• Title/Summary/Keyword: Self-insurance

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The Determinants and Comparison of Health Behavior and Health Service by Private Medical Insurance on National Health-Nutrition Survey (국민건강영양조사 대상자들의 민간의료보험 가입 요인 및 가입여부에 따른 건강행태·의료이용 비교)

  • Lee, Yong-Chul;Im, Bock-Hee;Park, Young-Hee
    • The Journal of the Korea Contents Association
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    • v.10 no.12
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    • pp.190-204
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    • 2010
  • This study firstly examined the socioeconomic and health factors associated with infiltration of private health insurance. Secondly, we compared health behavior, outpatient and inpatient use of private health insured with uninsured. The method of this study is that secondary analysis of the 2008 Korea National Health and Nutrition Survey was conducted for 7178 respondents aged 19 over. We use the logistic regression and t-test for data analysis. The first dependent variable was dichotomy which is divided to private health insured or uninsured and the second dependent variable was the presence and frequency of outpatient and inpatient use. The descriptive variables was gender, age, marital status, income, education, occupation, type of national health insurance, residential area, self confidence of health, prevalence rate of common disease, activity limitation, drinking and smoking status. The result of the major findings are as follows. First, 59 under aged person, married person, people in the higher brackets of income, national employee insured were more likely to infiltrate private health insurance. The poor self confidence of health, activity limitation, person with hypertension or allergic rhinitis and smoker were negatively related in infiltrating private health insurance. Second, private health insured did more preventive behavior such as self-paid health examination, cancer screening, regular exercise than uninsured. Third, private health insured was positively related with the presence of outpatient use and frequency of inpatient use

Recognition between laypersons and dental hygienists on expansion of health insurance of scaling (스케일링 건강보험 확대에 대한 일반인과 치과위생사의 인식도 조사)

  • Ju, On-Ju;Kang, Eun-Ju;Woo, Seung-Hee;Lee, A-Ju;Lee, Hea-Jung;Park, Mi-Yeon
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.3
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    • pp.431-438
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    • 2014
  • Objectives : The purpose of the study is to investigate the recognition between laypersons and dental hygienists on expansion of health insurance of scaling. Methods : A self-reported questionnaires was filled out by 100 laypersons and 100 dental hygienists from October 7, 2013. Data were analyzed by SPSS version 21.0 program. Results : All the dental hygienists recognized the introduction of the health insurance of scaling and 71.0% of the laypersons agreed. The introduction of health insurance of scaling was responsible for the interest toward scaling in 80 dental hygienists(80.0%) and 66 laypersons(66.0%). 94% of dental hygienists answered that health insurance of scaling would prevent periodontal diseases. The expansion of health insurance of scaling revealed many periodontal diseases and 52% of laypersons answered that prevention of periodontal diseases would deprive the dental hygienists of their jobs. Conclusions : The expansion of health insurance of scaling can prevent the periodontal diseases and enhance the oral health services. So the government must try to expand the health insurance of scaling.

Reforming the Rural Health Insurance Programs in Korea (농촌의료보험의 당면과제와 개선방향)

  • Moon, Ok-Ryun
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.179-194
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    • 1991
  • Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

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Integration of Unemployment Insurance with Retirement Insurance and Its Welfare Analysis (통합실업보험제의 후생분석)

  • Yun, Jungyoll
    • Journal of Labour Economics
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    • v.26 no.2
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    • pp.31-59
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    • 2003
  • This paper analyzes a social insurance system that integrates unemployment insurance with a pension program, allowing workers to borrow against their future wage income to finance consumption during an unemployment episode and thus improving their search incentives while reducing risks. This paper identifies the conditions under which the integration improves welfare and the factors which determine the optimal degree of integration. A fully integrated system is one in which no reliance is placed at all on a separate tax-funded unemployment insurance program. We show that when the duration of unemployment is very short compared to the period of employment or retirement, the optimal system involves an exclusive reliance on pension-funded self-insurance. This system imposes a negligible risk burden for workers while avoiding attenuating search incentives. We also argue that a joint integration of several social insurance programs with a pension program through an individual account is desirable unless the risks are perfectly correlated to each other.

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Public's Perception of Reimbursement for Advanced Practice Nurses' Education and Counseling in Intensive Care Units by the National Health Insurance (중환자실에서 전문간호사가 제공하는 교육상담의 국민건강보험 급여화에 대한 일반인의 인식조사 연구)

  • Ko, Chungmee
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.95-107
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    • 2018
  • Purpose : This study aimed to investigate the public's perception of reimbursement for the education and counseling services provided to advanced practice nurses in intensive care units. Method : This was a secondary data analysis study. The original data were collected utilizing an online panel. The sample comprised 615 individuals aged between 19 and 49 years nationwide. The study variables included the public's perception of reimbursement for education and counseling services, age, gender, education level, income, and health status. Variables such as past experience of being admitted to an intensive care unit by self, family, or relatives and the recognition of advanced practice nurses were also examined. Results : The mean of the perception score was 3.15 on a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). Among the participants, 89.2% answered "somewhat agreed" or "strongly agreed" to the question about the education and counseling services being covered by the National Health Insurance. Moreover, education level, past experience of being admitted to an intensive care unit by self, family, or relatives, and recognition of advanced practice nurses were significantly associated with the perception score. Conclusion : Efforts should be made to publicize the need for the education and counseling services that are provided to advanced practice nurses in intensive care units.

