• Health Policy and Management
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• v.6 no.1
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.107-116
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• 2005

Objectives : We analyzed the changes from 1996 to 2002 in distributive equity of the contribution burden in the Korean National Health Insurance. Methods : The study subjects were a total of 8,923 employee households and a total of 7,296 self-employed households over the period from 1996 to 2002. Those were the households meeting the two criteria as completing each annual survey and having no change in the job of head of the household during that period from the raw data of the Household Income and Expenditure Survey annually conducted by the Korean National Statistical Office. The unit of analysis was a household, and this was the standard for assessing the contribution that is now applied on a monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and Contribution Concentration Index were estimated as the index of inequality. Multiple regression analysis was conducted to compare the annual ability-to-pay elasticity of the contribution to the reference year of 1996 for three groups (all households, the employee households, and the self-employed households). Results : For the index of inequality, the distributive equity of contribution was improved in all three groups. In particular, the employee group experienced a substantial improvement. Using multiple regression analysis, the ability-to-pay elasticity of the contribution in the employee group significantly increased ($\beta$=0.232, p<0.0001) in the year 2002 as compared to the reference year of 1996. The elasticity in the self-employed group also significantly increased ($\beta$=0.186, p<0.05), although its change was smaller than that in the employee group. Conclusions : The employee group had a greater improvement for the distributive equity of the contribution burden than the self-employed group. Within the observation period, there were two important integration reforms: one was the integration of 227 self-employed societies in 1998 and the other was the integration of 139 employee societies in 2000. We expected that the equity of the contribution burden would be improved for the self-employed group since the integration reform of 1998. However, it was not improved for the self-employed group until the year 2000. This result suggests that capturing exactly the beneficiaries' ability-to-pay such as income is the precedent for distributive equity of the contribution burden, although a more sophisticated imposition standard of contribution is needed.

• Health Policy and Management
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• v.10 no.3
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• pp.108-128
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• 2000

The Korean government has implemented the policy for merging 141 health insurers into Korean Unified Health Insurer (KUHI) in July of 2000. The unification of multiple insurers will definitely effect the stability of financial management, equity of premium burdens and efficiency of administrative management. However, it is difficult to predict what forms the far-reaching effects of the unification would take. Thus, pursuing the unification may be express as a huge policy experiment. In order to lead the unification, which lies on a crossroad between success and failure, to the road of success, we need to infer the problems and obstacles predicted in the step-wise processes of merging organizations, finances and the systems of computing premium, and come up with the effective means to maintain the stability of financial management, to improve the equity of premium burdens and to increase the efficiency of administrative management. Thus, I first described the changes of the Korean medical insurance system, and analyzed the performances of self-employed medical insurance 1 year after the integration of societies in October of 1998. At the base of examining the stability of financial management, equity of premium burdens and efficiency of administrative management, I predicted the problems and obstacles that could occur after the unification of the multiple medical insurers, and proposed a few ways of leading the unification of the multiple medical insurers in Korea to success. The most worried factor is that insurance finance would become unstable since the expansion of premium revenues is not easy because raising the premium for all Koreans is to be difficult. In addition, the unification of insurance finance could weaken the insurer's efforts for declaring real incomes of the self-employed and increasing the collection rate of premiums from them. This weakening would be the decisive factor of lowering the equity of premium contributions between the self-employed and employees. And bureaucratization and rigidity that are unavoidable in a gigantic unified organization could lower the efficiency of administrative management. Furthermore, by having 3 labor unions in the unified organization, it is possible to experience frequent difficulties and discords among the unions and between the unions and organization. Thus, when smooth pursuing of the unification of multiple insurers gets difficult, the social expenses derived from the failure would eventually end up on all Koreans. The unification is to be performed after coming up with the ways to eradicate these worries, so that the unification of multiple insurers would step onto the road of success.

• Health Policy and Management
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• v.21 no.4
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• pp.585-598
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• 2011

This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

• Journal of the Korea Convergence Society
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• v.9 no.2
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• pp.125-136
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• 2018

The purpose of the study is to investigate dental health insurance coverage the awareness and dental health insurance coverage extension to scaling in service consumers. There were significant differences according to education level, age on the appropriateness of the age of yearly scaling benefit, and to married, regions, self-oral health of the frequency of yearly scaling benefit, who their teeth brushed frequence a day on the appropriateness of the fee of yearly scaling benefit. It implies that should be added to the coverage list national health insurance every age group after increasing periodontal disease. It is to be more extension as to age, frequency and fee health insurance coverage of scaling, the effort to improve dental health insurance coverage policy must be continue for oral health in the future.

• Journal of the Korea Convergence Society
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• v.13 no.5
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• pp.77-84
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• 2022

The purpose of this study is to provide basic data necessary for preparing a sustainable health insurance system in the future by analyzing the difference in the results of claims according to the claims status of health insurance of dental medical institutions and the level of health insurance knowledge. In this study, a self-written online questionnaire was conducted for dental medical institutions 209 workers from March to May 2019. As a result of the study, The demand for professional manpower according to claim satisfaction was statistically significant in the qualification requirements (p<.05). Therefore, the necessity of professional workers for dental health insurance claims was confirmed and policies for this should be prepared.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.75-81
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• 1985

Urine contains protein and nucleic acid(urea, uric acid, creatinine, ammonia, amino acids), various organic and inorganic materials, vitamin, hormone, enzyme etc. The examination of gualitative or quantitative change of the above mentioned materials and picking up the abnormal materials are useful to diagnose diseases. The test strip for examination of urine is applied to the routine test, monitoring of medical therapy and recurrence, self monitoring, and screeing in preventive medicine. We have been using multitest strip for checking the bacterial infection(nitrite), PH, protein, glucose, ketone body, urobilinogen, bilirubin and occult blood. So it is possible to diagnose three groups of diseases as follows, abnormal metabolism of the carbohydrate, diseases of kidney and other urogenital system, diseases of hepatobiliary system and hemolytic disease causing abnormal metabolism of bile juice.

