• 제목/요약/키워드: insurance policy

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A Study on the Application of Survival Analysis to Terminated Life Insurance Polices

  • Kang, Jung-Chul
    • Journal of the Korean Data and Information Science Society
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    • 제16권2호
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    • pp.237-253
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    • 2005
  • In Korea, the volume of insurance industry has been increased rapidly with helping the economic growth, the increment of GNP and derive of public welfare policy. But the other side of the volume increment, the life insurers have some problems, such as the high rate of turnover, lapses and surrenders, in processing of acquiring more insurance contracts. The object of this paper is the analysis of the causes and properties of the high rate of turnover, lapses and surrenders using statistical survival model. Also we hope that the insurers will use the results of analysis to reduce the rates.

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치석제거 건강보험 급여화에 관한 일부 지역 치과의료소비자의 인식 및 태도 (Awareness and attitude toward health insurance coverage extension to scaling in dental service consumers)

  • 천혜원
    • 한국치위생학회지
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    • 제16권4호
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    • pp.539-548
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    • 2016
  • Objectives: The purpose of the study is to investigate the awareness and attitude toward health insurance coverage extension to scaling in dental service consumers. Methods: A self-reported questionnaire was completed by 349 adults in Jeonbuk from May 4 to 15, 2015. The questionnaire consisted of general characteristics of the subjects (7 items), Awareness of the dental health insurance system(8 items), Health insurance system coverage extension to scaling(8 items), Self-perception of oral health(7 items), Recognition toward yearly scaling benefit(10 items). Results: There were significant differences according to age in opinions on the appropriateness of the frequency of yearly scaling benefit, and the respondents who were in their 20s, who were unmarried and who brushed their teeth three times a day had significantly different opinions on the appropriateness of the fee of yearly scaling benefit. Their opinions on the expansion of scaling benefit was significantly affected by age. It implies that scaling should be added to the coverage list of the national health insurance in every age group since there is an increase in periodontal diseases with age. Concerning awareness of dental health insurance policy, the better-educated respondents took a better view of this system as they showed a more positive interest in its policies and shifts. Conclusions: It is desirable to provide more precise information as to eligible age, frequency and cost through public promotion of health coverage of scaling, and the effort to improve the health insurance coverage policy should be made in order to extend the scope of health coverage of scaling in the near future.

국민건강보험공단 표본코호트 DB를 이용한 스케일링 보험급여화 전후 실태조사 (Evaluation of national health insurance coverage of periodontal scaling: A nationwide cohort study in Korea)

  • 김영택;이재홍;권혜인;이중석;최정규;김동욱;최성호
    • 대한치과의사협회지
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    • 제54권8호
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    • pp.604-612
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    • 2016
  • The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.

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의료보험 실시가 입원환자의 진료내용에 미치는 영향 -한 병원의 정상분만산모와 충수절제술환자를 통한 사례연구- (The Influences of Health Insurance on the Contents of Medical Services for Selected Hospitalized Patients)

  • 박태진;문옥륜
    • 보건행정학회지
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    • 제3권2호
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    • pp.130-158
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    • 1993
  • This study was written to discover the changes that may exist in the contents of medical services after introduction of health insurance system, and to identify the net-effect of health insurance system on medical services. Uncomplicated nornmal delivery and appendectomy patients were divided into 4 groups, the non-insured in pre-NHI periods(group A), the insured of health insurance for employees in pre-NHI periods(group B), the insured of regional health insurance for city residents in post-NHI periods(group C) and the insured of health insurance for employees in post-NHI periods(group D). The mehtod of matching was applied to control for major demographic differences among these 4 groups of each disease. In pre-NHI period, the medical services and the variation of medical services of the non-insured were compared with those of the insured. The difference between the change of medical services from group A to those of group C, and the change of medical services from group B to those group D is defined as the net-effect of health insurance. The results are as follows. First, in length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients, frequency of sitz bath in delivery patients, there was net-effect of health insurance in increasing direction. Second, length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients and frequency of sitz bath in delivery patients were significantly more in the insured than in the non-insured group in pre-NHI period. Third, the variation of medical services of post-NHI period was not less then those of pre-NHI period. Fourth, antenatal care on which the third party does not pay and the patient pays for all, was diffrerent by socioeconomic and educational level of patients.

