• Korean Journal of Health Education and Promotion
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• v.8 no.1
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• pp.22-33
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• 1991

The Korean people are all the beneficiaries of medical insurance or medical aid. It is important and needful to develop the preventive health program such as health examination and health education for disease prevention and health promotion of the beneficiaries. This paper diagnoses the status and problems of the current preventive health services to the beneficiaries and recommends how to develop the preventive health program in the medical insurance. This paper suggests that the government should strengthen the political support and supervision in order to develop the preventive health program in the medical insurance. In addition to the above suggestion, the following are recommended ; 1) to designate the large number of qualified hospitals for health examination. 2) to use the supplementary methods such as the health questionnaires in order to give the accurate health examination services. 3) to combine the health examinations by both laws of medical insurance and industrial health. 4) to arrange the manpower in charge of health education and to establish the health promotion centers. 5) to develop the effective mass media and materials for health education by use of TV, radio, VTR and slide projector.

• Journal of Preventive Medicine and Public Health
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• v.33 no.2
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• pp.150-156
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• 2000

Objective : To analyze the factors affecting the participation rate in the health screening program of medical insurance. Method : We investigated the factors associated with the participation rate in the health screening program in Korea. Data were collected at the aggregate level from 145 employee health insurance societies and 227 self-employed health insurance societies from 1995 to 1997 Data were also collected at the individual level from four health insurance societies. This study hypothesized that the participation rate of the health screening program was related to 1) the characteristics of its members and the size of the health insurance society; 2) the specifications of the health screening program; 3) the venue of the health screening institution and the interests of individuals in the health screening program; and 4) the activities of the health insurance society. We used bivariate and multiple regression models to examine the factors on the participation rate of the health screening program. Results : First, in the case of dependents of on employee health insurance society, the ratio of dependents 40 years old and over, the average monthly contribution per household, the interest and satisfaction level of individuals in health screening, and the level of refunds for over-payment were all associated with the participation rate in the health screening program, accounting for 54.4% of the participation rate. Second, in case of those insured by the self-employed health insurance society, the interest and satisfaction level of individuals in health screening, the level of refunds for over-payment, and the performance level of on-the-spot health screening were statistically significant, accounting for 40.1% of the participation rate. Conclusion : The factors concerning the participation rate in the health screening program of medical insurance, in both a health insurance society and for individuals, were closely related to the age and gender of individuals and household contributions.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.148-155
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• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.450-461
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• 1995

This paper tested by using Micro TSP, an empirical econometric analysis to approve officially a hypothesis of price elasticity of the demand for medical care services in Korean national medical insurance and the economic effect of health care delivery system with time-series datas of Medical Insurance Statistical Yearbook$(1981\sim1993)$. The results suggest that the Korean medical insurance system shows moral hazard due to the change of coinsurance and the economic effect according to intervention of the health care delivery system, but it is different by insurers regardless of the same structure of the medical insurance scheme.

• Health Policy and Management
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• v.15 no.4
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• pp.161-175
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• 2005

Since the introduction of mandatory health insurance in In, the Korean national health insurance(KNHI) has grown rapidly. In 2004, about $96.9\%$ of the total population are covered by the KNHI and the remaining $3.1\%$ by the Medical Aid program. Despite national health insurance system in Korea, private health insurance market has grown rapidly. In 2004, the size of the private health insurance market was estimated at 6,568 billion won. The purpose of this study Is to identify the factors that determine the purchasing decisions of supplementary private health insurance under mandatory national health insurance system in Korea. The data from n04 Busan Health Survey were analysed for the Purpose. The variables in this study are demographic factors, health status and health behavioral factors, health care systemic factors, and socioeconomic factors. For statistical analyse, we used logistic regression. The Findings show that female, economically active age group(especially 35-49 years), persons with better health status or experience of health screening test are more likely to purchase private health insurance. And higher household income and expenditure, higher education level are more associated with the increased probabilities of private health insurance purchases. This results imply that the expanding of private health insurance market could widen the gap between the have and have-not in terms of equal health care accessibility.

• Journal of Preventive Medicine and Public Health
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• v.22 no.3 s.27
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• pp.398-405
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• 1989

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

• Journal of Preventive Medicine and Public Health
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• v.25 no.4 s.40
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• pp.399-412
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• 1992

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason fur the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium rate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.

• Korean Journal of Health Education and Promotion
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• v.25 no.3
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• pp.45-57
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• 2008

Objective: The aim of this study was to find out the factors associated with the health status and life satisfaction in the elderly who participated in an exercise program practiced by the National Health Insurance Corporation and the elderly who did not. Methods: The subjects of this study included 105 elderly people in K-city who participated in the elderly exercise program of the National Health Insurance Corporation and 103 elderly who did not. Results: The elderly group that participated in the exercise program showed slightly better physical health than non-participants but the difference was significant only in the item of bowel control. The elderly group that participated in the exercise program displayed slightly better mental health status than non-participants but the difference was significant only in the item of memory and cognitive ability. The elderly group that participated in the exercise program showed significantly higher life satisfaction than non-participants. The factors affecting the satisfaction of life were participation of exercise program, higher level of education, and perception of health, and the attributable rate was 24.6%. Conclusions: In conclusion, this study suggested that the people who participated in elderly exercise program showed higher level of physical and mental health status and life satisfaction than non-participants. Therefore, various National Exercise Program for elderly tailored by characteristics should be implemented.

• 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.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.205-233
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• 1999

This study is an effort to make policy suggestions by analysing the current health examination program as a benefit service provided by the national health insurance system, including health screening for the insured, screening of cancer and chronic diseases for their dependents. Analyses found some issues being gave attention to; 1) The insured under the community health insurance system do not get the health examination benefit. A program for them should be set to have equity in benefit services. 2) Low rates of using screen services compromise purpose and the efficiency the services have first intended to. An immediate attention should be made to increase low rate of use of screen test to detect chronic diseases in particular. 3) Selection of diseases and test items covered by health examination program does not reflect the need of the insured, but to reflect financial resources of the national health insurance system. 4) Lack of health screening facilities and their geographical maldistribution is observed, which with preference of a general hospital as a screening post by the insured may lead to unreliable test. 5) A follow-up system should have been developed for the suspected classified by test results of carrying chronic diseases. They should be cared for within the health examination program. Public health care systems incorporate such a system, along with caring for those who are in need of having a health counselling on preventive care. In conclusion, the national health insurance system should be a medical insurance of giving a higher priority on preventive care benefits, health examination program in particular. That could be done by making rearrangements of test items, screening methods and system, rationalizing current reimbursement system of service fee, increasing accessibility to and utilization of the services, and making an establishment of follow-up system.