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COVID-19: Perspective
New Obligations of Health Insurance Review and Assessment Service: Taking Full-fledged Action Against the COVID-19 Pandemic
Seung Mi Yoo, Seol Hee Chung, Won Mo Jang, Kyoung Chang Kim, Jin Yong Lee, Sun Min Kim
J Prev Med Public Health. 2021;54(1):17-21.   Published online January 26, 2021
DOI: https://doi.org/10.3961/jpmph.20.594
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  • 3 Web of Science
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AbstractAbstract AbstractSummary PDF
In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.
Summary
Korean summary
건강보험심사평가원은 전 국민과 전체 요양기관의 축적된 정보, 전체 요양기관과 연결된 네트워크, 실시간 데이터 공유를 통해 이번 코로나19 위기 대응에 기여했다. 건강보험심사평가원은 1) 진단검사∙약제 등재, 2) 요양기관 내 고위험군 감지, 3) 마스크 중복구매 방지 시스템 구축, 4) 주요 보건의료자원 가동현황 모니터링 시스템 구축, 5) 환자관리 정보시스템 구축 및 익명화된 환자 데이터 공개로 국제협력연구 촉진의 다섯 가지 전략을 성공적으로 수행했다. 건강보험심사평가원은 현재의 보건위기 상황을 극복하고, 코로나19 시대 이후로도 새롭게 주어진 위기대응의 역할과 소명을 다할 것이다.

Citations

Citations to this article as recorded by  
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Special Article
Korean National Health Insurance Value Incentive Program: Achievements and Future Directions
Sun Min Kim, Won Mo Jang, Hyun Ah Ahn, Hyang Jeong Park, Hye Sook Ahn
J Prev Med Public Health. 2012;45(3):148-155.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.148
  • 10,592 View
  • 102 Download
  • 26 Crossref
AbstractAbstract PDF

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

Summary

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English Abstract
Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea.
Kyoung Hoon Kim, Choon Seon Park, Jin Hee Chang, Nam Soon Kim, Jin Seo Lee, Bo Ram Choi, Byung Ran Lee, Kyoo Duck Lee, Sun Min Kim, Seon A Yeom
J Prev Med Public Health. 2010;43(3):235-244.
DOI: https://doi.org/10.3961/jpmph.2010.43.3.235
  • 5,933 View
  • 89 Download
  • 10 Crossref
AbstractAbstract PDF
OBJECTIVES
To examine the prophylactic antibiotic use in reducing surgical site infection. METHODS: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. RESULTS: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. CONCLUSIONS: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
Summary

