1.Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data.
Jee Ae KIM ; Seokjun YOON ; Log Young KIM ; Dong Sook KIM
Journal of Korean Medical Science 2017;32(5):718-728
Health Insurance and Review Assessment (HIRA) in South Korea, also called National Health Insurance (NHI) data, is a repository of claims data collected in the process of reimbursing healthcare providers. Under the universal coverage system, having fee-for-services covering all citizens in South Korea, HIRA contains comprehensive and rich information pertaining to healthcare services such as treatments, pharmaceuticals, procedures, and diagnoses for almost 50 million beneficiaries. This corpus of HIRA data, which constitutes a large repository of data in the healthcare sector, has enormous potential to create value in several ways: enhancing the efficiency of the healthcare delivery system without compromising quality of care; adding supporting evidence for a given intervention; and providing the information needed to prevent (or monitor) adverse events. In order to actualize this potential, HIRA data need to actively be utilized for research. Thus understanding this data would greatly enhance this potential. We introduce HIRA data as an important source for health research and provide guidelines for researchers who are currently utilizing HIRA, or interested in doing so, to answer their research questions. We present the characteristics and structure of HIRA data. We discuss strengths and limitations that should be considered in conducting research with HIRA data and suggest strategies for optimal utilization of HIRA data by reviewing published research using HIRA data.
Delivery of Health Care
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Diagnosis
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Health Care Sector
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Health Personnel
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Humans
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Insurance, Health*
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Korea*
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National Health Programs
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Universal Coverage
2.Public healthcare--welfare, market share or laissez-faire?--a Sentosa Carlsberg skytower view.
Annals of the Academy of Medicine, Singapore 2006;35(2):119-122
How much the Government should provide for its people in sickness and in health, till death do us part, is open to different interpretation in different societies. One of the great paradoxes is that welfare states with high taxation can be globally competitive, innovative, successful market economies, and still provide quality universal healthcare. The Nordic countries, classical welfare states, have achieved top global ranking in economic competitiveness. Denmark's people are the most satisfied with their healthcare in the world, and the world's fourth most responsive healthcare system. This paper examines some of the factors that have made Denmark a successful, open and civil society that provides free-access healthcare to all of its people.
Culture
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Denmark
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Humans
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National Health Programs
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Quality of Health Care
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Singapore
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Social Security
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Social Welfare
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Universal Coverage
3.Main Indicators of National Health Insurance during 40 Years.
Health Policy and Management 2017;27(3):267-271
This year marks the 40th anniversary of the introduction of National Health Insurance (NHI) which has contributed to improving public health and accessibility. This article aims to show the trends of main indicators during the last 40 years. NHI has achieved rapid expansion of target population (1977–1989). The percentage of population covered increased from 8.8% in 1977 to 94% in 1990. The average number of visit days per person was 0.75 in 1977 but significantly increased to 31.11 in 2015. In 2015, NHI revenues were 52.4 trillion won and expenditures were 48.2 trillion won which is 9.5 times and 9.6 times higher than in 1995. NHI achieved universal coverage in short period of time and has contributed to improving the healthcare status. However, there still remain problems including low-benefit coverage and high out of pocket money. Therefore, the effort to reform these problems is needed.
Anniversaries and Special Events
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Delivery of Health Care
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Health Expenditures
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Health Services Needs and Demand
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Humans
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National Health Programs*
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Public Health
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Universal Coverage
4.Main Indicators of National Health Insurance during 40 Years.
Health Policy and Management 2017;27(3):267-271
This year marks the 40th anniversary of the introduction of National Health Insurance (NHI) which has contributed to improving public health and accessibility. This article aims to show the trends of main indicators during the last 40 years. NHI has achieved rapid expansion of target population (1977–1989). The percentage of population covered increased from 8.8% in 1977 to 94% in 1990. The average number of visit days per person was 0.75 in 1977 but significantly increased to 31.11 in 2015. In 2015, NHI revenues were 52.4 trillion won and expenditures were 48.2 trillion won which is 9.5 times and 9.6 times higher than in 1995. NHI achieved universal coverage in short period of time and has contributed to improving the healthcare status. However, there still remain problems including low-benefit coverage and high out of pocket money. Therefore, the effort to reform these problems is needed.
Anniversaries and Special Events
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Delivery of Health Care
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Health Expenditures
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Health Services Needs and Demand
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Humans
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National Health Programs*
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Public Health
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Universal Coverage
5.Prevention of HIV Infection in Health Care Setting.
Korean Journal of Nosocomial Infection Control 2008;13(2):64-68
Health care workers are exposed to a small risk of being infected with HIV as a result of occupational exposures. The risks for occupational transmission of HIV vary with the type and severity of exposures. The average risk for HIV transmission after a percutaneous exposure to HIV-infected blood has been estimated to be approximately 0.3%. Health care workers can minimize their risk of occupational HIV infection by following universal precautions, ensuring timely postexposure management, and considering the administration of postexposure prophylaxis.
