PubMed | National Health Insurance Authority, Seoul National University, University of Ghana, National Health Insurance Service and 3 more.
Type: Journal Article | Journal: BMC health services research | Year: 2016
Despite universal population coverage and equity being a stated policy goal of its NHIS, over a decade since passage of the first law in 2003, Ghana continues to struggle with how to attain it. The predominantly (about 70%) tax funded NHIS currently has active enrolment hovering around 40% of the population. This study explored in-depth enablers and barriers to enrolment in the NHIS to provide lessons and insights for Ghana and other low and middle income countries (LMIC) into attaining the goal of universality in Universal Health Coverage (UHC).We conducted a cross sectional mixed methods study of an urban and a rural district in one region of Southern Ghana. Data came from document review, analysis of routine data on enrolment, key informant in-depth interviews with local government, regional and district insurance scheme and provider staff and community member in-depth interviews and focus group discussions.Population coverage in the NHIS in the study districts was not growing towards near universal because of failure of many of those who had ever enrolled to regularly renew annually as required by the NHIS policy. Factors facilitating and enabling enrolment were driven by the design details of the scheme that emanate from national level policy and program formulation, frontline purchaser and provider staff implementation arrangements and contextual factors. The factors inter-related and worked together to affect client experience of the scheme, which were not always the same as the declared policy intent. This then also affected the decision to enrol and stay enrolled.UHC policy and program design needs to be such that enrolment is effectively compulsory in practice. It also requires careful attention and responsiveness to actual and potential subscriber, purchaser and provider (stakeholder) incentives and related behaviour generated at implementation levels.
News Article | March 3, 2017
SEJONG, SOUTH KOREA, March 03, 2017-- Dr. Sunho B. Chang has been included in Marquis Who's Who. As in all Marquis Who's Who biographical volumes, individuals profiled are selected on the basis of current reference value. Factors such as position, noteworthy accomplishments, visibility, and prominence in a field are all taken into account during the selection process.Backed by many years of practiced industry experience in the field of otolaryngology, Dr. Chang currently serves as the chairman and chief executive officer of Danyoung Laboratories Inc., and director of King Sejong ORL-HNS Clinic. He started his career in the ROK Army as a medical officer for the Gyeonggi-do Medical Center PAJU Hospital and Sorokdo National Hospital. That background propelled him to become a clinic professor at Soonchunhyang University Hospital and Korea University Anam Hospital, where he worked for a number of years.An alumnus of Soonchunhyang University, Dr. Chang holds a Bachelor and Master of Medical Science, an MD, and a Ph.D. His doctoral research focused on gene profiles in tonsillar squamous carcinoma by microarray-based comparative genomic hybridization. Notably, he has also taken courses in endoscopic surgery of the sinuses, Eustachian tube and ear, healthcare and medical policies, and disaster relief. Dr. Chang's professional affiliations include the Sejong and Korean Medical Associations, the Korean National Tuberculosis Association, the Seoul Medical Association, and the American Academy of Otolaryngology-Head and Neck Surgery.Along with other scholars, Dr. Chang has contributed his extensive knowledge to publications on such topics as allergic rhinitis classification (DANYOUNG classification), highly pathogenic infectious diseases (especially H1N1 Influenza Type A virus), Eolsorilogy (DANYOUNG HUNMINJEONGEUM, Korean language research), as well as many others. Throughout his career, Dr. Chang has been recognized for his professional accomplishments with the Good Conduct Award from the Korean Medical Association, an Appreciation plaque from the National Health Insurance Service, a Letter of Appreciation from the city mayor of San Pedro, Laguna, Philippines, a Letter of Commendation from the city mayor of Seoul Metropolitan government, Korea, Republic of, and Shimmian Research Award, as well as many others.About Marquis Who's Who :Since 1899, when A. N. Marquis printed the First Edition of Who's Who in America , Marquis Who's Who has chronicled the lives of the most accomplished individuals and innovators from every significant field of endeavor, including politics, business, medicine, law, education, art, religion and entertainment. Today, Who's Who in America remains an essential biographical source for thousands of researchers, journalists, librarians and executive search firms around the world. Marquis publications may be visited at the official Marquis Who's Who website at www.marquiswhoswho.com
PubMed | Soonchunhyang University, Korea University, Eulji University, National Health Insurance Service and National Cancer Control Institute
Type: Journal Article | Journal: Health policy (Amsterdam, Netherlands) | Year: 2016
The Korean government implemented an outpatient co-payment scheme in July 2007 to control Medical-Aid beneficiaries overutilization of healthcare services.To assess changes in the utilization of medical services resulting from the outpatient co-payment scheme.410,142 subjects were selected and health insurance reimbursement data from July 2006 to June 2011 was examined. We assessed the changes in the total medical cost, total adjusted patient days, inpatient days, inpatient total medical cost, the number of outpatient visits, and outpatient total medical cost using segmented regression analysis.Following the introduction of the policy, the number of outpatient visits per person fell by 0.16 days in July 2008, and by 0.06 days in July 2010, compared to June 2007. The outpatient total medical cost per person rose by $4.11 in July 2010 compared to June 2007. The inpatient utilization increased constantly during the period of the study. So the total medical cost as well as the total adjusted number of patient days also increased constantly.The outpatient co-payment policy was effective for reducing the number of outpatient visits. It could not control the cost per outpatient visit and inpatient utilization. So the total medical cost was increased.
