• 한국병원경영학회지
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• 제25권4호
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• pp.38-47
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• 2020

Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

• 보건행정학회지
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• 제18권4호
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• pp.148-169
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• 2008

As the Korean Government began to perceive healthcare as one of foundational industries for national dynamics, there has been mounting advocacy for the introduction of for-profit hospitals with a view to bringing efficiency in healthcare services industries and improvement of their international competitiveness. The Government is now considering the issue from all angles in favor of permitting for-profit hospitals. However, There have been few precedent studies on this subject to provide helpful data for the discussion and in the health policy making. This study used private hospitals - for-profit and nonprofit - in Florida, USA as study subjects to accumulate basic data that may be utilized for those involved in debates and health policy making relating to the introduction of for-profit hospitals in Korea. Among all the private general hospitals in Florida, those surveyed by AHA(American Hospital Association) for four consecutive years from 2001 and 2004 and others reported about to MCR(Medicare Cost Report) included in the collected data for analysis. In total 139 private general hospitals consisting of 73 for-profit hospitals and 66 nonprofit hospitals were included in the collected analysis data. Results of analysis revealed no significant difference between for-profit hospitals and nonprofit hospitals in the usage aspects of healthcare services including the average length of stay and the ratio of Medicare vs Medicaid patients. However, financial performances indicated by such factors. as the pre-tax return on assets and the pre-tax operating margin showed to be significantly higher in for-profit hospitals compared with nonprofit hospitals. And the ratio of personnel expenses and the turn period of total assets showed to be significantly lower in for-profit hospitals. Based on the hypothesis that arguments about the introduction of for-profit hospitals have considerably different viewpoints depending on the size of hospital represented by the number of bed, these two hospital types were compared again using the number of beds as a controlled factor, but the results were similar. We, therefore, could conclude that the for-profit hospitals in Florida included in this study could, in their for-profit operation, improve their financial performance by pursuing cost reduction and effectively utilizing their assets without limiting the amount and the range of their services or avoiding less medically protected groups such as Medicare and Medicaid patients.

• 보건행정학회지
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• 제10권3호
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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.

• 대한가정학회지
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• 제43권6호
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• pp.113-131
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• 2005

본 연구의 목적은 미국 노인층을 중심으로 자산 분배 계획(estate planning)의 한 형태인 유언장 작성 현황 및 유언장 준비에 영향을 미치는 요인들을 살펴보는 것이다. 이를 위하여 미시간 대학 Survey Research Cutter에서 조사하고 National Institute on Aging에서 지원한 1994년 미국 노인층의 자산과 건강역동성에 관한 조사(Assets and Health Dynamics Among the Oldest Old) Wave 1을 이용하였으며, 조사대상자는 70세 이상의 5,365 노인가구이다. 본 연구의 구체적인 목표는 (1) 유언장을 준비한 노인들의 profile을 작성하고, 유언장 준비 여부별 노인들의 financial portfolio에 어떤 차이가 있는지를 비교하고, (2) 유언장 작성과 관련된 여러 요인들을 조사하며, (3) 본 결과를 바탕으로 가정경제학자 및 가계 재무상담자에게 시사점을 제시하는 것이다. 주요 결과는 (1) 자산 분배 계획(유언장 준비, 증여, 종신보험 가입등) 정도는 노인층들에게서 조차 낮은 것으로 나타났다 (2) 나이가 많으며, 부유하고 교육수준이 높으며, 백인이고 건강한 노인들이 그렇지 않은 노인들보다 유언장 준비를 할 확률이 높았으며, (3) 이타심(altruism)의 proxy 변수인 자선봉사 활동 참여와 기부여부도 유언장 준비에 긍정적인 영향을 미치는 것으로 나타났으며, (4) 재무 advisor가 있고, 자녀수가 적은 노인들이 그렇지 않은 노인들에 비해 유언장을 준비할 가능성이 높았다. (5) 그리고, 종신보험에 가입했거나, 지난 10년간 자녀에게 증여를 한 노인들이 그렇지 않은 노인들에 비해 유언장을 준비할 확률이 낮게 나타났다. 조사 결과를 바탕으로 가계 재무 상담자 및 후속 연구 위한 제언들이 제시되었다.

• 보건행정학회지
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• 제16권2호
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• pp.117-134
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• 2006

Korean health care system introduced the reform for separation between prescribing and dispensing of drugs (SPD reform) in the latter part of the year 2000. The objective of this paper is to look at what change this reform has brought about in the financial situation of Korean public health insurance scheme, particularly in terms of insurance benefit outlay. Since the inception of the reform is a development of more than five years ago, its impact on the finance situation would now start to become apparent. Hypothesis is set in this study for each of three components of drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. In terms of the classification of health care services by mode of production, the impact of the SPD reform is confined mainly to the last two among three drug reimbursement fields including inpatient department, out-patient department and pharmacy. Pure impact of the SPD reform was estimated to be more or less than 1.7 trillion won, 13.1% of the total outlay of the Nation Health Insurance in 2001, and more than 2.0 trillion won, 14.9% of the total outlay of the Nation Health Insurance in 2003. Both dispensing fees for the pharmacists, which had been newly introduced on occasion of the SPD reform, and larger share of expensive drugs in the medicines prescribed by doctors were confirmed to be main drivers of the augmentation of drug reimbursement.

