• Title/Summary/Keyword: social insurance

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The Medical Insurance Program for the Elderly Person's (노인 의료보장제도의 개선 방안)

  • Hwang, Hyun-Sook
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.735-744
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    • 2001
  • After providing the purpose, scope and methods of present study in the first chapter. the second chapter discusses a theoretical overview on the social implication of medical expenditure and the medical insurance program for the aged population. In conclusion, to realize the reduction of aged population's medical expenditures, some possible plans are conceivable. Firstly, the payment level of medical insurance should be upgraded and the insurance coverage in oriental medicine treatment and the drug-store protection program need to be implemented. Secondly, the medical facilities and man-power have be expanded for the sake of reducing the social and geographical distances the aged population has to overcome to receive the medical benefits. Thirdly, the expansions of medical services for the home-stay aged are all the more required. Finally, a wide range of programs needs to be augmented to promote health for the aged population.

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Is the Single-Insurer a Powerful Purchaser?: In Case of Indonesia (단일보험자는 강력한 구매자인가: 인도네시아 사례를 중심으로)

  • Kim, Yanghee;Byeon, Jinok
    • Health Policy and Management
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    • v.30 no.2
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    • pp.151-163
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    • 2020
  • This study reviewed primary care purchasing issues of the Indonesian single-insurer, BPJS-K, in the context of triangular power relations between the government, the insurer, and the providers, and considered its challenges of purchasing as the national single-insurer. Some literature reviews and interviews with Indonesian stakeholders and residents were used to describe the historical and social contexts of Indonesian healthcare and social health insurance systems especially focusing legal and institutional status of BPJS-K and primary care provision and delivery conditions in remote areas. Though BPJS-K directly belongs to the presidential office of Indonesia, it has limited power in terms of purchasing as a single insurer. Mainly it was due to the lack of primary care resources, Ministry of Health's strong power as the regulator and provider, and BPJS-K's powerlessness against monitoring and quality of care assessment. Ambiguous accountability was another issue among the insurer and the Ministry of Health. This created confusions in primary care provision. It is suggested that each agencies' accountability should be obvious in terms of legal, political, and social contexts.

The Impact of Public Pension on Chinese Household Consumption

  • Ya-Hao LI;Fan YANG;Shuang ZHANG
    • Journal of Wellbeing Management and Applied Psychology
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    • v.7 no.1
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    • pp.1-7
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    • 2024
  • Purpose: The improvement of the social security system can greatly affect residents' future uncertainty, and it is important to study the relationship between public pensions and household consumption. Research design, data and methodology: Using the 2018 China Household Panel Survey (CFPS) data, the instrumental variable method is used to analyze the impact of pension insurance on urban residents' consumption. Results: The results of the study show that there are differences in the impact of three different pension insurance systems on household consumption. The pension insurance for public sector significantly boosts household consumption, and having a pension insurance for public sector can increase household consumption by 7.7%. The pension insurance for enterprise employee will reduce household consumption, but this is only significant for urban households. The pension insurance for urban and rural residents has a negative impact on household consumption. For the 16- to 39-year-old group, having a pension insurance for urban and rural residents will reduce household consumption by 5.7%. At the same time, household income, assets, scale, and education level will positively stimulate household consumption. Conclusions: The study reveals varying impacts among different pension types, highlighting the need for optimizing social security schemes to incentivize higher consumption rates.

Development and Validation of a Practical Instrument for Injury Prevention: The Occupational Safety and Health Monitoring and Assessment Tool (OSH-MAT)

  • Sun, Yi;Arning, Martin;Bochmann, Frank;Borger, Jutta;Heitmann, Thomas
    • Safety and Health at Work
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    • v.9 no.2
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    • pp.140-143
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    • 2018
  • Background: The Occupational Safety and Health Monitoring and Assessment Tool (OSH-MAT) is a practical instrument that is currently used in the German woodworking and metalworking industries to monitor safety conditions at workplaces. The 12-item scoring system has three subscales rating technical, organizational, and personnel-related conditions in a company. Each item has a rating value ranging from 1 to 9, with higher values indicating higher standard of safety conditions. Methods: The reliability of this instrument was evaluated in a cross-sectional survey among 128 companies and its validity among 30,514 companies. The inter-rater reliability of the instrument was examined independently and simultaneously by two well-trained safety engineers. Agreement between the double ratings was quantified by the intraclass correlation coefficient and absolute agreement of the rating values. The content validity of the OSH-MAT was evaluated by quantifying the association between OSH-MAT values and 5-year average injury rates by Poisson regression analysis adjusted for the size of the companies and industrial sectors. The construct validity of OSH-MAT was examined by principle component factor analysis. Results: Our analysis indicated good to very good inter-rater reliability (intraclass correlation coefficient = 0.64-0.74) of OSH-MAT values with an absolute agreement of between 72% and 81%. Factor analysis identified three component subscales that met exactly the structure theory of this instrument. The Poisson regression analysis demonstrated a statistically significant exposure-response relationship between OSH-MAT values and the 5-year average injury rates. Conclusion: These analyses indicate that OSH-MAT is a valid and reliable instrument that can be used effectively to monitor safety conditions at workplaces.

