• Title/Summary/Keyword: insurance policy

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Process Evaluation for Reliability Insurance: An Industrial Case Study

  • Hong, Yeon-Woong
    • Journal of the Korean Data and Information Science Society
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    • v.16 no.2
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    • pp.401-410
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    • 2005
  • In this paper, we calculate the premium rate of reliability insurance policy for brake pads for automobiles using real failure data obtained from use-condition. We try process capability analysis for the manufacturing process of brake-system. We describe the performance factors which have an effect on failure characteristics of brake pads. We also obtain the maximum likelihood estimates of shape and scale parameters of the fitted Weibull distribution for brake pads.

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Reliability Insurance Rate-Making for Wiper Motors

  • Hong, Yeon-Woong;Kwon, Yong-Man
    • Journal of the Korean Data and Information Science Society
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    • v.15 no.1
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    • pp.49-57
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    • 2004
  • In this paper, we calculate the premium rate of reliability insurance policy for wiper motors under the assumption of Weibull physics of failure. We also describe the performance factors which have an effect on failure characteristics of wiper motors. The maximum likelihood estimates of shape parameter and scale parameter are obtained by using interval censored real data of sample sizes 6 using MINITAB.

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What Can Koreans Learn from the Dutch Experiences in Reforming the Health Insurance System? (한국의료보험제도(韓國醫療保險制度)의 개혁필요성(改革必要性)과 네덜란드의 경험(經驗)이 주는 교훈(敎訓))

  • Kwon, Soon-won;Sunwoo, Duk
    • KDI Journal of Economic Policy
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    • v.12 no.3
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    • pp.47-69
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    • 1990
  • The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.

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Suggestions for Redirection of Korean Price Policy for Reimbursement Drug in Health Insurance (선진국의 약가정책 고찰을 통한 건강보험 약가제도의 개선방안)

  • Lee, Kyu-Sik;Jeong, Hyoung-Sun
    • Korea Journal of Hospital Management
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    • v.8 no.1
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    • pp.1-23
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    • 2003
  • General drug prices involve three stages: shipment stage, wholesaler stage and retail stage. Policies on drug price differ from country to country. Shipment stage prices are tightly regulated in countries like France and Netherlands. They are free in only a minority of advanced countries, even if these include some major players such as the US, Germany and, in a very limited sense, Japan. The situation in the UK is very complex with a semi-free system, where drug companies are free to set their own prices but cannot exceed a predetermined profit ceiling. Mark-up at both wholesaler and retail stages is formally admitted in most countries observed. Apart from the general drug prices, reimbursement price of insured drugs has been major policy concerns. Most countries reviewed in this study has exerted some control over reimbursement prices, but differ both in the way how and in the extent to which prices are admitted or fixed. Price fixing has been used in France and Japan. Some countries have transformed their system over time, particularly to move to reference pricing in the last decade. This mechanism has empowered the customer, and improved price competition on the market. Referring to the drug price policies in the advanced countries, this study makes some suggestions for the redirection of Korean price policy for reimbursement drug in health insurance as follows: to match appropriate policy tools to each policy goal; to maximize market mechanism through effective reimbursement price fixing which admits mark-ups in wholesaler and retail prices; to introduce reference pricing system in order to redirect patient's demand with a financial incentive to choose the best-priced drugs and to save the finance of health insurance; and to strengthen surveillance and monitoring mechanism in the drug market.

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The Effects of Changed Selective Treatment System on Medical Service Usage and Payments for Lung Cancer Patients (선택진료제도 개선이 폐암환자 의료이용 및 본인부담액에 미치는 영향)

  • Jeon, Insook;Lee, Haejong
    • Korea Journal of Hospital Management
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    • v.22 no.4
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    • pp.61-73
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    • 2017
  • In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.

The First Comprehensive Plan of National Health Insurance (제1차 국민건강보험 종합계획)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.2
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    • pp.99-104
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    • 2019
  • On May 1, 2019, the Minister of Health and Welfare announced publicly the first Comprehensive Plan of National Health Insurance (NHI). The Comprehensive Plan which is the 5-year plan including expenditure and revenue aspect of NHI, is desirable in 42 years of introduction of NHI and 30 years of universal coverage of NHI, though the Plan was late and had some conflict process. The Comprehensive Plan was established without evaluation of Moon's Care Plan, did not included to relationship with NHI and other health security systems, and did not have the blue print of NHI. The Plan was not sufficient in content of adequate health care utilization and relationship with service benefit and cash benefit. The Comprehensive Plan should be modified in considering the blue print of NHI and national healthcare system with participating stakeholder in turbulent environment-low fertility, rapid ageing, low economic growth rate, era of non-communicable diseases, unification of the Korean Peninsula, and 4th industrial revolution. Therefore, I suggest to establish the President's Committee of Improving Healthcare System for the blue print of health care and NHI.

