• Title/Summary/Keyword: national health insurance data

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The Effect on Health Care Utilization of the Non-Use of Beneficiaries of Long-Term Care Insurance Service - around of Geriatric Hospital's Medical Cost - (장기요양 서비스 이용자와 미이용자의 의료비 지출 차이 및 의료비 지출에 미치는 영향 - 요양병원 의료비 지출을 중심으로 -)

  • Jung, Woon-Sool;Yim, Eun-Shil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7463-7473
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    • 2015
  • This study aims to analyze the effect of long-term care utilization on health care utilization of the national health insurance elderly. This study is a secondary data analysis of the long-term care insurance data that comprised of total 21,213 long-term care insurance with the level 1 elders who received either service or non-service. This study evaluated the impact of long-term care service on the probability of health care utilization experience and costs of health care utilization. The total medical cost, geriatric hospital's medical cost, inpatient day and geriatric hospital's inpatient day by 2007-2009 were significant factor influencing the long-term care utilization. This study suggests long term care system should proper medical service linkage system. The current long-term care insurance system should more resource allocation on long-term care utilization to increase the efficiency of insurance system.

Factors of Influencing the Benefit Amount according to the National Health Insurance Coverage in Pit and Fissure Sealants (치면열구전색 급여화에 따른 수혜량에 영향을 미치는 요인)

  • Ahn, Eun-Suk;Hwang, Ji-Min
    • Journal of dental hygiene science
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    • v.15 no.6
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    • pp.768-774
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    • 2015
  • The purpose of this study was to grasp the benefits from pit and fissure sealants and to analyze the factors of influencing the benefit amount by using the raw data of the Korea National Health and Nutrition Examination Survey for 2007~2013 targeting the subjects aged from 6 years in full to 18 years. The analysis was used STATA 11.0. As a result of the analysis, the following conclusions were obtained. It rose up to 1.24 pieces after carrying out the national health insurance coverage from averagely 0.93 piece until the year in 2007~2009 (up to November) when is before enforcing the national health insurance coverage in the pit and fissure sealants. The benefits from pit and fissure sealants depending on general characteristics were surveyed to be higher in the higher income level, in the more subscription to health insurance and private insurance, and in the more toothbrushing frequency per day. The factors that have influence upon the benefits from pit and fissure sealants were shown to include whether or not to have the national health insurance coverage in the pit and fissure sealants, income level, health insurance type and private insurance subscription appearance, and one-day toothbrushing frequency. Synthesizing the results, a rise in the benefits from pit and fissure sealants is shown in 2010 based on December 2009 when the national health insurance coverage in the pit and fissure sealants was implemented, but is showing the tendency of declining again from 2011. To increase the benefits from pit and fissure sealants, it is thought that the schemes will need to be discussed such as reinforcing publicity on the national health insurance coverage in the pit and fissure sealants, expanding a support for low-income bracket, and differentiating the outpatient cost sharing according to socio-economic level.

The Effect of Public Report on Antibiotics Prescribing Rate (급성상기도감염 항생제 처방률 공개 효과 분석)

  • Kim, Su-Kyeong;Kim, Hee-Eun;Back, Mi-Sook;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.242-247
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    • 2010
  • Controlling inappropriate antibiotics prescribing for acute upper respiratory infections(URI) is a very important for prudent use of antibiotics and resistance control. Health Insurance Review and Assessment Service (HIRA) introduced Prescribing Evaluation Program and publicly reported antibiotics prescribing rate for URI of each health institution. We performed segmented regression analysis of interrupted time series to estimate the effect of public report on antibiotics prescribing rate using national health insurance claims data. The results indicate that just before the public report period, clinics' monthly antibiotics prescribing rate for URI was 66.7%. Right after the public report, the estimated antibiotics prescribing rate dropped abruptly by 12.3%p. There was no significant changes in month-to-month trend in the prescribing rate before and after the intervention.

