• Title/Summary/Keyword: 건강보험

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Formation, Development and Task of the Health Insurance Act (건강보험법의 형성과 발전, 그리고 과제)

  • CHEON, Kwang Seok
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.3-45
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    • 2019
  • Health insurance is the main instrument to protect the people against sickness. To examine the task of in the future it would be necessary to extract and understand the components formed in its formation and development, benefit related and normative characteristics of the health insurance itself. The health insurance oriented itself to the universal coverage at a law level. Paradoxically this worked positively for the universal development of the health insurance. The task of the health insurance is on the one hand universal, positive and open. On the other hand it has to shape type of allowed method, art and content of the medical treatments into the regulation to ensure the equal benefit as well as the financial stability. That is, the health insurance should check the aberrant medical treatment, and at the same time should be compensated for the their necessity and effectiveness. However there are always some structural differences between both requirements. This article aims to restate and analyse the development of the health insurance, based on the characteristics formed hitherto show the way to reform the health insurance. The problem to enhance the coverage of health insurance, its institutional as well as financial crisis, its peculiar governance would be handled.

A Study on Strengthening of Health Care Protection and Sustainability Plan (건강보험 보장성 강화 및 지속가능성 제고 방안 연구)

  • Jung, Yong-Ju
    • The Journal of the Korea Contents Association
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    • v.21 no.4
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    • pp.96-110
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    • 2021
  • Korea is faced with the challenge of adapting to the world's fastest - growing low birthrate, aging society, and low growth with low interest rate era. With low fertility and aging population, the factors of financial income of health insurance are decreasing, and the increase of public interest in health, high cost medical technology and the development of medicine are leading to increase expenditure of health insurance. In this study, I will examine the strengthen protection of health insurance, financial stabilization, and fairness of medical care. First, the present status and limitations of health insurance were identified through domestic policy report, domestic and foreign literature, and precedent research. Second, the foreign health insurance policy measures to stabilize the finances were examined separately. Based on this study, in order to maintain sustainable health insurance through reinforcement and financial stabilization of health insurance, the current financial income structure of health insurance must be renovated. It will be necessary to expand government subsidies and discover new tax revenues. In addition, a policy to save finances by reorganizing the medical bill payment system and medical delivery system will also be needed.

The Relationship between Perception and Satisfaction for National Health Insurance in Korea (국민건강보험 인식수준과 만족도의 관계)

  • Ahn, Young-Chang
    • The Journal of the Korea Contents Association
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    • v.14 no.8
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    • pp.277-286
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    • 2014
  • The purpose of this study was to identify the relationship between the health insurance perception level and health insurance satisfaction for national health insurance subscriber. The collected data were analyzed by $X^2$-test, t-test, ANOVA using the SPSS/WIN (ver.14.0). Research results can be summarized as follows. The relationship between the health insurance perception level and health insurance satisfaction was relatively high. The study showed significantly high levels in the score of health insurance satisfactions according to perception of security level, health insurance premium, positive thinking, and fair in premium charge. Also health insurance satisfaction scores were significantly low levels according to perception of raise health insurance premium and burden on households. This study investigated the relationship between the detail perception and satisfaction for national health insurance. Therefore, we are setting the overall direction of national health insurance perception, and look forward to utilizing the basis data as help to improve the system of health insurance for people.

Affecting Factors on National Health Insurance Coverage Dental Scaling Experience (건강보험 치석제거 수진에 영향을 미치는 요인)

  • Heo, Yun-Min;Kim, Hyoung-Joo;Kim, Mi-Na;Lim, Hee Jung;Kim, Myoung-Hee;Lim, Do-Seon;Ahn, Yong-Soon
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.287-294
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    • 2015
  • The aim of the study was to investigate the affecting factors on National Health Insurance coverage dental scaling experience. The self-reported survey for the adults living in Seoul, Gyeonggi province and Incheon had been progressed from February 10, 2014, to February 28, 2014, after receiving informed consents. And the 238 survey results had been analysed as the data of this study. The data analysis such as frequency analysis, ${\chi}^2$-test, and multi-logistic regression (p<0.05) for all collected survey data had been processed using IBM SPSS Statistics ver. 20.0. According to multiple logistic regression analysis, regular dental check-up (odds ratio [OR], 2.63; confidence interval [CI], 1.05~6.59) and dental scaling experience (OR, 3.06; CI, 1.09~8.54), monthly income (OR, 3.55; CI, 1.01~12.56) were the factors having statistically significant influence. Therefore, in order to increase of National health insurance dental scaling experience, it is necessary to increase awareness of the new dental scaling system through the promotion and oral health education about national health insurance dental scaling, and to emphasize the importance of dental Scaling by regular dental check-up.