• 대한통합의학회지
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• 제7권4호
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• pp.223-230
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• 2019

Purpose : Wellness tourism is defined as travel for the purpose of promoting health and well-being through physical, psychological, or spiritual activities. The development and verification of a comprehensive wellness program for health care for workers is needed. The purpose of this study is to investigate the wellness and skin health effects of skin health programs in order to develop high-value health care services. Methods : The subjects were 15 middle-aged women who understood the research and volunteered and participated in the two-day skin health wellness program. Participants were measured to determine their wellness index and skin health twice: before and after participating in the program. Wellness index measures include comprehensive wellness, physical wellness, mental wellness, emotional wellness, social/cultural wellness, financial wellness, and environmental wellness. Skin health measurement items consisted of skin oil, skin water, skin pore, skin elasticity, skin wrinkle, and skin pigment. The skin wellness program included aerobic exercise, endurance exercise, functional food, cosmetics, herbal tea, massages, spa treatments, meditation, and marine leisure sports. The t-test analysis was used to compare the difference between wellness index and skin health measurement items before and after the program. Results : Among the wellness index items, the comprehensive wellness index (p<.05), mental wellness index (p<.05) and environmental wellness index (p<.05) showed statistically significant differences. Among skin health items, skin oil (p<.05), skin elasticity (p<.01) and skin wrinkle (p<.01) all showed statistically significant differences. There was no statistically significant difference in physical wellness, emotional wellness, social/cultural wellness, financial wellness, skin water, skin pore and skin pigment. Conclusion : This study confirmed that the two-day complex wellness program is an effective program for some items of wellness index and skin health.

• 보건행정학회지
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• 제33권1호
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• pp.55-64
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• 2023

Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.

• 보건행정학회지
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• 제12권2호
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• pp.43-75
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• 2002

This study focuses on the factors that make the financial structure of hospitals in Korea different, and on recommended courses of action that could be very helpful to hospitals in maintaining a sound financial structure. Data used in this study were collected from 132 hospitals with complete general data of present conditions as well as financial statements. They were chosen from the 174 hospitals that passed the standardization audit undertaken by the Korean Hospital Association from 1996 to 2000 for the purpose of accrediting training hospitals. The dependent variable in this study is financial structure. It consists of liabilities as against total assets (total liabilities to total assets, short-term liabilities to total assets, long-term liabilities to total assets, short-term borrowings to total assets, long-term borrowings to total assets). The independent variables are ownership type, hospital type, location, whether or not a representative is a director of the hospital, the possibility of changing a hospital director, bed size, period of establishment, asset structure, profitability, growth, tax shields, business risk, competition. The factors that appear to have the strongest impact on the liabilities to total assets of all the hospitals sampled are ownership type, hospital type, profitability, tax shields, and business risk. It was found that not-for-profit private hospitals and for-profit private hospitals have more liabilities than public hospitals, and tertiary medical institutions have less liabilities than the secondary general hospitals. Moreover, hospitals earning more at the expense of high business risk have a distinct tendency to lower liabilities. Concerning the current ratio, it was found that factors such as ownership type, hospital type, period of establishment, asset structure, and business risk are the more significant variables. The current ratio of public hospitals is higher than that of both not-for-profit private hospitals and for-profit private hospitals, and the current ratio of tertiary medical institutions is higher than that of general hospitals. As business risk is higher in hospitals compared to other businesses, the current ratio becomes higher; this is because it is assumed that for fear of bankruptcy, hospitals lessen liabilities to total assets. On the other hand, as hospitals become older, the fixed assets to total assets become lower. It is remarkable that in hospitals, the factors affecting liabilities to total assets have an opposite regression coefficient sign against factors affecting current ratio. It brings out the same results borne out by the old financial theories and researches, in which a lot of the liabilities of hospitals are considered as the cause of worsening liquidity. Therefore, it is very important for hospitals to maintain a sound financial structure in order to survive using the rational acquisition and maintenance of capital.

• Journal of Preventive Medicine and Public Health
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• 제25권4호
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• pp.399-412
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• 1992

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason fur the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium rate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.

• 간호행정학회지
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• 제19권5호
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• pp.565-577
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• 2013

Purpose: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act. Methods: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift. Results: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%. Conclusion: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.