• Health Policy and Management
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• v.24 no.3
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• pp.261-270
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• 2014

Background: This study examined what factors affected a complete examination of infant health checkup. Methods: We used Korean national health insurance claim data of 2,936,650 infants, taking examination in 2012. These claim data included enrollment status of householders and records of infant health checkup from 2008 to 2013. Results: Our results shows that for infant characteristics, the likelihood of complete examination of infant health checkup is significantly lower in female, older aged, and handicapped ones. For householder characteristics, the likelihood of complete examination of infant health checkup is also significantly lower in female, older group and self-employed ones. For household characteristics, the likelihood of complete examination is also significantly lower in single-parent families, multi-cultural families, parent with unexperienced health checkup and lower monthly premiums. Conclusion: It is necessary to support an additional use-guide and follow-up management services to improve incomplete examination of infant health checkup.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.3
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• pp.29-43
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• 2015

Objective : The purpose of this study was to identify characteristics of patients' self-perceived health in traditional Korean medical facilities. Method : This research was conducted based on the survey on patients whom have visited traditional Korean medical facilities in 2011 by the Ministry of Health and Welfares and Korean Institute for Health and Social Affairs. Using a sample of 3,931 (1,180 male and 2,751 female) outpatients' self-perceived health based on the data from usage and consumption of Korean Medicine. 'Healthy', 'Fair', and 'Poor Health' were used to measure patients' self-perceived health status. The data was analyzed by frequency, t-test, cross correlation analysis and multiple logistics regression analysis using the SPSS program package. Results : Sex(P<0.001), age(P<0.001), marital status(P<0.001), education(P<0.001), employment status(P<0.001), occupation(P<0.001), health insurance(P<0.001) and income level(P<0.0001) showed statistical significance. Main Treatment Facilities(P<0.001), experience of taking Korean medicine(P=0.032), experience of receiving acupuncture treatment(P<0.001), number of visits(P<0.001), medical expense (P=0.005), and subjective health status after the treatments showed statistical significance for Korean herbal medicine(P=0.038), acupuncture (P=0.001), cupping therapy(P=0.006), oriental physiotherapy(P=0.003), and treatment satisfaction(P<0.001). For subjective health status based on suffering disorders in the past three months, the response of poor health was higher in the group suffering recent illnesses. Statistical significance was seen in hypertension (P=0.002), arthritis(P<0.001), lumbar pain(P<0.001), diabetes mellitus(P=0.001), stroke(P<0.001), hwa-byung (P=0.001), gastric disorders(P=0.021), common cold(P<0.001), ankle sprain(P<0.001), muscular injury(P<0.001), lumbar sprain(p=0.009) and fracture(P=0.03). Also the number of diseases during the past three months showed statistical significance(P<0.001). Statistical significance was also seen in Level of knowledge(P<0.001), route of information(P<0.001), reliability of Korean medicine(P=0.003), insurance coverage(P=0.005), medical costs(P<0.001), and future willingness to use Korean medicine(P<0.001). As a result of the multiple logistics regression analysis, risks of subjective poor health statistically increased in female population, elderlies, medicaid beneficiaries, less educated, higher medical expense, and more disorders during the past three months. Conclusion : Patients' self-perceived health status has significant differences with each variables such as sex, age, marital status, education, health insurance, medical expense, number of diseases.

• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.113-122
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• 2017

Purpose: The purpose of this study was to identify influencing factors on rehabilitation adherence in stroke patients. Methods: This study was a descriptive survey. A structured questionnaire was used for face-to-face interviews with a convenient sample of 192 subjects, who were admitted in 5 rehabilitation hospitals located in G metropolitan city. Results: The score of rehabilitation motivation in the subjects was a mean of $2.04{\pm}0.35$, self-efficacy $6.22{\pm}2.32$, family support $3.40{\pm}0.82$ and rehabilitation adherence $3.08{\pm}0.41$. The rehabilitation adherence was a statistically significant difference according to the education level (F= 3.40, p= .035), marital status (F= 4.04, p= .019), number of personal insurance policies (K= 9.80, p= .020), location of paresis (F= 2.72, p= .046), and status of current smoking (M = 657.00, p= .001). There was significant correlation among degree of rehabilitation adherence, rehabilitation motivation (r= .30, p< .001), self-efficacy (r= .14, p= .046) and family support (r= .18, p= .011). Rehabilitation motivation (${\beta}=0.19$, p= .007), self-efficacy (${\beta}=0.14$, p= .035), marital status (${\beta}=0.14$, p= .038), number of personal insurance policies (${\beta}=-0.15$, p= .045) and location of paresis(${\beta}=-0.15$, p= .028) were identified as significant predictors. This model explained 22.6% of variance in rehabilitation adherence (F= 5.92, p< .001). Conclusion: There is a need to develop an effective intervention for rehabilitation adherence improvement considering the identified variables in this study.