• Title/Summary/Keyword: Private Utilization

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The Effect of Private Health Insurance Coverage Reduction on the Korean Medicine Utilization (실손형 민간보험의 비급여 보장축소가 한방의료이용에 미친 영향)

  • Park, Minjung;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.57-66
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    • 2015
  • Objective : Private health insurance coverage in Korean medicine has been reduced since October 2009 for preventing unnecessary utilization. The aim of this study is to identify how private health insurance coverage reduction affects on the Korean medicine utilization. Method : We analyzed the Korea Health Panel data from 2008 to 2012. Panel negative binominal regression model was used to analyze the relationship between private health insurance coverage reduction and utilization of outpatient service. Panel tobit regression analysis was used to identify the relationship between private health insurance coverage reduction and health expenditure of outpatient service. Results : Private health insurance coverage reduction significantly dropped both utilization and health expenditure of outpatient service by 9%, 9.22% respectively. In addition, therapeutic utilization significantly decreased up to 10%. Conclusion : Private health insurance coverage reduction seems to have an effect to reduce both utilization and the health expenditure of Korean medicine outpatient service. This effect was more noticeable in the therapeutic utilization. Thus, more elaborate policy will be needed to prevent unnecessary utilization of Korean medicine.

Disparities in High-cost Outpatient Imaging Test Utilization between Private Health Insurance Subscribers and Non-subscribers: Changes Following the National Health Insurance Benefit Expansion Policy (민간의료보험 가입자와 미가입자 간 외래 고가영상검사 이용의 격차: 건강보험 보장성 강화 정책에 따른 변화)

  • Yukyung Shin;Young Kyung Do
    • Health Policy and Management
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    • v.33 no.3
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    • pp.325-337
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    • 2023
  • Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

Effect of Private Health Insurance on Medical Care Utilization: Six Year Unbalanced Panel Data Model (민간의료보험 가입 유형별 의료 이용: 6개년 불균형패널 분석)

  • You, Chang-Hoon;Kang, Sung-Wook;Choi, Ji-Heon;Kwon, Young-Dae
    • The Korean Journal of Health Service Management
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    • v.11 no.3
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    • pp.51-64
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    • 2017
  • Objectives : This study examined the effect of private health insurance on medical care utilization by subscription type. Methods : The data used were the six waves of the Korea Health Panel (2009-2014), and 16,187 persons were the subjects of the analysis. We performed a panel regression with a fixed effects model. Results : Indemnity private health insurance was positively related to the number of physician visits, number of admissions, and total length of stays. However, fixed-benefit private health insurance was not related to medical care utilization. Conclusions : The result of this study, which shows the difference by subscription type in the effect of private health insurance on medical care utilization, suggests that continuous monitoring of indemnity private health insurance is needed in the future.

Characteristics of Supplementary Private Health Insurance Insured and Medical Utilization Behavior (실손형 민간의료보험 가입 특성 및 의료이용행태)

  • Oh, Hyang-Suk;Kim, Chang-Yoon
    • The Korean Journal of Health Service Management
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    • v.8 no.2
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    • pp.115-125
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    • 2014
  • This study tries to investigate inequity in supplementary private health insurance insured in terms of the analysis of insurance insured general characteristics and to analyze the influence of supplementary private health insurance on their admission and their outpatient medical utilization behavior. As a result of the analysis of the general characteristics of supplementary private health insurances insured, it has turned out that men, persons at low ages, people with a spouse and chronic diseases, and persons with a high income have applied such insurances more. We can also tell that low-income classes have difficulty in applying private health insurances as people in the fifth income quintile have applied such insurances about 9 times as much as those in the first income quintile. The analysis of supplementary private health insurance insured health care utilization behavior has revealed that both male and female insured aged less than 55 and without chronic diseases have increases the number of their use of health care, their patient charge, and their medical cost per visit.

The Determinants and Medical Care Utilization Behavior of Private Health Insurance (민간의료보험의 가입요인과 의료이용행태)

  • Baek, In-Rib;Park, Hyun-Soo;Byun, Sung-Soo
    • The Journal of the Korea Contents Association
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    • v.12 no.7
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    • pp.295-305
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    • 2012
  • This study analyzes actual conditions of private health insurance empirically by using the decision to join Korea Health Panel data. First, the study investigates how sociodemographic factors influence joining the private health insurance. Next, the relationship between the private health insurance membership and the frequency of medical service utilization is analyzed. The main results of these analyses can be summarized as follows: the socially vulnerable are less likely to join private health insurance relative to the middle and upper classes. The frequency of medical service utilization of private insurance members is relatively higher. This fact contains the possibility that the middle and upper classes are able to receive more medical services through private health insurance membership, while the socially vulnerable have difficulty with obtaining medical services in spite of much need. Therefore, policies are needed which manage the private health insurance more effectively and secure the publicity of health service socially.

Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center (민간의료보험이 암 환자의 의료이용과 의료비에 미치는 영향: 일개 암전문의료기관의 우리나라 주요 암종을 중심으로)

  • Lim, Jin-Hwa;Choi, Kui-Son;Kim, Sung-Gyeong;Park, Eun-Cheol;Park, Jae-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.329-335
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    • 2007
  • Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

Factors Affecting the Purchase of Indemnity Private Health Insurance and Related Factors of Outpatient Healthcare Utilization among Chronic Disease Patients (만성질환자에서 실손형 민간의료보험의 가입 관련 요인과 외래 의료이용의 관련 요인)

  • Hur, Jung Won;Kwon, Young Dae
    • Korea Journal of Hospital Management
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    • v.24 no.3
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    • pp.1-10
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    • 2019
  • Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

The Effects of Private Health Insurance on Healthcare Utilization of People with Physical and Mental Illness: According to 2018 Korea Health Panel Survey Data (신체·정신복합질환자의 민간의료보험 가입 여부가 의료이용에 미치는 영향: 한국의료패널 데이터 2018년 자료 활용)

  • Riyoung Na;Seok-Jun Yoon
    • Health Policy and Management
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    • v.33 no.3
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    • pp.264-272
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    • 2023
  • Background: Private health insurance supplements the coverage of national health insurance in Korea. In this situation, the subject of the study is to identify the healthcare utilization of people with physical and mental illnesses according to private health insurance. Methods: This study used data from the Korea Health Panel Survey 2018. The study population consisted of 813 individuals with physical and mental illnesses (PMI). Multiple logistic regression analysis and binominal logistic regression analysis were conducted about the utilization of emergency, inpatient, and outpatient medical services of people with PMI depending on enrollment in private health insurance (PHI). Results: The results of this study indicated that individuals with PHI utilized emergency and outpatient medical services less frequently compared to those without PHI. Conversely, having PHI was associated with a higher utilization of inpatient medical services compared to not having PHI. Binomial logistic regression analysis revealed that individuals with PMI who had PHI exhibited a higher frequency of visits to emergency and outpatient medical services compared to those without PHI. However, the significance of this trend was not observed in the case of emergency medical services. On the other hand, individuals with PMI who had PHI showed a lower frequency of visits to inpatient medical services compared to those without PHI. Conclusion: In conclusion, there was a significant relationship between having PHI and the utilization of medical services in people with PMI. There is a need for a follow-up study considering the type of mental illnesses, length of stay, and health outcome of people with PMI depending on having PHI.

The Utilization of Military Welfare Facilities by Private Sectors (군 복지시설의 민간활용 연구)

  • Syung uk Lee;Jinsoo Ko
    • Land and Housing Review
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    • v.14 no.2
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    • pp.83-95
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    • 2023
  • The purpose of this study is to improve the private utilization of military welfare facilities that are aging or underutilized in urban areas. It also aims to develop ways to strengthen cooperative win-win strategies between the military and local communities. The use of military welfare facilities by the private sector refers to activities where the private sector generates additional benefits or added value by allowing the use of these facilities, including both private use and improvements to facilities or development of land through private sector involvement. From the perspective of the city and the locals, military welfare facilities are perceived as resident-friendly and excellent urban resources that can promote reciprocal satisfaction between the military and local communities. From the perspective of the military, military welfare facilities are important for enhancing the welfare of military personnel. However, they often face limitations in providing various welfare services due to the aging of facilities and limited operations with a single purpose. The improvement of private utilization of military welfare facilities will bring diverse reciprocal benefits to the military, the city, and the locals. Above all, improving the private utilization of military welfare facilities can help the military and local communities jointly address diverse urban issues. To establish cooperative governance and find flexible and diverse development strategies that can promote the welfare of the military and enhance the quality of life for the locals, it is important that both the military and local communities make continuous efforts.

A Study on Legal Limits of Occupational Safety & Health Law and Application of Private Standards (산업안전보건법의 한계와 민간기준의 활용에 관한 연구)

  • Jung, Jinwoo
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.24 no.2
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    • pp.103-112
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    • 2014
  • Objectives: The present system of occupational safety and health law gives priority to traditional command and control regulations. However, this may give rise to problems such as the delay of standard-setting and shortages of human resources. The aim of this study is to examine the usability of private standards in occupational safety and health systems. Materials: After the limits of occupational safety and health law were examined, an application plan for private norms (EN, as enforced in the EU) and occupational safety and health management systems (OSHMS) was investigated. Results: The utilization of private norms and OSHMS may address the limits of the current legal system. In particular, OSHMS is known internationally as a measure for achieving improvements in overall occupational safety and health performance. As a result, occupational safety and health law and private norms/OSHMS are complementary to one another. Conclusions: Even though the utilization of private standards may give rise to legal questions, such standards as complementary measures to traditional command and control regulations need to be utilized progressively in occupational safety and health systems.