• Health Policy and Management
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• v.33 no.3
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• pp.295-310
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• 2023

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

• Korean Journal of Social Welfare
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• v.62 no.2
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• pp.279-306
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• 2010

This study is to compare and analyze the policy decision process between Korea Long-term Care Insurance and Japan's using policy network theory as an analysis tool, and to lead political and theoretical implications. The result of the study is summarized as follows. First, a policy agenda about Long-term Care problem for the Elderly set up by the government-leading both Korea and Japan. and the number of policy participation(actors) increased to characteristics of policy process stage. but there is a difference between Korea and Japan in a background of setting up policy agenda about Long-term Care problem. Second, interaction among policy actors is corporative from early policy agenda establishment stage in Korea and Japan. but it changes to dissenting or critical rapidly as being announced the frame of system to the people. Also, it shows that main policy actors play a role in policy making decision and the connection structures of network is similar to both countries although it has a difference in the interaction frequency. Fourth, although the number of policy actors and the extent of their opinion reflection to the policy effect are different, it shows that policy network pattern is very similar to from policy agenda setting stage to parliament(The National Assemble) policy decision stage as a result of government-leading policy process. The theoretical and political implications of this study are as follows. The number and the variety of policy participation, the importance of establishing opened-interaction system, lots of limitation of policy making-decision process of Japan Long-term Care system, and exclusively the government-leading network has demerits about the reflection of too much government's opinion to the policy outcomes.

• International Commerce and Information Review
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• v.10 no.4
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• pp.495-512
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• 2008

Because Korea and Japan has joined WTO and OECD, it is impossible to carry out a direct export-promoted policy such as export subsidies. Therefore, the only policy which is internationally valid for promoting an export is the export insurance. Hence export insurance system became more useful tool since it's one of the few allowed subsidies under WTO. This paper examines to find the impacts of export insurance on the export supply in Korea and Japan. The period of data is from 1980 to 2006. Unlike previous studies on the effectiveness of export subsidy in export supply, the current study examines the stationarity nature of the concerned variables. The unit root tests show that all variables are not I(0) Time Series. Instead, they are I(1) Time Series. To this, cointegration verification was conducted based on the use of Johansen verification method to define the existence (or non-existence) of long-term balance relationship among variables. The concerned variables are revealed to be cointegrated. In order to analyze, this study introduce a VEC model. In this paper we construct two VEC models. The one is about Korea, the other is about Japan. The empirical evidences show that export insurance system has not contributed to promoting export supply in Japan. But the results of empirical analysis showed significant and positive effects of Korea export insurance upon the export supply.

• Health Policy and Management
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• v.8 no.2
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• pp.76-87
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• 1998

This study analyzed the effect of foreign currency exchange rate on the increasing rate of medical care cost by items of fee schedule of Korean Medical Insurance. This study uses the data of cost analysis including cost of imported goods and the data of for a university hospital National Federation's Medical Insurance for a trend of claim. The method of cost analysis is as same as that used in the study of the development of Korean RBRVS(Resource Based Relative Valus Scale). The main findings of this study are as follows; 1. The proportion of imported goods in cost related to Medical Insurance fee schedule is 7.93%, and in case of substitution of available domestic goods 6.96%. 2. If foreign currency exchange rate changes from 800wen per $1 to 1,300won, the affecting rate of Medical Insurance fee schedules is 5.00%. If the imported goods will be substituted with available domestic goods, the rate 4.35%. Our results can be used a data for updating Medical Insurance fee schedule. But this result is limited to be generalized, because this study used the cost analysis for a university hospital.

• Health Policy and Management
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• v.20 no.3
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• pp.104-122
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• 2010

Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.

• Research in Community and Public Health Nursing
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• v.23 no.4
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• pp.415-426
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• 2012

Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

• Korean Journal of Social Welfare
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• v.45
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• pp.72-100
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• 2001

Despite the rapid expansion of social security coverage in the 1990s, many wage earners in Korea, especially the majority of the nonstandard workforce are excluded in the social insurance programs. In this regards, the purpose of this paper is to analyze causes of the exclusion of nonstandard workers to the social insurance scheme and to suggest the feasible policy options. Through this paper, four arguments are addressed as follows. First, the main issue for exclusion from coverage of those workers is that they have no entitlement to social insurance. This is not an issue of that they fall below hours or income thresholds for the entitlement Second, the top-down process of the extension in the Korean social insurances have divided the wage earners into two groups, the insider (the included) and the outsider (the excluded). Many nonstandard workers belong to the latter category. Third, the social insurance systems have been designed for the regular workers who were characterized by a full-time with some degree of stability. Reform designed to cope with the growth of nonstandard workers must build on the existing structure of social insurance. Finally, the governance capacity by social security administration body must be improved in order to provide a basic social protection for those workers. For that, four separated social insurance administration bodies could be unified to one administrative body, or tax and contribution of social insurance could be collected by one integrated administration body, the National Tax Service.

• Health Policy and Management
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• v.32 no.3
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• pp.258-271
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• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• The Journal of Information Technology
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• v.8 no.2
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• pp.27-42
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• 2005

The S.G. Policy form contains the words "the good ship or vessel called the.....". The words "good ship" mean that the ship is deemed to be seaworthy at the commencement of the voyage and this was very necessary in the day when a separate policy was issued for each voyage. In fact the warranty do seaworthiness still applies to all voyage policies. Nevertheless, the law does not apply an absolute warranty of seaworthiness to a time policy, so a ship is not required to be seaworthy at the time the hull policy is effected. The implied warranty of seaworthiness does not extend to good, for the underwriter is not responsible for their condition, apart fro the action of the perils insured against. The implied warranty of seaworthiness is limited to the vessel herself, and does not extend to a lighter or other craft used to convey the goods to the ship. The underwriters waive any breach of the implied warranties of the seaworthiness of the ship and fitness of the ship to carry the subject-matter insured to destination, unless the assured or their servants are privy to such unseaworthiness of unfitness.

• The Journal of the Convergence on Culture Technology
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• v.10 no.3
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• pp.667-673
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• 2024

This study aims to diagnose the issues arising from the relationship between the out-of-pocket maximum in health insurance and private indemnity health insurance and propose policy tasks for institutional improvement. Through literature research, the study analyzed the damage to consumers caused by the non-payment of refunds exceeding the out-of-pocket maximum and the changing role of indemnity insurance due to the strengthening of health insurance coverage. The results confirmed that unilateral interpretation of insurance clauses and incomplete sales practices infringe upon consumer rights, and that insurance premiums do not decrease despite the reduction in coverage of indemnity insurance. Therefore, the study emphasized the urgency of institutional improvements such as rationalization of product structure, transparency of risk rate calculation, and reinforcement of consumer information provision, as well as the need for social consensus on the rational division of roles between health insurance and private insurance. This study is significant in that it provides policy implications for the developmental reorganization of the healthcare system.