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농촌의료보험의 당면과제와 개선방향 (Reforming the Rural Health Insurance Programs in Korea)

  • 문옥륜
    • 농촌의학ㆍ지역보건
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    • 제16권2호
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    • pp.179-194
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    • 1991
  • Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

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공간효과분석을 이용한 건강보험 환자 관외 의료이용도와 관련된 요소분석 (Analysis on Factors Relating to External Medical Service Use of Health Insurance Patients Using Spatial Regression Analysis)

  • 노윤호
    • 보건행정학회지
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    • 제23권4호
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    • pp.387-396
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    • 2013
  • Background: The purpose of this study was to analyze the association between areas of Korea Train Express (KTX) region and external medical service use in Korean society using spatial statistical model. Methods: The data which was used in this study was extracted from 2011 regional health care utilization statistics and health insurance key statistics from National Health Insurance Corporation. A total spatial units of 229 districts (si-gun-gu) were included in this study and spatial area was all parts of the country excepted Jeju, Ulleungdo island. We conducted Kruskal-Wallis test, correlation, Moran's I and hot-spot analysis. And after, ordinary linear regression, spatial lag, spatial error analysis was performed in order to find factors which were associated with external medical service use. The data was processed by SAS ver. 9.1 and Geoda095i (windows). Results: Moran's I of health insurance patients' external medical service use was 0.644. Also, population density, Seoul region, doctor factors positively associated with health insurance patients' external medical service. In contrast, average age, health care organization per 100 thousand were negatively associated with health insurance patients' external medical service use. Conclusion: The finding of this study suggested that health insurance patient's external medical service use correlated for seoul region in korea. The study results imply the need for more attention medical needs in the region (si-gun-gu unit) for health insurance patients of seoul region. It is important to adapt strategy to activation of primary health care as well as enhancing public health institution for prevent leakage of patients to other areas.

보험진단제도의 효율적 운영에 대한 연구 (A study on the effective administration of medical risk selection system for life insurance)

  • 함동운;전진만;심숙경
    • 보험의학회지
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    • 제27권2호
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    • pp.85-95
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    • 2008
  • When an insurance company receives an application for life or health insurance, the company must evaluate the degree of risk the individual for insurance coverage presents before the company agrees to issue the policy. A medical factor is a physical or psychological characteristic that may increases a hazard. A financial factor is financial information that is taken into account by underwriter to determine if a person is applying for more than he/she reasonably needs or can afford. A personal factor is a lifestyle choice. There are several medical risk selection systems in Korean life insurance market. They are attending physician's statement, direct examination by insurance doctors, and paramedic examination. However there is some dissatisfaction of current system. It is possible that cooperation of part-time insurance doctors system may be one of useful system of medical risk selection. Improvement of medical risk selection system will be an important matter of profitability of insurance company and it will contribute to sound life insurance system.

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영국 해상보험법상 피보험자의 고지의무에 관하여 (What is the Duty to Disclose a Material Circumstances by the Assured, M.I.A., 1906)

  • 박용섭
    • 한국항해학회지
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    • 제7권1호
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    • pp.83-103
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    • 1983
  • The duty of disclosure it is a preliminary requirement to effect marine insurance contract between the assured and the underwriter. The contract of Marine Insurance is called a uberrimae fidei contract, the assured, therefore, in the law of marine insurance, shall communicate a material circumstances to the latter before the policy to be effected. As growing the maritime industries in Korea, there is forming a larger marine insurance market, accordingly, and having a wide relation with the practice of the marine insurance in England. It means that the most of the legal theories of the marine insurance would be adopted by the English Marine Insurance Case Law and M.I.A., 1906. From the viewpoint of the said this author has tried out to study what is the duty of disclosure of the marine insurance based upon the English Marine Case Law.

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The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform

  • Emmanuel Otieno;Josephine Namyalo
    • Journal of Preventive Medicine and Public Health
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    • 제57권1호
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    • pp.91-94
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    • 2024
  • For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda's health sector.