Hospital's Internal Review Procedure of Health Insurance Reimbursement (병원의 진료비 청구 자체심사 과정과 이의신청 사례)

  • Choi, Gil-Lim;Kim, Won-Joong
    • Korea Journal of Hospital Management
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    • v.7 no.3
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    • pp.121-136
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    • 2002
  • The main purpose of this study is to examine the overall procedure of hospital's internal review of health insurance reimbursement, to present the case of protest against reimbursement cut, and hence to provide some information on hospital's management of medical revenue. The object of the case study is 'P' university medical center, possessing 5 different hospitals under its system. Presentation of the case of protest against reimbursement cut has following meanings: Firstly, to the hospitals that already have internal review departments, information on the details of the protest process and results can be exchanged. Secondly, to the Government and National Health Insurance Corporation, useful data are provided for the improvement of the rules and procedures of health insurance reimbursement. Thirdly, to the hospitals without internal review departments, fundamental materials on the internal review process are provided for the effective management of medical revenue.

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Longitudinal Study on the Equity of National Health Insurance Contribution of the self-employed (건강보험 지역가입자의 보험료 부담 형평성 종단분석)

  • Rhee, Okjin;Moon, Yongpil;Park, Hyunshik
    • Korean Journal of Social Welfare Studies
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    • v.47 no.4
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    • pp.309-332
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    • 2016
  • This research attempts to calculate the vertical equity of National Health Insurance Contribution of locally provided policy holders by abilities to pay. Also, this longitudinal study examined the influence of abilities to pay and demographic characteristics on the health insurance premium. Using data from the Korea Welfare Panel Study, this study followed the self-employed households who continued to participate in the survey from 2011 to 2015. Kakwani's index of progressivity was measured as a measure of vertical equity and panel regression analysis was conducted by STATA program. The results of this research are as follows. First, from 2011 to 2015, the values of kakwani's index were negative according to composite income, which meant some levels of regressiveness of contribution. Secondly, panel regression analysis showed that the lowest household of composite income had a significantly negative effect on premiums, which also meant regressiveness. Based on the results, the author suggested political discussions on reorganizing the system of imposing the National Health Insurance contribution.

Factors Affecting the Participation Rate in the Health Screening Program of Medical Insurance (의료보험 성인병 건강검진율의 결정요인)

  • Youn, Sung-Tae;Jee, Sun-Ha;Suh, Il;Ohrr, Hee-Choul;Kim, Han-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.2
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    • pp.150-156
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    • 2000
  • Objective : To analyze the factors affecting the participation rate in the health screening program of medical insurance. Method : We investigated the factors associated with the participation rate in the health screening program in Korea. Data were collected at the aggregate level from 145 employee health insurance societies and 227 self-employed health insurance societies from 1995 to 1997 Data were also collected at the individual level from four health insurance societies. This study hypothesized that the participation rate of the health screening program was related to 1) the characteristics of its members and the size of the health insurance society; 2) the specifications of the health screening program; 3) the venue of the health screening institution and the interests of individuals in the health screening program; and 4) the activities of the health insurance society. We used bivariate and multiple regression models to examine the factors on the participation rate of the health screening program. Results : First, in the case of dependents of on employee health insurance society, the ratio of dependents 40 years old and over, the average monthly contribution per household, the interest and satisfaction level of individuals in health screening, and the level of refunds for over-payment were all associated with the participation rate in the health screening program, accounting for 54.4% of the participation rate. Second, in case of those insured by the self-employed health insurance society, the interest and satisfaction level of individuals in health screening, the level of refunds for over-payment, and the performance level of on-the-spot health screening were statistically significant, accounting for 40.1% of the participation rate. Conclusion : The factors concerning the participation rate in the health screening program of medical insurance, in both a health insurance society and for individuals, were closely related to the age and gender of individuals and household contributions.

