Sustainability of Korean National Health Insurance

Kang, Myoung Sheen; Jang, Hoo Sun; Lee, Minjee; Park, Sohee

doi:10.3346/jkms.2012.27.s.s21

Cited by 30 publications

(29 citation statements)

References 2 publications

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“…Many households fall into poverty due to OOP medical spending [ 10 - 12 ]. Despite relatively low benefit coverage, by OECD standards, Korea is experiencing a sharp increase in medical expenditures due to an aging population and costs associated with utilizing new medical technologies [ 13 ]. This increase in medical costs often results in catastrophic medical fees that exceed the amount households can afford [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Association between chronic disease and catastrophic health expenditure in Korea

Choi

Kim

et al. 2015

BMC Health Serv Res

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BackgroundThe prevalence and economic burden of chronic diseases are increasing worldwide. Nevertheless, little information is available on catastrophic health expenditures (CHE) associated with chronic diseases in Korea. This study explored the burden of household out-of-pocket health expenditures among the Korean population for different chronic diseases.MethodsThis study was conducted utilizing data collected from the 7,006 households that participated in the Korea Health Panel Survey (KHPS) in 2008. The effect of CHE in relation to type of chronic disease was assessed via multiple logistic regression analysis.ResultsRoughly 3.5% of the participating households experienced CHE. As opposed to households headed by females and middle-aged individuals (40–59 years), those of low economic status, elderly households, and households with a member who suffered from a chronic disease were more likely to experience CHE. According to type of chronic condition, households with a member who suffered from cerebrovascular disease, diabetes, or chronic kidney disease were at a significantly higher risk of experiencing CHE.ConclusionAlthough Korea has greatly expanded its health insurance coverage, financial protection against CHE remains a concern. Policy-makers need to focus on expanding benefits according to the economic burden of individual chronic conditions.

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Section: Introductionmentioning

confidence: 99%

Association between chronic disease and catastrophic health expenditure in Korea

Choi

Kim

et al. 2015

BMC Health Serv Res

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“…One of the reasons for these phenomena is a low contribution rate to the NHI (5.89% of payroll income, 2013), which was induced from a low economic level in South Korea when the NHI started back in 1977, in addition to low contribution rates for developing non-covered services from medical care providers [ 4 ]. High out-of-pocket expenses result from copayment for insured services, full payment for non-covered services, and health care provider reimbursement for fee-for-service payments [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching

et al. 2015

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Study ObjectivesHealth care utilization has progressively increased, especially among Medical Aid beneficiaries in South Korea. The Medical Aid classifies beneficiaries into two categories, type 1 and 2, on the basis of being incapable (those under 18 or over 65 years of age, or disabled) or capable of working, respectively. Medical Aid has a high possibility for health care utilization due to high coverage level. In South Korea, the national health insurance (NHI) achieved very short time to establish coverage for the entire Korean population. However there there remaine a number of problems to be solved. Therefore, the objective of this study was to investigate the differences in health care utilization between Medical Aid beneficiaries and Health Insurance beneficiaries.Methods & DesignData were collected from the Korean Welfare Panel Study from 2008 to 2012 using propensity score matching. Of the 2,316 research subjects, 579 had Medical Aid and 1,737 had health insurance. We also analyzed three dependent variables: days spent in the hospital, number of outpatient visits, and hospitalizations per year. Analysis of variance and longitudinal data analysis were used.ResultsThe number of outpatient visits was 1.431 times higher (p<0.0001) in Medical Aid beneficiaries, the number of hospitalizations per year was 1.604 times higher (p<0.0001) in Medical Aid beneficiaries, and the number of days spent in the hospital per year was 1.282 times higher (p<0.268) for Medical Aid beneficiaries than in individuals with Health Insurance. Medical Aid patients had a 0.874 times lower frequency of having an unmet needs due to economic barrier (95% confidence interval: 0.662-1.156).ConclusionsHealth insurance coverage has an impact on health care utilization. More health care utilization among Medical Aid beneficiaries appears to have a high possibility of a moral hazard risk under the Health Insurance program. Therefore, the moral hazard for Medical Aid beneficiaries should be avoided.

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“…South Korea introduced the National Health Insurance (NHI) system in 1977 and set up coverage for the entire Korean population within a very short time by 1989. In South Korea, waiting times for various medical diagnoses and treatments are short, and the quality of medical care is good [1]. South Koreans' health status has improved rapidly during this period, and life expectancy at birth rose from 64.4 years in 1976 to 79.1 years in 2006 [2].…”

Section: Introductionmentioning

confidence: 99%

“…In particular, proper reimbursement of physicians was an unpopular policy, and physician's fees remained low long after universal coverage was achieved. This situation kept public expenditure as a proportion of total health expenditure low (55.3%), compared to an average of 72.5% among member countries of the Organisation for Economic Co-operation and Development (OECD) [1]. On the patient side, low benefit coverage and increases in out-of-pocket expenses led to a decrease in patient satisfaction rate, with only 49.2% of those insured reporting being satisfied with the NHI system [4,5].…”

Section: Introductionmentioning

confidence: 99%

Hourly wages of physicians within medical fees based on the Korean relative value unit system

Kim

Jung

Park

et al. 2020

Korean J Intern Med

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Background/Aims: It is difficult to reach a social agreement on the appropriate level of compensation for professionals. This study was performed to examine the physician fee embedded in the relative value unit (RVU) system in comparison with the Korean hourly minimum wage. Methods: The Health Insurance Service Price and the Korean Classification of Procedural Terminology were used to obtain the hourly wages of physicians for designated health care services. In addition, the physician fee schedule at the United States Centers for Medicare and Medicaid Services and the Organisation for Economic Cooperation and Development (OECD) report on minimal wage were used. Health care service fees were selected based on laboratory, pathology, imaging, and procedure codes as well as examination fees. For calculation of physician labor costs per hour, physician workload × conversion factor was divided by the time involved. To calculate the proportion of physician labor fee in the total fee, the physician workload RVU for each service fee was divided by the total RVU. Results: A total of 27 physician fee codes were selected. Compared to the Korean hourly minimum wage in 2015, the average physician wages were greater by 2.80fold for primary care and by 3.05-fold for tertiary care. The mean proportion of physician labor cost in the total cost was 0.19, which was significantly lower than that of corresponding procedures in the United States RVU (mean, 0.48). Conclusions: The average Korean physician wages compared to the hourly minimum wage were disproportionately low compared to the USA and other reference OECD countries.

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Sustainability of Korean National Health Insurance

Cited by 30 publications

References 2 publications

Association between chronic disease and catastrophic health expenditure in Korea

Association between chronic disease and catastrophic health expenditure in Korea

The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching

Hourly wages of physicians within medical fees based on the Korean relative value unit system

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