• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.611-621
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• 2020

Objectives: This study aimed to verify the impact of dental health care insurance coverage policy by analyzing the changes in dental care utilization and expenditures over 5 years from 2012 to 2016, when the dental health insurance coverage expansion policy was implemented. From the national cohort data collected by the Korea Health Panel Survey, a retrospective study was conducted for all household members using dental services. Methods: This study statistically verified the difference in the dependent variables by frequency analysis, chi-square test, t-test, and one-way analysis of variance (SPSS version 22, IBM Co. USA, p<0.05). Results: The annual utilization rate steadily increased from 23.4% to 26.1% between 2012 and 2016. Although there were differences in utilization rates by gender, age, and income level, patients kept using the dental services in 2016 regardless of the type of health insurance. The average annual copayment for patient expenditures (out-of-pocket amount) increased from ￦463,844 to ￦537,401 in 2012 and 2016, respectively. Of the dental care expenditures over 5 years, the ratio of uninsured expenses by the elderly decreased from 38.5% to 25.9%, and the national health insurance service coverage increased from 40.3% to 49.1%. Conclusions: Although this policy did not reduce overall patient expenditures, it has been found that there was a positive effect on the elderly and low-income groups; it increased the utilization and access to dental services.

• The Journal of the Korea Contents Association
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• v.17 no.9
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• pp.39-49
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• 2017

This was a qualitative study on medical aid patients to understand the cause and process of statistical difference of health service utilization between medical aid and health insurance patients. The main results were the following; 1) There was few overuse of health service in medical aid patients. The reason of heavy utilization was mainly due to the complicated disease. Some of them were considered to overuse physical therapy and oriental acupuncture. 2) In case of medical aid patients, medical cost was paid by their welfare benefit of government or by the support of family or neighbors. They usually could not adequately use the services of uninsured benefit or large hospitals due to the cost. Some patients just endured the pain. There was still discrimination for medical aid patients in some medical institutions. 3) The health officials and institutions did not provide sufficient information to medical aid patients about the policy of medical cost support. 4) Health policies, such as selective clinic system, medial aid case management, approval of extended care, were considered to contribute in preventing unnecessary use of health service. However, this might limit adequate use of medical aid service. In conclusion, there is little evidence of overuse of health service for medical aid patients, which is different from the previous studies. A new plan is necessary, because medical aid patients thought that the necessary health service was not accessible to them.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.51-64
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• 2018

Purposes : In February 2014, the government said that the National Health Insurance Service (NHIS) will enforce plan for reducing the financial burden from two major non-covered services including physician surcharges and private room charges, the main causes to increase uninsured, by 2017. The purpose of this study is to analyze the policy effect that performed so far by comparing out-of-pocket payment rates of policy process Methodology: This study analyzed admission medical expenses that occurred from January 2013 to March 2016 at a upper grade general hospitals in Daejeon. Number of study subjects were 134,924 and the data were analyzed with SPSS 22.0 program by using frequency, percentage, mean, standard deviation, ANOVA. The effect of two major non-payment improvement plan on out-of-pocket rates was ascertained via generalized estimating equation. Findings: Out-of-pocket payment rates was statistically significantly declined 2.7 percent than enforcement ago. Also, out-of-pocket payment, physician surcharge, the proportion of out-of-pocket payment of hospital room charge to out-of-pocket payment was statistically significantly declined. However, a further analysis of the cause of the decline in total medical costs is needed. Practical Implications: Physician surcharges and private room charges improvement policy had a positive effect on the decline of out-of-pocket payment rate. The policy of physician surcharges was very effective after the first policy enforcement but it was less effective to medical aids and near poor that was a more greater coverage than national health insurance. Since the policy has not been finalized, we have to continue a research for the successful implementation of the policy.

• Women's Health Nursing
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• v.15 no.4
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• pp.261-269
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• 2009

Purpose: The purpose of this study was to investigate health management state during pregnancy, childbirth, and postpartum of immigrant women. Methods: A descriptive research design was employed. Data were collected from 182 immigrant women who lived in four provinces and D city. Subjects were completed the following questionnaires: demographic, medical service use, pregnancy and childbirth, and health management during the ante-postpartum. Results: The average age of subjects was 28.96 and 83 subjects (45.6%) were coming from Vietnam. 55 Subjects (30.2%) were within the low-income group with less than 4 million won per month. So, 62 subjects were uninsured women because of the expensive costs. Subjects mainly visited a health care center with their husband. On the using a health care center, subjects complained about communication difficulties and transportation problems. 42 Subjects were pregnant but 21.4% of pregnant subjects did not receive ante-natal care. Subjects got information about pregnancy and childbirth through their husbands and husband's family. Conclusion: Nursing intervention to manage the pregnancy, childbirth, and the postpartum of immigrant women need to be developed and should include strategies to take care of themselves after delivery and provide knowledge and information about ante-postpartum.