• 보건행정학회지
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• 제33권3호
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• pp.325-337
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• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

• 보건행정학회지
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• 제22권3호
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• pp.383-402
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• 2012

The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

• 보건행정학회지
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• 제19권4호
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• pp.53-65
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• 2009

Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

• 보건행정학회지
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• 제31권3호
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• pp.364-373
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• 2021

Background: This study aims to examine the regressiveness of national health insurance (NHI) premium burdens for local subscribers. The government has established a restructuring of health insurance contributions in 2017. Therefore, insurance premium reform began in 2018 and the second national health insurance premium reform will be carried out in 2022. We will analyze local subscribers before and after the policy reform of 2018. Methods: This study used data from 'local premium imposition elements' in the health insurance statistics annual reports (2017-2019) on National Health Insurance Service (NHIS). This study was calculated contribution rates according to levels of income and property for local insured by the method of comparing. Simulations of primary and secondary reforms were conducted in the study to determine regressiveness. Results: Insurance premiums for local subscribers were analyzed separately by income and property insurance premiums. In the income premium analysis, the higher the income, the lower the premium rate, and then the fixed rate was maintained from a certain section. The regressiveness of income insurance premiums has been eased in part. On the other hand, the property insurance premium burden was found to be regressive still by income class. Conclusion: Regressiveness analysis showed that a decrease in income contributions was achieved to local insured in the first phase of reform. But in the second phase of reform, more consideration should be given to reductions of property premium portions of local subscribers. Based on the results, the author suggested policy discussions to reorganizing the new systems of NHI contribution of local Insured.

• 보건의료산업학회지
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• 제6권4호
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• pp.83-98
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• 2012

The objective of this study is to analyze the utilization patterns of national health insurance and medical aid inpatients in tertiary hospitals. For the analysis, the study utilize the nationwide data on '2010 Survey of Patients' of Ministry of Health & Welfare. The statistical methodology used in the study is the logistic regression model. This study has three major findings. First, utilization rate of national health insurance inpatients was higher than medical aid inpatients in tertiary hospitals. Second, the significant affecting demographic factors in utilizing tertiary hospitals were sex, age, surgery case, treatment result, inpatients residence region and short length of stay. Third, compared to other disease groups, the inpatients on 'congenital malformation, deformity and chromosomal abnormalities', 'factors influencing health status and contact with health services' and 'neoplasm' groups are more likely to utilize tertiary hospitals. Finally, according to residence region, Seoul residence inpatients in both of national health insurance and medical aid more likely to utilize tertiary hospitals than other region inpatients.

• 대한한의학회지
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• 제28권3호통권71호
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• pp.244-260
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• 2007

Objectives : The purpose of this study was to provide lawmakers with basic data for the purpose of establishing a policy on health insurance for packed herbal medicine. Methods : To properly execute an insurance system for packed herbal medicine, we surveyed the following questions from May 1st to June 15th, 2006: (1)the way to pay the insurance benefits (2)specific impression (disease) names as related to insurance (3)the range of insurance coverage. We obtained answers from 304 Korea traditional doctors. Results : 89.4% respondents were agreed on execution of health insurance for packed herbal medicine. 93.86% respondents answered that the way to pay insurance benefits and the range of insurance coverage have to be changed properly. Most respondents answered that the coverage should be based on a specific disease being treated, not the current symptoms method which relates to the prescription. The execution of health insurance for packed herbal medicine is expected to increase the number of patients and make the Korean medical system more popular. Conclusion : The findings are expected to make it easier for the general public to get treatment by providing basic data with policy makers that will cover packed herbal medicine in insurance. Also, a proper Korea traditional health insurance program should be set up as soon as possible to widen the choice of medicine for the general public.

• 대한치과기공학회지
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• 제32권1호
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• pp.35-43
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• 2010

Purpose: The purpose of this study is dental technicians perception investigation about national health insurance of old persons denture in metropolitan area. Methods: A survey was performed on 103 subjects in metropolitan from January 14 to April 30 in 2009. The research tool was a structured questionnaire. The collected data was analyzed by frequency, descriptive and multiple linear regression. Results: Total dental technician who respond to questionnaire was 103(100.0%). Male respondent appeared by 66.0%. 30-year-old low respondent appeared by 60.2% and subjects lived the most in seoul(68.0%). When got married, was expose that realization about national health insurance of old person s denture was high(p<0.05). When made denture, was expose that realization about national health insurance of old person s denture was high(p<0.05). Also, When got married, was expose that necessity about national health insurance of old persons denture was high(p<0.001). Conclusion: When did national health insurance of old persons denture, there were a lot of problems. But, old people was need it. Therefore, I desire that this study is used to basic data of the national health insurance.