The Moderating Effect of Social Support in the Relationship between Job Stress and Emotional Burnout of Insurance Call center consultants (보험회사 콜센터 상담사의 직무스트레스와 정서적 소진의 관계에서 사회적 지원의 조절효과)

  • Kim, Hyun-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.53-59
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    • 2018
  • This study was to investigate the moderating effect of the social support in the relationship between job stress and emotional burnout of insurance call center consultants. Participants in this study were 186 consultants working in insurance call center. They completed survey questionnaires of job stress, emotional burnout and social support. Collected data was examined using correlation analyses and hierarchical multiple regression analyses. There was a positive relationship between job stress and emotional burnout and a negative relationship between emotional burnout and coworker support. Also, it was found that the social support(supervisor support, coworker support) moderated the relationship between job stress and emotional burnout of insurance call center consultants. The implications and limitations of this study were discussed.

A Study on the Applicability of the Population-Based Health Care Model: Focusing on Social Cooperative-type Medical Clinics in a Local Area (인구집단 기반 건강관리모형의 적용가능성 검토: 한 지역의 의료복지사회적협동조합형 의료기관을 중심으로)

  • Lee, Keun-Jung;Oh, Ju-Yeon;Lee, Da-Hee;Hahm, Myung-Il;Lee, Jin-Yong
    • Quality Improvement in Health Care
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    • v.26 no.2
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    • pp.95-103
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    • 2020
  • Purpose: This study was to examine whether a health care model that provides comprehensive medical services based on population groups to members of the medical cooperative is applicable as a policy alternative in terms of medical use and cost. Methods: Data were derived from National Health Insurance claim data in 2019. We compared the medical volume and expenses of patients who visited social cooperative-type medical clinics with other patients, control group who visited other clinics in a local area. Results: The average number of visit days was 25.3 days in social cooperative-type medical clinics, more than 24.2 days in the control group (p=.004). However, the average medical cost per visit was KRW 46 thousand in social cooperative-type medical clinics, which was significantly lower than KRW 51 thousand in the control group (p<.001), and the total medical cost was also KRW 16.1 billion in social cooperative-type medical clinics and KRW 16.9 billion in the control group. Conclusion: We identified that a population-based health care model might change patients' behaviors to health care services and decrease total medical cost. Further population based experiment is needed to develop alternative healthcare model.

The Analysis on Annual Utilization Patterns of Inpatients in Korean Medical Hospitals for the Past 10 years (10년간 일개 한의대 부속 한방병원에 입원한 환자에 대한 연도별 이용실태 분석 : 침구의학과를 중심으로)

  • Kim, Hye Su;Kim, So Yun;Kim, Jung Ho;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.61-76
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    • 2016
  • Objectives : This study was designed to clarify population-social characteristics that influence the utilization patterns of hospitalized patients in a traditional korean hospital, thereby providing clinical data which would help further improvements of traditional korean medical service in particular the Acupuncture and Moxibustion. Methods : We investigated population-social characteristics and annual utilization patterns of all patients who were hospitalized for more than 24 hours in a Korean Medical Hospital from January 2005 to December 2014. The obtained data were recorded in the EMR chart and statistical analysis was performed using SPSS 21.0. Additionally, data from the patients admitted to the department of Acupuncture and Moxibustion were analyzed separately. Results : 1. All inpatients had a significant annual difference in age, gender, hospitalized department, and disease code annually but not in re-hospitalization number. Inpatients of the department of Acupuncture and Moxibustion also varied in their age, gender, and disease code annually, but not in re-hospitalization number. 2. Pearson correlation analysis on all inpatients showed that the mean days of hospital treatments had a negative correlation with all variables except medical care insurance. Total cost, cost per day per person and recuperation cost had a positive correlation with all variables except medical care insurance. There was no meaningful relationship between nonrecuperation cost and the variables. 3. Stepwise multiple regression analysis on all inpatients showed that the mean days of hospital treatments had a negative correlation with all variables except automobile insurance. The total hospitalization costs had a positive correlation with both general insurance and medical care insurance. Cost per day per person and recuperation cost had a positive correlation with the females. There was no meaningful relationship between non-recuperation cost and the variables. 4. Pearson correlation analysis on inpatients of the department of Acupuncture and Moxibustion inpatients showed that the mean days of hospital treatments had a positive correlation with all variables except general insurance and automobile insurance. Total cost and recuperation cost had a positive correlation with all variables except medical care insurance, and cost per day per person had a positive correlation with females and general insurance. There was no meaningful relationship between non-recuperation cost and the variables. 5. Stepwise multiple regression analysis on inpatients of the department of Acupuncture and Moxibustion inpatients, the mean days of hospital treatments, total cost, cost per day per person and recuperation cost had a positive correlation with general insurance. There was no meaningful relationship between non-recuperation cost and the variables. Conclusion : Population-social characteristics of inpatients annually varies, and the change influences the utilization pattern.