An Empirical Study on the Determinants of Trust for the Insurance Industry : a case of China (보험소비자의 보험업 신뢰 결정요인 : 중국 사례 연구)

  • Nam, Sang-Wook
    • Journal of Digital Convergence
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    • v.12 no.2
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    • pp.211-221
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    • 2014
  • The study aims to estimate the determinants of policyholder's trust for the Chinese insurance industry by structural equation model. In particular, differences in determinants of trust among Chinese life insurance and auto insurance were derived from the latent mean and multi group analysis. The result shows the most effective determinants of trust were honesty, followed by credibility which shows the compensation ability of insurance company. However, benevolence is not influence statistically on the determinants of trust of both life insurance and auto insurance. Moreover, the policyholder's trust for the insurance industry was later extended to relationship commitment such as renewal and recommendation intentions. Especially, the linkage between the level of trust and relationship commitment was the strongest in life insurance than auto insurance. Even though the result is differ based on types of insurance, in order for the insurance industry to grow stably it is importance to get trust from policyholder.

Introduce and Promote the Home-based Hospice and Palliative Care (가정호스피스·완화의료 제도 도입을 위한 국민 인식도 조사)

  • Choi, Jung-Kyu;Tae, Yoon-Hee;Choi, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.18 no.3
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    • pp.219-226
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    • 2015
  • Purpose: This study was conducted to understand public perception of home-based hospice and identify related factors. Methods: Between August 19, 2014 and August 30, 2014, data were collected using an E-mail questionnaire that was filled by 1,500 adults who were over 20 years of age. Data were analyzed using descriptive statistics, ${\chi}^2$-test and logistic regression. Results: Among the respondents, 15.9% were aware of home-based hospice care, and 61.3% were willing to receive home-based hospice care. The factors that influenced the participants' willingness to use home-based hospice services included residential district, religion and private health insurance. Respondents who lived in Seoul (OR: 1.56, 95% CI: 1.04~2.33), Gwangju/Jeolla province (OR: 2.02, 95% CI: 1.23~3.32), Busan/Ulsan/South Gyeongsang province (OR: 1.81, 95% CI: 1.17~2.82) were more well-aware of home-based hospice care than those who lived in Incheon/Gyeonggi province. The faithful were more informed about the services than those without non-faithful participants (Roman Catholics (OR: 2.03, 95% CI: 1.30~3.17), Protestants (OR: 1.76, 95% CI: 1.22~2.53). Participants who had a private health insurance plan knew more about the services than those without one (OR: 1.45, 95% CI: 1.03~2.04). Conclusion: First, it is necessary to improve perception of the public and healthcare providers regarding home-based hospice care. The government should review a measure to institutionalize operation of a palliative care team at hospitals and community home-based hospice care centers.

2018 Current Health Expenditures and National Health Accounts in Korea (2018년 경상의료비 및 국민보건계정)

  • Jeong, Hyoung-Sun;Shin, Jeong-Woo;Moon, Sung-Woong;Choi, Ji-Sook;Kim, Heenyun
    • Health Policy and Management
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    • v.29 no.2
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    • pp.206-219
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    • 2019
  • This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

A Study of Determinants on Institutionalization of Elderly using Home Care Services (노인장기요양보험 재가서비스 이용자의 시설서비스 이용 결정요인)

  • Han, Eun-Jeong;Kang, Im-Ok;Kwo, Jinhee
    • 한국노년학
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    • v.31 no.2
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    • pp.259-276
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    • 2011
  • If frail elderly could use home care services adequately, quality of their life might improve and their costs of service would be decreased. The purpose of this study is to examine the factors on institutionalization of elderly using home care services in Korean long-term care insurance system. This study used the data of '2009 satisfaction survey of Korean long-term care system'. The survey proceeded using sampling data by region, level of long-term care need, and insurance type among beneficiaries from August 2009 to September 2010. The onset dates of institutionalization of 1,230 participants were ascertained from long-term care insurance claim data. This study calculated hazard ratio through Cox Proportional Hazard Model. The results showed that if elderly using home care services suffer a fracture, the hazard ratio of institutionalization is higher significantly. Although not significant, if older persons have more items of damaged cognitive functions, the hazard ratio of institutionalization is higher. The results have policy implications to supplement of home care service system and postpone institutionalization of elderly.