Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage

Kwon, Soonman

doi:10.1093/heapol/czn037

Cited by 452 publications

(408 citation statements)

References 17 publications

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“…Because there is mandatory health insurance for residents in Korea managed by the NHIS, the claims data used represented the entire population in the country (10). Therefore, access to this data allowed us to estimate the overall medical expenditure resulting from hepatitis infections in South Korea as a whole.…”

Section: Methodsmentioning

confidence: 99%

The Economic Burden of Hepatitis A, B, and C in South Korea

et al. 2016

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SUMMARY:The prevalence of hepatitis in South Korea is relatively high compared to that in other high-income countries. For this reason, viral hepatitis infection not only affects the population's health, but also impacts national healthcare costs. This study was performed in order to estimate the individual economic costs of the hepatitis A, B, and C viruses as well as to determine, using nationally representative data, the trends in South Korea with respect to these viruses during the 2008-2011 period. The study found that the prevalence of hepatitis A had decreased, but those of hepatitis B and C had increased overall. The mortality rate of hepatitis C was higher than that of the other two types. The mortality rate of hepatitis B had changed little, whereas that of hepatitis C had risen.

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Section: Methodsmentioning

confidence: 99%

The Economic Burden of Hepatitis A, B, and C in South Korea

et al. 2016

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“…14 Some countries such as Turkey, [15][16][17] South Korea, 18,19 Brazil, Thailand, Ghana, Peru, 20 Estonia, Lithuania, 21 and Indonesia [22][23][24] have adopted this policy to expand the size of the risk pool, and to improve the equity, efficiency, and redistribution of cross-subsidization throughout the entire health insurance system.…”

Section: Policy Contextmentioning

confidence: 99%

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Bazyar¹,

Rashidian²,

Kane³

et al. 2016

Int J Health Policy Manag

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There are fragmentations in Iran's health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI) schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper.

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“…Korea also faces with health care spending issue that the highest rate of growth, more than twice the OECD average (OECD, 2012). NHI members still need to pay high out-of-pocket payment (copayments) and full payment for uncovered services, to some extent related to fee-for-service reimbursement system that might supplier induces demand and relatively fast adoption of state-of-art technologies (Kwon, 2009). …”

Section: Introductionmentioning

confidence: 99%

Copayment Policy Effects on Healthcare Spending and Utilization by Korean Lung Cancer Patients at End of Life: A Retrospective Cohort Design 2003-2012

Kim¹,

Han²,

Park³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.

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Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage

Cited by 452 publications

References 17 publications

The Economic Burden of Hepatitis A, B, and C in South Korea

The Economic Burden of Hepatitis A, B, and C in South Korea

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Copayment Policy Effects on Healthcare Spending and Utilization by Korean Lung Cancer Patients at End of Life: A Retrospective Cohort Design 2003-2012

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