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Current Epidemiological Data on Asthma Management in South Korea from Qualitative Assessment of Asthma Management by Health Insurance Review and Assessment Service (HIRA)

  • Kim, So Ri;Lee, Yong Chul;Sung, Myung Ju;Bae, Hye Won
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.221-225
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    • 2017
  • Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.

The exponentiated extreme value distribution

  • Cho, Young-Seuk;Kang, Suk-Bok;Han, Jun-Tae
    • Journal of the Korean Data and Information Science Society
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    • v.20 no.4
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    • pp.719-731
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    • 2009
  • This paper deals with properties of the exponentiated extreme value distribution. We derive the approximate maximum likelihood estimators of the scale parameter and location parameter of the exponentiated extreme value distribution based on multiply Type-II censored samples. We compare the proposed estimators in the sense of the mean squared error for various censored samples.

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An Analysis of Factors Affecting Financial and Operating Efficiency at Regional Public Hospital (지방의료원의 재정 및 운영효율성에 영향을 미치는 요인)

  • Jin Won Noh;Hui Won Jeon;Jung Hoe Kim;Jeong Ha Kim;Hyo Jung Bang;Hae Jong Lee
    • Health Policy and Management
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    • v.33 no.3
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    • pp.355-362
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    • 2023
  • Background: Financial efficiency in monetary units and operational efficiency in non-monetary units are separately classified and evaluated. This is done to prevent the duplication of monetary units and non-monetary units in inputs and outputs. In addition, analyses are conducted to determine the factors that affect each aspect of efficiency. To prevent duplication of monetary and non-monetary units in inputs and outputs, financial efficiency, consisting of monetary units, and operational efficiency, comprising non-monetary units, are separately classified and evaluated. Furthermore, an analysis is conducted to identify the factors that affect each aspect of efficiency. Methods: This study conducted a panel analysis of 34 regional public hospitals and influencing factors on efficiency for 5 years from 2015 to 2019. Financial efficiency and operational efficiency were calculated through data envelopment analysis. Moreover, multiple regression analysis was conducted to identify the factors that influence both financial efficiency and operational efficiency. Results: The factors that affect financial efficiency include the number of medical institutions within the treatment area and the ratio of patients receiving medical care. Additionally, operational efficiency is influenced by the type of medical institution, the number of medical institutions within the treatment area, and the number of nursing positions per 100 beds. Conclusion: In order for regional public hospitals to faithfully fulfill their functions and roles as regional base public hospitals, several measures are necessary. Firstly, continuous monitoring and reasonable support are required to ensure efficient operation and performance. Secondly, a financial support plan tailored to the characteristics of local medical centers is needed. Additionally, local medical centers should strive to enhance their own efficiency.

Analysis of the incidence of dementia in complete edentulous patients using the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD) (국민건강보험공단 노인 코호트 자료를 이용한 완전 무치악 환자의 치매 발병률 분석)

  • Koo, Bonsuk;Yoo, Jin-Joo;Kim, Manyong;Lim, Hyunsun;Yoon, Joon-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.193-200
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    • 2020
  • Purpose: To investigate the relationship between dementia and complete tooth loss on both sides or one side using large demographic data. Materials and methods: A retrospective cohort study was designed using the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD) which was established for people over the age of 60. The experimental group was the complete edentulous cohort, which had a history of treatment for national health insurance covered complete denture on both sides or one side from July 1, 2012 to December 31, 2013. And the control group was the dentulous cohort, which had a history of conservative dental treatment for the same period. All subjects had no history of diagnosis or treatment of dementia during this time. These cohorts were matched 1:1 by age, gender, and place of residence according to the propensity score matching method. Then the incidence of dementia was compared between these cohorts. Results: Compared with those groups, the incidence of dementia was significantly higher in the experimental group (12.13%) than in the control group (9.74%) (P<.05). No clear association between other factors has been identified. Conclusion: The analysis of large-scale demographic data shows that the incidence of dementia is high in complete edentulous patients on both sides or one side.