A study on dental professionals' recognition on a system of long-term care insurance for the elderly (노인장기요양보험제도에 관한 치과종사자의 인식도 연구)

  • Ahn, Kwon-Suk;Ji, Min-Gyeong;Min, Hee-Hong
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.1
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    • pp.169-180
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    • 2009
  • This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

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A Study on Unconstitutionality of Insurance Premium Rating System in Accordance with National Health Insurance Act. - Focused on Age and Gender in Premium Rating Standards Activity Rate and Living Standards of the Local Insured - (국민건강보험법상 보험료부과체계에 관한 법적 고찰 -지역가입자 생활수준 및 경제활동 참가율 부과기준 중 성과 연령을 중심으로 -)

  • Song, Kimin;Jeong, Jeong-Ile
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.185-209
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    • 2014
  • While the local health insurance and the employment-based insurance were integrated in July 2000, the insured is divided into employment-based insured and the local insured and the relevant premium has been applied to both groups. The health insurance premium having the feature of social solidarity has to be determined depending on income, that is, the ability to pay in accordance with the principles of social insurance. While employment-based insurance premium has been determined depending on the earned income, the local insurance premium for the local insured has been determined by scoring gross income(evaluated income), property and possession of automobiles. A variety of improvement approaches has been implemented including introduction of the employment-based insurance premium ceiling system (2002) and the change of property scoring system for the local insured (2006). However, the health insurance system which was merged in 2000 has been implemented up to now without significant change even though there were lots of socio-demographic change including increase of income level and the population structure such as low birth and aging. In other words, it is required to implement the premium rating system securing the income-based equity. Nevertheless, it was inevitable to apply the diverse rating standards in the early stage because it was very difficult to verify the income of the self-employed. Although the income verification rate was significantly increased from 23% in 1989 to 44% in 2010, the irrational standards including property, automobiles, living standard and activity rate have been still applied to the local insured because it is difficult to secure the validity of insurance premium rating system and it severely lacks of security. This paper investigated whether the current insurance premium rating system for the local insured imposing the premium on the basis of 'gender' and 'age' complies with the basic human rights secured by the current Constitution of the Republic of Korea with respect to the practical and theoretic irrationality of insurance premium rating system and standards for he local insured. In accordance with the analysis results, this paper proposed the approach to improve the system.

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The Study on Sustainable Development Strategy of the Insurance Agency : Focusing on the Case of Japan (보험대리점의 지속가능 발전방안에 관한 연구 : 일본 사례를 중심으로)

  • Ryu, Sung-kyung;Son, Seong-dong
    • Journal of Venture Innovation
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    • v.5 no.3
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    • pp.19-40
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    • 2022
  • The purpose of this study is to analyze and evaluate the role and merits and demerits of insurance agencies, which are the main sales channels of the domestic insurance market, from a neutral standpoint, and to present a roadmap by finding ways and tasks for the sustainable development of the insurance agency industry. Recently, criticisms and regulations on independent distribution channels have been strengthened due to deterioration in growth potential and profitability, and increase in civil complaints of insurance companies. In the 2000s, as the center of insurance sales channels shifted to GA and bancassurance, the supervisory authorities regarded the irrationality of project costs and recruitment fees as the root causes and announced a regulatory improvement plan. In view of these circumstance, the operating status, problems of domestic insurance agencies and their contribution to the insurance industry were reviewed. In addition, we tried to find a mid-to-long term development plan by analyzing the case of insurance agency operation in Japan. This study identified the operating status and contribution of insurance agencies in South Korea, and focused on the major status of the Japanese insurance agency industry, ways to improve management efficiency, and the status and role of self-regulatory organizations for insurance agencies. Based on this, it was proposed to improve the professionalism of the sales organization, introduce a company specializing in insurance sales, and to strengthen the status of the association of the insurance agency as for the development plan of the insurance agency industry in South Korea.

Factors Affecting National Health Insurance Mass Screening Participation in the Disabled (장애인의 국민건강보험 건강검진 수검에 영향을 미치는 요인)

  • Park, Jong-Hyock;Lee, Jin-Seok;Lee, Jin-Yong;Hong, Ji-Young;Kim, So-Young;Kim, Seong-Ok;Cho, Byong-Hee;Kim, Yong-Ik;Shin, Young-Soo;Kim, Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.511-519
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    • 2006
  • Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

ANXIOUS-DEPRESSIVE ATTRIBUTES TO SUICIDAL IDEA OF ADOLESCENTS (청소년의 자살사고와 관련된 우울-불안 성향)

  • Jin, Yong-Tak;Ha, Eun-Hye;Song, Jung-Eun;Park, Eun-Young;Choi, Tae-Kyou;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.95-102
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    • 2003
  • Objectives:This study was aimed at examining the emotional predictors of adolescent suicidal ideas in a community. Methods:The subjects were 1909 middle and high school students(936 males, 973 females) in Koyang-shi. We evaluated all subjects using Center for Epidemiologic Study for Depression(CES-D), Revised Children's Manifest Anxiety Scale(RCMAS), Korean-Youth Self Report(K-YSR), Psychological Self-1 of Offer's Self Image Questionnaire(PS-1 of OSIQ) and Suicide Ideation Questionnaire (SIQ). We compared the PS-1 of OSIQ scores of Anxious-depressive group(above cut-off points of CES-D, RCMAS and K-YSR) to those of control group, and conducted correlation analysis and stepwise multiple regression analysis to all subjects. Results:The number of anxious-depressive group was 126(6.58%) among 1909 subjects with significant gender difference(M:F ratio 1:1.5). Both PS-1 of OSIQ and SIQ scores were significantly higher in Anxious-depressive group than in control group. There were significant correlations among the scales:CES-D, RCMAS, A/D of K-YSR, PS-1 of OSIQ and SIQ. Through stepwise multiple regression analysis, we found that significant predictors of suicidal idea were CES-D, RCMAS and A/D of K-YSR. Conclusion:Anxious-depressive adolescents may be the high-risk group for suicidality and need preventive interventions of suicidality in a community.

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