was also established. From the origin of medical insurance system in 1977, the Korean reimbursement system has been fee-for-service system, and after the establishment of HIRA, it has been providing objective and expert medical cost review services and health quality assessment services.

• Journal of Periodontal and Implant Science
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• v.49 no.4
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• pp.248-257
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• 2019

Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

• Health Policy and Management
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• v.33 no.3
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• pp.295-310
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• 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 Environmental Health Sciences
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• v.40 no.2
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• pp.88-97
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• 2014

Objectives: The aim of this study was to evaluate the occurrence of microbiological contamination of kitchen utensils and environments of food service operations at university located in Seoul, Korea. Methods: We collected swab samples from the surfaces of knives, chopping boards, floors, and drains, as well as drinking water and airborne bacteria samples from 20 food service operations. Three bacterial indicators and five food poisoning bacteria were measured quantitatively and qualitatively, respectively. We used selective culture media and the PCR assay targeting 16S rRNA gene for the microbiological analysis. Results: We detected bacterial indicators on knives or chopping boards in eight different food service operations and, three food service operations (I, M, and O) showed more than 3 log colony forming units $(CFU)/100cm^2$ on their knives, significantly higher than the others. The levels of bacterial indicators on the floors and drains in the cooking areas were much higher than those on the cooking utensils. S. aureus was detected on 10 floors and 8 drains. Culturable bacteria were identified in 5 drinking water samples, and food service operation B ($431.1CFU/m^3$) and C ($551.2CFU/m^3$) showed more than $400CFU/m^3$ of total airborne bacteria. Conclusions: These results suggest that some of food service operations in this study may require additional investigation to secure the microbial safety of cooking environments. In addition, further actions including hygiene education for employees and proper guidelines to maintain clean cooking environments should be prepared.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.4
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• pp.362-372
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• 2014

Purpose: The purpose of this research was to develop and test the validity and reliability of the Service Orientation Scale for Health Care Organization. Methods: The Service Orientation Scale for Health Care Organization, $SERV^*OR$, was developed through forward-backward translation methods. Internal consistency and reliability, construct and criterion validity were calculated using SPSS Statistics WIN 17.0. Survey data were collected from 283 clinical nurses in a general hospital in J province. Results: The Service Orientation Scale for Health Care Organization showed reliable internal consistency with Cronbach's ${\alpha}$'s for the total scale ranging from .85~.91. Factor loading of the 30 items on four sub-scales ranged from .67~.83. The sub scales were named service leadership, service system, customer focus, and service control. Item convergent and discriminant validity were also established for the Service Orientation Scale for Health Care Organization. Criterion validity showed a significant correlation with customer orientation. Conclusion: The findings of the study demonstrate that the Service Orientation Scale for Health Care Organization has satisfactory construct and criterion validity, and reliability and can be used to measure service orientation.

• Safety and Health at Work
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• v.12 no.3
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• pp.304-310
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• 2021

Background: Healthcare settings have been recognized among the most hazardous places to work. Based on the five categories of occupational hazards that were identified by the ILO and WHO, this study aimed to analyze policy framework relevant to occupational health protection of health workers (HWs) in public health service in China, then discussed how to share the experience of the National Health Service (NHS) England for improvement. Methods: Based on policy learning theories, policy analysis and qualitative interview were used in this study. Results: In the Chinese public health service, at least five laws related to the regulation of occupational health protection for HWs; however, enforcement of relevant laws was separated and multi-centered; the national monitoring system, which targeted to occupational hazards and health outcome for HWs in China, had yet to be developed; the top three priorities were workplace violence, bloodborne pathogens, and musculoskeletal disorders; national strategies included Security Hospital, and Healthy China 2030. In NHS England, three laws were fundamental; several monitoring systems had been set up, including NHS Staff Survey, Commissioning for Quality and Innovation incentive scheme; mental health, musculoskeletal problem, and nutrition disorder and overweight were raised great concern; Health and Safety, and NHS Healthy Workforce Program were critical nationwide strategies. Conclusion: There were several similarities as well as differences between the Chinese public health system and NHS England, which laid foundation of learning by China. Recommendations of improving occupational health policies in China were provided, based on the lessons learned from the NHS England.

• Health Policy and Management
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• v.32 no.3
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• pp.323-329
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• 2022

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.