Analysis of changes National Health Insurance Policy and Claim Data of PET (양전자단층촬영 건강보험 적용 정책 및 이용량 변화에 관한 연구)

  • Cho, Young-Kwon
    • Journal of the Korean Society of Radiology
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    • v.14 no.6
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    • pp.801-810
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    • 2020
  • In this study, the health insurance application of PET and the change in the pay standard were examined, and the amount of health insurance use over the past 10 years was analyzed. Positron tomography was applied as health insurance in 2006, and after 18F-FDG was first applied as health insurance, positron tomography tests using various radioactive isotopes have been applied as health insurance. As of 2019, the number of positron emission tomography tests was 198,651 cases, and the treatment amount was about 88.3 billion won, and the number of tests according to general characteristics was higher in men than in women, and by age, the number of tests was the highest in 60s. The number of outpatient examinations was higher than that of inpatient examinations, and the number of examinations in tertiary hospitals(68.2%) was significantly higher than that of general hospitals and hospitals. As for the test site, torso test was the most common at 86.6%, and radioisotope was the most at 93.6% using 18F-FDG. The change in the use of PET for 10 years increased steadily from 2010 to 2014, but the amount of use decreased sharply afterwards as the recognition of asymptomatic long-term follow-up tests was deleted due to the government's change in health insurance application standards in 2014. As changes in health insurance standards have a great influence on changes in health insurance usage, continuous monitoring will be required in the future.

preference of dental insurance-related and dental health insurance professional qualifications (치과 건강보험 교육이 자격증 취득에 미치는 영향)

  • Son, Eun-Gyo;Kim, Young-Jin;Jung, Hwa-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.386-394
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    • 2017
  • The purpose of this study was to investigate how employed dental hygienists (graduates) and alumni are aware of dental health insurance and how to organize their classes for running efficient dental health insurance courses, and therefore to suggest opinions on the introduction of professional dental hygienist qualifications. The analyses was carried out using IBM SPSS Statistics 24.0. Sixty-nine students (56.1%) preferred one semester dental health insurance course as two semester courses and 63 students (51.2%) preferred theoretical course as practical course. Ninety-six (78%) students preferred dental health insurance claimants as others for their most necessary certification. Ninety-three dentists (75.6%) thought of the dental hygienist as the appropriate occupation for dental health insurance claims. The correlation coefficient was significant at the 0.01 level (both sides) and all showed a positive correlation. The effect of subjective understanding of dental health insurance and the perception of dental health insurance claim on students' intention to complete those courses explained 32% of the response, and the effect of the intention to complete those courses on the willingness to earn a certificate explained 22.3%. This study reveals the willingness of students to complete those courses to acquire qualifications in order to achieve a competitive advantage in employment, and suggests the necessity of institutional improvements such as changing the method of dental insurance education, varying the class time distribution, and introducing dental health insurance professional dental hygienist qualification in the country.

Analysis of the Trend and the Factors Influencing the Usage Before and After the Application of the National Health Insurance for the Magnetic Resonance Imaging (자기공명영상의 건강보험 적용 전·후 이용량 동향 및 요인 분석)

  • Gil, Jong-Won;Choi, Sung-Oog
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.477-484
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    • 2016
  • This study was carried out to determine the factors affecting the trend and usage of Magnetic Resonance Imaging before and after the implementation of National Health Insurance. The research materials were the MRI Execution Data, Health Insurance Review Data, and Medical Expenses in the Health Insurance Data from a General Hospital located in Dae-jeon Metropolitan City from 2004 to 2013. The subjects of analysis were 3,754 people in 2004 (prior to the implementation of Health Insurance), and 4,107-8,603 people from 2005-2013(after the implementation of Health Insurance). In terms of analysis, a comparison of the use of MRI before and after implementation of the Health Insurance of User Characteristics and Provider Characteristics were taken as $X^2$, while factor analysis for the elements that affect MRI usage was carried out by Hierarchical Multiple Regression Analysis. According to the results of this study, the level of use decreased temporarily in the initial application stages of the national health insurance, but it soon increased. In particular, the inspection rates for women, the head and neck, those not subject to the application of the national health insurance, internal medicine, and the inpatients increased. The application of the national health insurance for MRI influenced the increasing inspection rates (P<.0001). As the inspection rate for the MRI increased, it is important to expand the application of the national health insurance to reduce the national health expenditure.

Differences of Cancer Patient's Health Care Utilizations between Medical Aid Program and National Health Insurance in the Elderly (노인 암환자의 건강보험과 의료급여 이용차이 분석)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.270-279
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    • 2011
  • This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.

Awareness of Oral Health Workforce on the National Health Insurance Coverage of Topical Fluoride Application (구강보건인력의 전문가불소도포 건강보험 급여화에 대한 인식)

  • Lee, Sun-Ho;Lee, Heung-Soo;Oh, Hyo-Won
    • Journal of dental hygiene science
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    • v.15 no.1
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    • pp.46-53
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    • 2015
  • The purpose of this study is to identify the awareness of oral health workforce and the attitude concerning the health insurance benefit on topical fluoride application. The subjects are 173 dentists and 288 dental hygienists. The data were collected using a self-administered questionnaire and analyzed using SPSS 12.0 statistical program. The findings of the study were as follows: Agree's (including strongly agree) ratios regarding to the health insurance benefit of topical fluoride application was 92.5% for dentists and 90.8% for dental hygienists. Appropriate age of health insurance benefit about the topical fluoride application was elementary, middle and high school students (8~19 years). This response ratio was high 45.7% for dentists and 43.2% for dental hygienists. Appropriate copayment (mean value) of health insurance about topical fluoride application coverage showed that NaF, $SnF_2$ solution and acidulated phosphate fluoride gel were 25,782 Korean Won (KRW) for dentist and 14,282 KRW for dental hygienist. Fluoride varnish copayment was 31,705 KRW for dentist and 17,979 KRW for dental hygienist. Fluoride iontophoresis copayment was 40,156 KRW for dentist, and 21,210 KRW for dental hygienist. The frequency of health insurance benefits about topical fluoride application was high in 'unlimited (37.5%)' for the dentists and 'two times (31.3%)' for dental hygienists. In conclusion, topical fluoride application should be included as one of the health insurance benefit items for oral health.