• Journal of Preventive Medicine and Public Health
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• 제49권2호
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• pp.118-128
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• 2016

Objectives: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. Methods: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. Results: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only ('I'-only) and of fixed amount+indemnity-type ('F+I') increased, whereas the proportion of holders with fixed amount-type only ('F'-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding outpatient care, subjects with 'F'-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with 'I'-only PMI or 'F+I' PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for 'I'-only: 1.39, 1.63, and 1.38, respectively; ORs for 'F+I': 1.67, 2.09, and 1.37, respectively). Conclusions: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

• 보건행정학회지
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• 제17권2호
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• pp.52-67
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• 2007

Korean government is preparing the long-term care financing and delivery system in order to cope with rapid population aging. The system should be designed to provide demented patients with an appropriate services that the patients want to take, and considered to be necessary for them. In this regard, this study aims to analyse empirically a relationship between the types of long-term care services that demented patients wanted to take and they actually received during 2004. The caregivers of 609 dementia patients, who were randomly selected in a manner of proportional allocation from a nationwide claim database of the Korean National Health Insurance Corporation, were interviewed in September, 2005. Independent variables include socio-demographic characteristics, Activities of Daily Living(ADL) and Instrumental Activities of Daily Living(IADL). To explore the correspondence of the types of long-term care services that demented patients wanted to take and that they actually received, and its affecting factors, we conducted chi-square test and logistic regression analysis. Main findings are as follows. First, while only 20% of study subjects wanted home services as a long-term care services, those who wanted to use the long-term care facilities and general hospital were 37%, 43% respectively. Second, the correspondence rate was just 38% on average, and extremely low in the demented patients who wanted to use long-term care facilities. Third, the demented patients who resided in urban areas and received relatively high level of education showed high correspondence rate. Fourth, the high ADL score was closely related to low correspondence rate.

• 대한치과보철학회지
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• 제62권1호
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• pp.1-5
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• 2024

목적: 의치를 장착한 환자에서 성별, 연령, 보험적용여부 및 종류, 의치를 장착한 악궁, 의치 종류에 따라 의치 장착 후 사후 점검 횟수에 차이가 있는지 분석하고자 한다. 대상 및 방법:이 연구는 10년 간 일산병원 치과보철과에서 의치를 장착한 만 65세 이상의 환자 988명을 대상으로 하였다. 성별, 연령, 보험 적용 여부 및 종류, 의치를 장착한 악궁, 의치 종류 등의 변수를 고려하여 사후 점검의 횟수와 기간을 평가하였으며, 통계 분석은 5%의 유의수준에서 진행하였다. 결과: 총 988개의 의치가 포함되었으며, 사후 점검 횟수의 중위수는 3으로 나타났다. 남성이 여성보다 유의미하게 (P = .017) 내원 횟수가 더 많았으며, 의치 종류에 따라서는 금속상 총의치가 국소의치보다 유의미하게 (P = .005) 사후 점검 횟수가 더 많았다. 그 외의 변수는 사후 점검 횟수에 영향을 미치지 않았다. 결론: 이번 연구의 한계 내에서 남성 환자와, 금속상 총의치 환자의 경우 의치의 조정 횟수가 증가하였다.

• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.245-256
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• 2010

Objectives: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. Methods: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). Results: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI = 0.43 - 0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb${\geq}$11 g/dL, blood pressure within the range of 100-140 /60-90 mmHg, calcium x phosphate${\leq}$55 $g^2/dL^2$ and albumin${\geq}$4 g/dL were not significantly different between the groups. Conclusions: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.

• 보건행정학회지
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• 제25권1호
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• pp.3-10
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• 2015

Background: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). Methods: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. Results: Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. Conclusion: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.

• Journal of the Korean Data and Information Science Society
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• 제19권3호
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• pp.951-957
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• 2008

We derive some approximate maximum likelihood estimators(AMLEs) and maximum likelihood estimator(MLE) of the scale parameter in the half-triangle distribution based on progressively Type-II censored samples. We compare the proposed estimators in the sense of the mean squared error for various censored samples. We also obtain the approximate maximum likelihood estimators of the reliability function using the proposed estimators. We compare the proposed estimators in the sense of the mean squared error.

• Journal of the Korean Data and Information Science Society
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• 제19권4호
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• pp.1441-1448
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• 2008

We propose the modified quantile-quantile (Q-Q) plot using the approximate maximum likelihood estimators and the modified normalized sample Lorenz curve (NSLC) plot for the extreme value distribution based on multiply Type-II censored samples. Using two example data sets, we picture the modified Q-Q plot and the modified NSLC plot.

• Journal of the Korean Data and Information Science Society
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• 제18권3호
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• pp.817-826
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• 2007

In this paper, we derive the approximate maximum likelihood estimators of the scale parameter and the location parameter in a generalized extreme value distribution under multiply Type-II censoring by the approximate maximum likelihood estimation method. We compare the proposed estimators in the sense of the mean squared error for various censored samples.

• Communications for Statistical Applications and Methods
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• 제15권5호
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• pp.765-774
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• 2008

In this paper, we derive the approximate maximum likelihood estimators(AMLEs) and maximum likelihood estimator of the scale parameter in a triangular distribution based on progressive Type-II censored samples. We compare the proposed estimators in the sense of the mean squared error through Monte Carlo simulation for various progressive censoring schemes.

• Communications for Statistical Applications and Methods
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• 제15권3호
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• pp.367-378
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• 2008

In this paper, we derive the approximate maximum likelihood estimators of the scale parameter and the location parameter in a double Rayleigh distribution based on multiply Type-II censored samples. We compare the proposed estimators in the sense of the mean squared error for various censored samples.