Park C.,Severance Hospital |
Guallar E.,Welch Center for Prevention |
Guallar E.,National Center for Cardiovascular Research |
Linton J.A.,Severance Hospital |
And 9 more authors.
Diabetes Care | Year: 2013
Objective-Although diabetes increases the risk of cardiovascular disease (CVD) and mortality, the dose-response relationship between fasting glucose levels below those diagnostic of diabetes with cardiovascular events has not been well characterized. Research design and methods-A prospective cohort study of more than one million Koreans was conducted with a mean follow-up of 16 years. A total of 1,197,384 Korean adults with no specific medical conditions diagnosed were classified by baseline fasting serum glucose level. Associations of fasting glucose level with CVD incidence and mortality, stroke incidence and mortality, and all-cause mortality were analyzed using multivariate proportional hazards regression. ResultsThe relationships between fasting glucose levels and CVD risks generally followed J-shape curves, with lowest risk in the glucose range of 85-99 mg/dL. As fasting glucose levels increased to .100 mg/dL, risks for CVD, ischemic heart disease, myocardial infarction, and thrombotic stroke progressively increased, but risk for hemorrhagic stroke did not. Fasting glucose levels ,70 mg/dL were associated with increased risk of all stroke (hazard ratio 1.06, 95% CI 1.01-1.11) in men and (hazard ratio 1.11, 1.05-1.17) in women. Conclusions-Both low glucose level and impaired fasting glucose should be considered as predictors of risk for stroke and coronary heart disease. The fasting glucose level associated with the lowest cardiovascular risk may be in a narrow range. © 2013 by the American Diabetes Association.
Kim H.-S.,Yonsei University |
Jo J.,Yonsei University |
Lim J.E.,Yonsei University |
Yun Y.D.,National Health Insurance Service |
And 4 more authors.
Endocrine | Year: 2013
Adiponectin is found to associate with diabetes in studies apart from cohort studies. This prospective cohort study is to evaluate the predictive role of adiponectin in diabetes among participants with impaired fasting glucose (IFG). A total of 42,845 participants who visited 7 health examination centers located in Seoul and Kyunggi province, South Korea, during 2004-2008 were first included. Of the 42,845 participants, 5,085 participants had IFG. IFG was categorized as stage 1 (fasting glucose 100-109 mg/dL) or stage 2 (110-125 mg/dL). The incidence rates of diabetes were followed up to December, 2011. Hazard ratios (HRs) and 95 % confidence intervals (CI) were performed by Cox proportional hazard model. Of the 5,085 participants, 652 participants developed diabetes during a mean follow-up of 4.4 years. Low adiponectin was associated with diabetes among men with stage 2 IFG (HR, 1.78; 95 %CI, 1.33-2.38) while it was associated with diabetes among women with stage 1 IFG (HR, 2.64; 95 %CI, 1.38-5.03) and stage 2 IFG (HR, 2.17; 95 %CI, 1.07-4.42). When combined men and women, the association between adiponectin and diabetes was statistically significant in stage 2 IFG with an increase of about 82 % (HR, 1.82; 95 %CI, 1.40-2.39) after adjusting for age, sex, body mass index, waist circumference, and fasting serum glucose. There was an interaction by sex and stage 1 IFG in the association between adiponectin and risk of diabetes (P < 0.001). Adiponectin was independently associated with diabetes among participants with IFG. This association was apparent in stage 2 IFG. Adiponectin may be used as a predictor of diabetes in patients having IFG. © 2013 Springer Science+Business Media New York.
Jang S.Y.,Sungkyunkwan University |
Ju E.-Y.,Seoul National University |
Seo S.R.,National Health Insurance Service |
Choi J.Y.,Samsung |
And 3 more authors.
International Journal of Cardiology | Year: 2014
Background The aim of this study is to assess the changes in the causes of valvular heart disease between 2006 and 2011 in Korea. Methods Data were collected from the Korean National Health Insurance Service from 2006 through 2011. These data consisted of primary diagnoses related to valvular heart disease regardless of other conditions. Valvular heart disease included non-rheumatic mitral valve disorders, non-rheumatic aortic valve disorders, rheumatic mitral valve disorders, and rheumatic aortic valve disorders. Results Overall, the age-standardized cumulative prevalence of non-rheumatic valvular heart disease was 70.6 per 100,000 persons in 2006 and 110.3 in 2011. This represented an increase from 42.2 to 65.2 in women and from 28.4 to 45.1 in men. In particular, there was a greater increase in prevalence in patients aged 65 years or older compared with groups aged 20-44 years or 45-64 years for both genders. The age-standardized cumulative prevalence of rheumatic valve disease did not change dramatically between 2006 and 2011. Conclusions The overall age-standardized cumulative prevalence of non-rheumatic valvular heart diseases increased between 2006 and 2011, especially in individuals older than 65 years. These changes should be considered in future designs of cardiovascular healthcare services in countries with a rapidly aging population. © 2014 Elsevier Ireland Ltd. All rights reserved.