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Original Articles
Cost-Benefit Analysis of Back School Program for Occupational Low Back pain Patients.
Yeong Su Ju, Mi Na Ha, Sang Hwan Han, Ho Jang Kwon, Soo Hun Cho, Chang Yup Kim, Sun Min Kim
Korean J Prev Med. 1996;29(2):347-358.
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AbstractAbstract PDF
Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.
Summary
Cross-sectional Study on Respiratory Symptoms due to Air Pollution Using a Questionnaire.
Ho Jang Kwon, Soo Hun Cho, Sun Min Kim, Mi Na Ha, Sang Hwan Han
Korean J Prev Med. 1994;27(2):313-325.
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AbstractAbstract PDF
A cross-sectional study was conducted in an effort to investigate the effect of air pollution on respiratory symptoms. Two groups of female aged more than 20 living in the unpolluted rural area of Taebul(n=159) and urban area of Taegu(n=140)were selected. The ATS-DAD-78 questionnaire was translated into Korean and administered with minor modification. The proportion of smoker was less than 1% in both area. Exposure to smoking and higher educational level were more frequent in Taegu. Age-adjusted prevalence rates of 'chronic cough', 'chronic sputum', 'wheezing', and 'dyspnea' were higher in Taegu than in Taebul. In particular, the prevalence rate of 'chronic sputum' in Taegu was found to be higher, which was statistically significant. Exposure to smoking and education level were not concerned with all respiratory symptom prevalence rates. In conclusion, this study indicates that an urban factor is related to the rates of respiratory symptoms in Korea.
Summary
Effects Of Glue Sniffing On Weight Increase Or Central Nervous System Of Young Rat.
Heon Kim, Sun Min Kim, Soo Hun Cho
Korean J Prev Med. 1993;26(2):222-230.
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  • 22 Download
AbstractAbstract PDF
Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th, 24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic difference were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.
Summary
Development Of An On Site Diagnostic Tool To Detect Neuropsychiatric Impairment Due To Chronic Organic Solvent Exposure.
Soo Hun Cho, Sun Min Kim, Ho Jang Kwon, Yong Hyun Yim, Hyun Sul Lim
Korean J Prev Med. 1993;26(1):147-164.
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AbstractAbstract PDF
A study has been conducted on developing questionnaire to serve as on site diagnostic tools for the early detection of neuropsychiatric impairment among workers chronically exposed to low-level organic solvents. Two drafts of tentative questionnaire have been developed as follows ; several question items were selected from questionnaires which were administered to workers exposed to organic solvents in previous studies and were grouped into each symptom category based on the presence of its association using Guttman scaling method, then these selected items were reviewed by neuropsychiatry specialists. The final draft of the questionnaire (total symptom score=36) was developed by selecting 33 question items which had more than a 0.88 Guttman coefficient of reproducibility in each symptom category from a pilot study in which these tentative questionnaires were administered to workers manufacturing soles. Three plants using organic solvents and one plant never using organic solvents as a control group were selected to test the reliability and validity of the developed questionnaires. The major organic solvent in the workplace environment detected by a personal air sampler and GC/MSD was toluene. The concentration of toluene in air from the department using organic solvent was statistically different from that of the department never using organic solvent. The concentration of toluene from almost all of the workplace did not exceed the allowable level. There was no statistically significant difference between the concentration of urinary hippuric acid from the workers of the department using organic solvent and that of the department never using it. Total symptom score of the plant never using organic solvents was 9.8 and those of the three plants using organic solvents were 15.6, 14.7, and 13.7 respectively. In order to evaluate the validity of the questionnaires, the workers from two different department of the plant in which usage of organic solvents are totally different were compared. The total symptom score was 17.8 for workers of the department using organic solvent and 13.5 for the department never using organic solvent and scores of each symptom group between exposure and non-exposure group also showed statistically significant difference. The finding that total symptom score of the usefulness of the developed questionnaire to assess the health effects of chronic exposure to organic solvents. The correlation coefficient, which was calculated to evaluate the test-retest reliability, was 0.581(p=0.001). The coefficient of Crohnbach which reflects the internal consistency of the questionnaire was 0.91. In conclusion, the reliability of the questionnaire was well maintained over the time lapse between the two administrations of the questionnaire and despite the seasonal difference.
Summary
Environmental pullution related health problems reported in newspapers.
Soo Hun Cho, Sun Min Kim, Sung Il Cho
Korean J Prev Med. 1993;26(1):126-136.
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AbstractAbstract PDF
To understand the possible hazards to health from the environmental pollution in Korea, the articles reported in 16 daily newspapers were collected and analyzed. From 1980 to 1991, ninety three cases were reported. Statistics show that, during the last 2 years, there has been a remarkable increases of health problems reported. The main sources of pollution were plants and the transportation facilities. Except the noise, the exact causative factors were, for the most part, not clearly described. Although many residents complained of neurological symptoms, the exact effects on health were not clearly investigated. The responses of the residents were diverse in the contents of the demand and the method of its pushing, however, the government did not show immediate and consistent counterplans.
Summary
Carboxyhemoglobin Dissociation Pattern by Age in the Rat.
Sun Min Kim, Heon Kim, Soo Hum Cho
Korean J Prev Med. 1991;24(4):507-515.
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AbstractAbstract PDF
One, two, six and ten week old Sprague-Dawley rats were exposed to carbon monoxide at 3,700 ppm for 30 minutes, and carboxyhemoglobin was measured immediateley, 5, 30, 60, 90, 120 minutes after the exposure. In each time after the exposure, the means of the carboxyhemoglobin levels were "compared among the week age groups. The regression analysis was done using the natural logarithm. of the carboxyhemoglobin concentration as a dependent variable and the time after the exposure. as an independent vaiable. From the regression equation, the half lives of the carboxyhemoglobin were calculated. The one week old rats showed significantly higher carboxyhemoglobin level than other week age rats in the entire time after the exposure. The corrected carboxyhemoglobin concentration calculated by subtracting the normal carboxyhemoglobin level from the me cured carboxyhemoglobin at each age group, showed no uniform differences.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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