• 보건행정학회지
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• 제4권1호
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• pp.138-175
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• 1994

The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

• 무역상무연구
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• 제60권
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• pp.195-209
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• 2013

South Korea, despite the financial turbulences has marked the trade volume of USD 1 trillion and marked $7^{th}$ largest exporter in 2013. Approximately 40% of the entire import of Korea was for export. In the South Korean trade structure, import and export are closely related, requiring proactive import financial assistance policies. Recognizing this, K-sure has made import insurance policy available on the market since July 2010. The K-sure insurance policy targets both financial institutions and importers. This is the reason why this research seeks to review the import insurance terms for importers and compare with foreign import insurance products to find out ways to improve. K-sure's import insurance for importers is to cover a loss of a policyholder when the policyholder or importer domestically addressed made a prepayment but cannot receive goods. The import insurance is applied to import transactions of goods or resources. K-sure's import insurance coverage needs to be expanded to intermediary trade and consignment processing trade, etc. In this sense, a more systematic educational program should be introduced about K-sure's import insurance.

• 보건행정학회지
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• 제29권2호
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• pp.195-205
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• 2019

Background: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. Methods: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. Results: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). Conclusion: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.

• 보건행정학회지
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• 제23권2호
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• 한국사회정책
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• 제24권2호
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• pp.31-60
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• 2017

이 논문은 독일에서 진행 중인 사회보험 개혁론의 배경과 쟁점을 드러내고 시사점을 제시한다. 사회보험 개혁론의 배경에는 사회보험이 근간으로 삼았던 산업사회 표준성의 위기가 자리 잡고 있다. 표준성의 위기는 재정과 이중화라는 이중적 위기로 표출되고 있다. 사회보험 개혁론은 개별 사회보험 영역에서 서로 다른 형태로 표출되는 표준성의 위기에 대한 대응으로서, 건강보험은 시민보험으로, 연금보험은 취업자 보험을 비롯한 다양한 대안적 제도로, 실업보험은 일자리 보험으로 재편을 모색하고 있다. 사회보험이 전통적으로 가정했던 표준성을 재구성하려는 사회보험 개혁론의 공통점 중 하나는 자신의 선조인 비스마르크로부터 벗어나려는 것이다. 그러나 경제 상황의 호전, 사회보험 개선의 역사적 경험, 높은 만족도 등으로 전통적인 사회보험에서 급진적으로 전환하기 보다는 점진적 개선으로 가닥을 잡을 것으로 전망된다. 사회보험의 성숙도가 낮은 한국의 경우 독일 사회보험이 직면한 위기를 반면교사로 새길 필요가 있다. 우리는 사회정책의 기본으로 돌아가 표준성과 보편성의 재구성이라는 관점에서 다양한 구상들을 열어 놓고 사회정책의 설계도를 다시 그려볼 필요가 있다.

• 보건행정학회지
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• 제27권2호
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• pp.103-113
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• 2017

There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

• 대한예방한의학회지
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• 제23권1호
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• pp.1-13
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• 2019

Backgrounds : The market of Complementary Alternative Medicine(CAM) in the United State(U.S.) accounts for a large proportion of the global CAM market and has a high growth rate. The recent introduction of Obama Care has brought the change in the health insurance system for CAM, and we need to analyze it for its implication to Korean system. Objectives : The purpose of this study is to investigate the current status of acupuncture and chiropractic health insurance in the U.S., and to draw implications for expanding the health insurance coverage for Korean traditional medicine through the comparison between the U.S. and Korean health insurance systems. Methods : We examined the data through the literature search and from the websites of both U.S. government departments and related organizations for the health insurance policy. Based on the collected data, we analyzed its CAM health insurance system in Korea. Results : The acupuncture covered by public health insurance in the U.S. has a limit in the number of treatments and a range of applied diseases compared with Korea. In addition, the practice of acupuncture is not subdivided. However, the chiropractic in the U.S. which also has a limited number of coverage and only three categories of practices are similar to that of Korea. Conclusions : Although the use of CAM by public health insurance is not active in the U.S., but the organizations such as Veterans Health Administration in Vermont is already discussing the use of acupuncture to solve the problem of opioid overuse. Thus Korea also needs to discuss to promote the expansion of the insurance system for CAM.

• 한국콘텐츠학회논문지
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• 제21권4호
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• pp.96-110
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• 2021

우리나라는 세계에서 가장 빠른 속도의 저출산·고령화와 저성장·저금리의 시대에 적응해야 하는 직면해 처해 있다. 저출산, 고령화로 인하여 건강보험 재정수입 요인은 감소하고 있으며, 국민의 건강에 관한 관심, 고비용 의료기술 및 의약품의 개발은 건강보험 재정 지출은 증가하게 있다. 본 연구에서는 건강보험의 보장성 강화와 재정의 안정화, 의료의 형평성에 대하여 검토해보고자 한다. 첫째, 국내의 정책보고서, 국내외 문헌, 선행연구를 통해 건강보험의 현황과 한계를 파악하였다, 둘째, 외국의 건강보험정책인 재정 안정화 대책에 대하여 구분하여 검토하였다. 이 연구를 근거로 건강보험의 보장성 강화와 재정 안정화를 통하여 지속 가능한 건강보험을 유지하기 위해서는 현재 건강보험의 재정수입 구조를 혁신하여야 할 것이다. 또한, 정부지원금의 확대, 새로운 조세 수입을 발굴하여야 할 것이다. 진료비 지불제도, 의료전달체계를 개편하여 재정을 절감하는 정책도 필요할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.150-154
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• 2007

Objectives : The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. Results : Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of \65,311 and an average benefit amount of \19million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. Conclusions : About half of Korean people have supple-mentary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.

• Communications for Statistical Applications and Methods
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• 제17권5호
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• pp.697-712
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• 2010

이 연구의 목적은 우리나라 생명보험사들의 보험계약대출(약관대출) 수요에 대한 통계적 분석과 그 예측을 위한 확률모형을 개발하는 데 있다. 이를 위해, 먼저 대출 금리가 정책적 변화를 거친 1999~2008 기간 동안 우리나라 보험계약대출의 수요계열에 대한 추세, 주기성, 종속성 등 확률 및 통계적 특성을 파악하였다. 다음에, 교차상관분석을 통해 대출수요와 인과관계를 가질 수 있는 경제변수들과의 상호관련성을 밝히고, 특히 소비자 물가지수가 보험계약대출 수요를 선도하고 있음을 밝혔다. 마지막으로, 이러한 결과를 기초로 보험계약대출 수요의 예측을 위한 단변수모형 그리고 선도변수계열을 이용한 전이함수모형을 각각 완성하고 그 효과를 비교 평가하였다. 마지막으로 유도된 확률모형을 이용하여 보험계약대출 수요예측의 통계적 절차를 제안하였다.