PubMed | Yonsei University, National Health Insurance Service, Seoul Metropolitan Government Research Institute of Public Health and Environment, Hallym University and Konkuk University
Type: Journal Article | Journal: BMC women's health | Year: 2016
The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography.Descriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rate of interval cancer of the breast were calculated.The crude detection rate of breast cancer screening per 100,000 participants increased from 126.3 in 2009 to 182.1 in 2014. The positive predictive value of breast cancer screening per 100,000 positives increased from 741.2 in 2009 to 1,367.9 in 2014. The incidence rate of interval cancer of the breast per 100,000 negatives increased from 51.7 in 2009 to 76.3 in 2014. The sensitivities of screening for breast cancer were 74.6% in 2009 and 75.1% in 2014 and the specificities were 83.1% in 2009 and 85.7% in 2014.To increase the detection rate of breast cancer by breast cancer screening using mammography, the participation rate should be higher and an environment where accurate mammography and reading can be performed and reinforcement of quality control are required. To reduce the incidence rate of interval cancer of the breast, it will be necessary to educate women after their 20s to perform self-examination of the breast once a month regardless of participation in screening for breast cancer.
PubMed | University of Ulsan and National Health Insurance Service
Type: Journal Article | Journal: NMR in biomedicine | Year: 2016
Contrast enhancement by an extracellular-fluid contrast agent (CA) (Gd-DOTA) depends primarily on the blood-brain-barrier permeability (bp), and transverse-relaxation change caused by intravascular T
PubMed | Yonsei University, National Health Insurance Service and Myongi Hospital
Type: | Journal: Cancer epidemiology | Year: 2016
Although reproductive and hormonal factors - such as early menarche and late menopause - have been reported as independent risk factors for cancer, few studies have examined these factors in East Asian populations.We performed a large prospective cohort study of 66,466 women. Ovarian hormone exposure was defined as length of time between menarche and menopause. Incidence rates for breast, ovarian, endometrial and cervical cancers were examined separately in relation to reproductive lifespan defined as age at menopause minus age at menarche. Multivariable adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated using the Cox proportional hazards model.Women with early menarche were at increased risk for developing breast cancer (HR, 1.57, 95% CI, 1.17-2.10) for age at menarche 12 years compared to women with age at menarche 17 years. Women with late age at menopause (52 years) had increased risks for cancers of the breast (HR, 1.59, 95%CI, 1.11-2.28) and ovary (HR, 3.22, 95% CI, 1.09-9.55) compared to women with early menopause (45 years of age). Women with longer duration of ovarian hormone exposure (40 years) were at increased risk for developing breast cancer (HR, 2.23, 95% CI, 1.35-3.68) as well as endometrial cancer (p for trend, 0.0209).We showed that longer reproductive spans are associated with an increased risk of breast and endometrial cancer in Korean women.
Epidemiology of Type 1 Diabetes Mellitus in Korea through an Investigation of the National Registration Project of Type 1 Diabetes for the Reimbursement of Glucometer Strips with Additional Analyses Using Claims Data
PubMed | National Health Insurance Service and National Health Insurance Service Ilsan Hospital
Type: Journal Article | Journal: Diabetes & metabolism journal | Year: 2016
The aim of this study was to estimate the prevalence and incidence of type 1 diabetes mellitus (T1DM) in Korea. In addition, we planned to do a performance analysis of the Registration Project of Type 1 diabetes for the reimbursement of consumable materials.To obtain nationwide data on the incidence and prevalence of T1DM, we extracted claims data from July 2011 to August 2013 from the Registration Project of Type 1 diabetes on the reimbursement of consumable materials in the National Health Insurance (NHI) Database. For a more detailed analysis of the T1DM population in Korea, stratification by gender, age, and area was performed, and prevalence and incidence were calculated.Of the 8,256 subjects enrolled over the 26 months, the male to female ratio was 1 to 1.12, the median age was 37.1 years, and an average of 136 new T1DM patients were registered to the T1DM registry each month, resulting in 1,632 newly diagnosed T1DM patients each year. We found that the incidence rate of new T1DM cases was 3.28 per 100,000 people. The average proportion of T1DM patients compared with each regions population was 0.0125%. The total number of insurance subscribers under the universal compulsory NHI in Korea was 49,662,097, and the total number of diabetes patients, excluding duplication, was 3,762,332.The prevalence of T1DM over the course of the study was approximately 0.017% to 0.021% of the entire population of Korea, and the annual incidence of T1DM was 3.28:100,000 overall and 3.25:100,000 for Koreans under 20 years old.