Collodion
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Delivery of Health Care
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HIV
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HIV Infections
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Occupational Exposure
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Universal Precautions
6.The fantasy of a new healthcare policy in Korea.
Journal of the Korean Medical Association 2017;60(12):936-939
According to Organization of Economic Co-operation and Development health statistics data, out-of-pocket expenditures account for 36.8% of current health expenditures in Korea, in contrast to the Organization of Economic Co-operation and Development average of 20.3%. The government has announced the implementation of a new healthcare policy to reduce out-of-pocket expenditures. Korea already has a universal coverage system for most essential health care services. Even though health services based on out-of-pocket expenditures are usually optional, and are supported by lower levels of evidence, the National Health Insurance program has promised to cover all medical services except for cosmetic plastic surgery. This will drive more demand for optional health services and drain healthcare resources. Korea needs improvement of its quality care system instead of high-cost optional services, because of the rapid transition to an aging society.
Aging
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Delivery of Health Care*
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Fantasy*
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Health Expenditures
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Health Services
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Insurance Coverage
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Korea*
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National Health Programs
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Surgery, Plastic
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Universal Coverage
7.A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan.
Yuliya DRONINA ; Jiyoung MOON ; Eun Woo NAM
Health Policy and Management 2017;27(3):256-266
BACKGROUND: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. METHODS: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. RESULTS: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. CONCLUSION: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.
Delivery of Health Care
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Health Care Reform
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Health Expenditures
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Health Promotion
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Immunization
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Information Services
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Korea
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Primary Health Care*
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Public Health
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Republic of Korea*
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Research Report
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Social Problems
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Universal Coverage
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Uzbekistan*
8.A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan.
Yuliya DRONINA ; Jiyoung MOON ; Eun Woo NAM
Health Policy and Management 2017;27(3):256-266
BACKGROUND: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. METHODS: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. RESULTS: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. CONCLUSION: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.
Delivery of Health Care
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Health Care Reform
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Health Expenditures
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Health Promotion
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Immunization
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Information Services
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Korea
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Primary Health Care*
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Public Health
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Republic of Korea*
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Research Report
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Social Problems
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Universal Coverage
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Uzbekistan*
9.Sustainability of Korean National Health Insurance.
Myoung Sheen KANG ; Hoo Sun JANG ; Minjee LEE ; Eun Cheol PARK
Journal of Korean Medical Science 2012;27(Suppl):S21-S24
Korean National Health Insurance (NHI) was established during only 12 yr from its inception (1977-1989), providing universal medical coverage to the entire nation and making a huge contribution to medical security. However, the program now faces many challenges in terms of sustainability. The low birth rates, aging population, low economic growth, and escalating demands for welfare, as well as unification issues, all add pressure to the sustainability of NHI. The old paradigm of low contribution - low benefits coverage - low NHI's fee schedule needs to be replaced by a new paradigm of proper contribution - adequate benefit coverage - fair NHI's fee schedule. This new paradigm will require reform of NHI's operating system, funding, and spending.
Health Care Reform
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Humans
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National Health Programs/*economics
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Program Evaluation
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Republic of Korea
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Risk Factors
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Universal Coverage/economics
10.Study on Pediatric Nurses' Attitudes and Compliance with Hospital Infection Standard Precautions.
Hye Yeun SHIN ; Kyung Hee KIM ; Ki sook KIM
Journal of Korean Academy of Child Health Nursing 2011;17(4):238-246
PURPOSE: The purpose of this study was to identify pediatric nurses' attitudes to, and compliance with, standard precautions in the prevention of hospital infections by enhancing their practice of standard precautions. METHODS: The participants were 206 nurses who worked in pediatric nursing departments of a general medical institution in Seoul. The questionnaire was a modification of Kim (2008) and consisted of 18 questions about hand washing, personal protective equipment, sharps, linen and patient care equipment. Collected data were processed using SPSS 15.0 WIN. RESULTS: Mean scores for attitudes to standard precautions and for compliance with standard precautions were 4.43 (+/-0.83) and 4.22 (+/-0.44) respectively. This difference was statistically significant (t=3.368, p=.001). The nurses' compliance with standard precautions differed significantly according to the general characteristics of age (F=8.705, p<.001), total clinical experience (F=9.426, p<.001), current department experience (F=6.555, p<.001), and education experience (t=0.616, p<.043). There was a positive correlation between attitudes to, and compliance with, standard precautions (r=.156, p=.025). CONCLUSION: The results of this study indicate that educational programs and policy on infection control and standard precautions for pediatric nurses are needed. Also these results should contribute to baseline data for establishing appropriate clinical policy on infection control.
Bedding and Linens
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Compliance
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Cross Infection
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Hand Disinfection
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Humans
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Infection Control
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Patient Care
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Pediatric Nursing
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Universal Precautions
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Child Health
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Surveys and Questionnaires