• 한국치위생학회지
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• 제24권1호
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• pp.9-16
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• 2024

Objectives: The demand for dental care is expected to increase as the population ages. This study aimed to predict the utilization of dental implant care following the expansion of national health insurance benefits for dental implants. Methods: Multiple linear regression analysis was performed on HIRA big data open portal data and DNN-based artificial intelligence models to forecast the utilization of dental care in relation to the national health insurance coverage for dental implants. Results: National health insurance coverage of dental implants was found to be associated with the number of patients using dental implant services and demonstrated a statistical significance. The dental implant services utilization increased with the increased dental implant health insurance benefits for the elderly population, increased mean by region, increased number of dental institutions by region, and increased health insurance coverage rate for dental implants. However, the dental implant services utilization decreased with the increased number of older people living alone and increased size of dental institutions. Conclusions: With the expansion of the national health insurance coverage for dental implants, it is predicted that the utilization of dental implant medical services will increase in the future.

• 한국치위생학회지
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• 제19권5호
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• pp.765-776
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• 2019

Objectives: The purpose of this study was to compare the oral health statuses pre- and post-insurance using the $5^{th}$ and $6^{th}$ National Health and Nutrition Examination Survey data to confirm the effect of scaling insurance after a year. Methods: Data were analyzed using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The four years were integrated, and a composite sample analysis was performed. A total of 26,990 people were included in the study before applying for scaling insurance (14,343 persons) or after receiving scaling insurance (12,647 persons). A chi-squared test was performed to compare the demographic characteristics and oral health status of the subjects. The significance level of the statistical test was 0.05. Results: The proportion of patients without implants was high before the provision of scaling insurance once a year, however, the proportion of patients with one or more implants was high (p<0.05) after the provision of scaling insurance once a year. Hemorrhagic periodontal tissues and tartar formation in periodontal tissues were highly prevalent before the provision of scaling insurance once a year, however, healthy periodontal tissues and formation of periodontal pockets were highly prevalent (p<0.05) after the provision of scaling insurance once a year. The decay, missing, and filled teeth index scores were higher before the provision of scaling insurance once a year (p<0.05). Conclusions: The aforementioned results showed that scaling once a year helps prevent or treat periodontal disease. In addition, we confirmed the effect of prevention on periodontal disease and dental caries, therefore, we expect it to develop into a stable policy.

• Safety and Health at Work
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• 제10권3호
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• pp.265-274
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• 2019

Background: Methyl alcohol poisoning in mobile phone-manufacturing factories during 2015-2016 was caused by methyl alcohol use for cleaning in computerized numerical control (CNC) processes. To determine whether there were health complications in other workers involved in similar processes, the Occupational Safety and Health Research Institute conducted a survey. Methods: We established a national active surveillance system by collaborating with the Ministry of Employment and Labor and National Health Insurance Service. Employment and national health insurance data were used. Overall, 12,048 employees of major domestic mobile phone companies and CNC process dispatch workers were surveyed from 2016 to 2017. We investigated methyl alcohol poisoning by using the national health insurance data. Questionnaires were used to investigate diseases due to methyl alcohol poisoning. Results: Overall, 24.9% of dispatched workers were employed in at least five companies, and 23.9% of dispatched workers had missing employment insurance history data. The prevalence of blindness including visual impairment, optic neuritis, visual disturbances, and alcohol toxicity in the study participants was higher than that reported in the national health insurance database (0.02%, 0.07%, 0.23%, and 0.03% versus 0.01%, 0.07%, 0.13%, and 0.01%, respectively, in 2015). Moreover, 430 suspicious workers were identified; 415 of these provided an address and phone number, of whom 48 responded (response rate, 11.6%). Among the 48 workers, 10 had diseases at the time of the survey, of whom 3 workers were believed to have diseases related to methyl alcohol exposure. Conclusion: This study revealed that active surveillance data can be used to assess health problems related to methyl alcohol poisoning in CNC processes and dispatch workers.