A Path Analysis on Morale among Staff of Long-term Care Insurance in National Health Insurance Corporation (노인장기요양인정조사원의 사기에 관한 경로분석)

  • Kim, Hyun Mi;Choi, Yeon Hee
    • Korean Journal of Occupational Health Nursing
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    • v.21 no.3
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    • pp.247-257
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    • 2012
  • Purpose: This study is designed to identify major factors that affect morale among staff of long-term care insurance in National Health Insurance Corporation. Methods: In order to collect the data, a survey was conducted by using the structured questionnaire based on 161 staff members of long-term care insurance of 50 long-term care operation centers, which were randomly selected by the table of random numbers in the whole centers of National Health Insurance Corporation from September 1 to 30, 2011. As for the data analysis, SPSS 18.0 was used to conduct the descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, mutiple regression, and path analysis. Results: The average point of morale was 3.37, and had a negative correlation with the job stress, while it had a positive correlation with the social support, professional identity, and self-efficacy. Job stress, social support, and professional identity have a significant effect on morale among the independent variables. These variables have significant effects on morale, and also have a positive effect on self-efficacy. The findings show that self-efficacy mediates the process of morale. Conclusion: In this study, the factor which influences the morale was identified. It turned out that the morale could be improved by reinforcing the professional identity, managing the health status as well as rotating the working place. As such, it expects both the improvement of long-term care insurance services outcome and its quality through the morale management.

Estimation of Willingness to Pay for Long-Term Care Insurance Using the Contingent Valuation Method (조건부가치측정법을 이용한 노인장기요양보험에 대한 지불의사금액 추정)

  • Lee, Tae-Jin;Lee, Sue-Hyung
    • Health Policy and Management
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    • v.16 no.1
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    • pp.95-116
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    • 2006
  • According to rapid increase of the population of senior citizens, there has been growing concern of Long-Tenn Care(LTC) services recently. Long-Tenn Care services, however, haven't been established systematically in Korea and the supply of LTC services is not sufficient despite the increase in the current social demand. This study aims to estimate the 'Willingness to Pay(WTP)' for LTC insurance which the government plans to introduce by means of social insurance, using Contingent Valuation Method(CYM). In addition, this study analyzes the factors affecting WTP for LTC insurance. An interview survey was carried out to derive WTP for LTC from 450 people who lived in Seoul aged 20 and above during the period from 16th to 21st of June 2003. Double-Bounded Dichotomous Choice Method was applied among several CVMs available to estimate both use value and no-use value of goods. There was pilot survey carried out prior to the main survey. The results show that the average monthly. WTP for LTC provided in home and residential setting is 18,192Won and 19,293Won, respectively. In the case of home care, WTP goes higher depending on reliability of LTC insurance policy and need for LTC insurance, as well as marital status, education and average monthly income. On the contrary, WTP is conversely affected by higher age and higher bids. In the case of institutional care, the factors affecting WTP are similar to those of home care, except age. This study followed NOAA's suggestions generally and the value derived through survey could be reliable. However, there can be the least bias in the process of survey because the CVM should be used under the supposed circumstances. Despite those limitations, it can be concluded that the amount the citizens are willing to pay for LTC is high enough to meet the costs needed to provide LTC.

A study on the ecosystem of welfare technology using social economy: a case study of dental clinics in health welfare social cooperative (사회적 경제를 통한 복지기술 생태계 탐구; 의료복지사회적협동조합 치과의원의 사례)

  • Park, Yuyi;Choi, Hyungkil;Han, Dong-Hun;Kang, Joon-Ho;Ahn, Sung Hoon;Ahn, Sang-Hoon
    • Journal of Korean Academy of Oral Health
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    • v.41 no.1
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    • pp.43-49
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    • 2017
  • Objectives: In this study, we strived to determine the possibility of socioeconomic welfare in oral healthcare by analyzing the National Health Insurance (NHI) coverage rate. To date, efforts to realize the "social economy" of healthcare are active. While oral disease is common and chronic among Koreans, the rate of NHI coverage of dental clinics is substantially lower than that of the medical clinics. Methods: We defined the NHI coverage of dental clinics as a proxy for "social skills" to improve oral health problems. The data were collected through a comparative analysis of the NHI coverage of dental clinics and that of non-dental clinics, in health welfare social cooperatives. Results: The NHI coverage rate of the dental clinics in health welfare social cooperatives ranged from 0.97 to 2.62 times that of the non-dental clinics in health welfare social cooperatives. Conclusions: In conclusion, responsible management is recommended for making health welfare social cooperatives meaningful as a social economy.