scholarly journals Cohort Profile: National health insurance service-senior (NHIS-senior) cohort in Korea

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e024344 ◽  
Author(s):  
Yong Ik Kim ◽  
Yeon-Yong Kim ◽  
Jong Lull Yoon ◽  
Chang Won Won ◽  
Seongjun Ha ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Care Service ◽  
Academic Research ◽  
Healthcare Utilisation ◽  
Malignant Neoplasms ◽  
Term Care ◽  
Public Data

PurposeThe National Health Insurance Service (NHIS)-Senior was set up to provide high-quality longitudinal data that can be used to explore various aspects of changes in the socio-economical and health status of older adults, to predict risk factors and to investigate their health outcomes.ParticipantsThe NHIS-Senior cohort, a Korean nationwide retrospective administrative data cohort, is composed of older adults aged 60 years and over in 2002. It consists of 558 147 people selected by 10% simple random sampling method from a total of 5.5 million subjects aged 60+ in the National Health Information Database. The cohort was followed up through 2015 for all subjects, except for those who were deceased.Findings to dateThe healthcare utilisation and admission rates were the highest for acute upper respiratory infections and influenza (75.2%). The age-standardised (defined with reference to the world standard population) mortality rate for 10 years (through 2012) was 4333 per 100 000 person-years. Malignant neoplasms were the most common cause of death in both sexes (1032.1 per 100 000 person-years for men, 376.7 per 100 000 person-years for women). A total of 34 483 individuals applied for long-term care service in 2008, of whom 17.9% were assessed as grade 1, meaning that they were completely dependent on the help of another person to live daily life.Future plansThe data are provided for the purposes of policy and academic research under the Act on Promotion of the Provision and Use of Public Data in Korea. The NHIS-Senior cohort data are only available for Korean researchers at the moment, but it is possible for researchers outside the country to gain access to the data by conducting a joint study with a Korean researcher. The cohort will be maintained and continuously updated by the NHIS.

scholarly journals Does insurance enrolment increase healthcare utilisation among rural-dwelling older adults? Evidence from the National Health Insurance Scheme in Ghana

2018 ◽  
Vol 3 (1) ◽  
pp. e000590 ◽  
Author(s):  
Nele van der Wielen ◽  
Andrew Amos Channon ◽  
Jane Falkingham
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Rural Areas ◽  
Outpatient Care ◽  
National Health Insurance Scheme ◽  
Healthcare Utilisation ◽  
Insurance Scheme ◽  
Inpatient And Outpatient Care

IntroductionThis paper examines the relationship between national health insurance enrolment and the utilisation of inpatient and outpatient healthcare for older adults in rural areas in Ghana. The Ghanaian National Health Insurance Scheme (NHIS) aims to improve affordability and increase the utilisation of healthcare. However, the system has been criticised for not being responsive to the needs of older adults. The majority of older adults in Ghana live in rural areas with poor accessibility to healthcare. With an ageing population, a specific assessment of whether the scheme has benefitted older adults, and also if the benefit is equitable, is needed.MethodsUsing the Ghanaian Living Standards Survey from 2012 to 2013, this paper uses propensity score matching to estimate the effect of enrolment within the NHIS on the utilisation of inpatient and outpatient care among older people aged 50 and over.ResultsThe raw results show higher utilisation of healthcare among NHIS members, which persists after matching. NHIS members were 6% and 9% more likely to use inpatient and outpatient care, respectively, than non-members. When these increases were disaggregated for outpatient care, the non-poor and females were seen to benefit more than their poor and male counterparts. For inpatient care, the benefits of enrolment were equal by poverty status and sex. However, overall, poor older adults use health services much less than the non-poor older adults even when enrolled.ConclusionThe results indicate that NHIS coverage does increase healthcare utilisation among rural older adults but that inequalities remain. The poor are still at a great disadvantage in their use of health services overall and benefit less from enrolment for outpatient care. The receipt of healthcare is significantly influenced by a set of auxiliary barriers to access to healthcare even where insurance should remove the financial burden of ad hoc out of pocket payments.

scholarly journals Physician Palliative Education Associated With High Use of Hospice Care Service

2021 ◽  
pp. 104990912110141
Author(s):  
Mei-Hsing Chuang ◽  
Fang-Niarn Lee ◽  
Yih-Tsong Shiau ◽  
Hsiu-Yi Shen ◽  
Chih-Ching Lee ◽  
...  
Keyword(s):  
Renal Failure ◽  
Health Insurance ◽  
End Of Life ◽  
National Health Insurance ◽  
National Health ◽  
Hospice Care ◽  
Care Service ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Services

Background: Taiwan’s National Health Insurance provides coverage for palliative and hospice care. The following 10 types of diseases have been added to the National Health Insurance reimbursement regulation: end-stage cancer, motor neuron disease, organic psychosis, brain degeneration, heart failure, chronic airway obstruction diseases, other lung diseases, chronic liver disease and cirrhosis, acute renal failure, and chronic renal failure. Objective: This study aimed to determine the association between physicians’ palliative education and use of hospice care in hospitalized patients at the end of life. Design and Setting: A cross-sectional study in a Taipei community hospital. Participants: Patients who died between 2014 and 2019 were identified. The deceased had at least 1 of the 10 diseases covered by health insurance were included. Hospice care services included hospice ward care and hospice shared care. This study included 2,661 individuals. In total, 972 (36.5%) patients used hospice care services. Results: After adjusting for age, gender, and comorbidities, physicians’ palliative education was found to significantly associated with the use of hospice care (OR: 14.38, 95% CI: 10.90-18.98). Conclusions: Physicians’ palliative education was found to be an independent factor associated with higher use of hospice care. The findings suggest increasing palliative and hospice education among physicians so that they can ensure that their patients have high-quality end-of-life medical care in an aging society.

scholarly journals Does the implementation of national health insurance affect the workload of a doctor and have an impact on service quality? A systematic literature review

2019 ◽  
Author(s):  
Tri A. Sugiyatmi ◽  
Usman Hadi ◽  
Djazuli Chalidyanto ◽  
Firdauz Hafidz ◽  
Muhammad Miftahussurur
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Care Service ◽  
Health Care Service ◽  
Health Financing ◽  
Research Database ◽  
Period Range ◽  
And Function

National Health Insurance (NHI) was originally a health financing reform that eventually became a ‘driver’ for changes in all health care sectors. The burden on doctors in health facilities is likely to increase due to its changes in standard fees for medical services. This study aimed to describe NHI system changes that will affect doctor’s professionalism. This is a systematic review taken from MEDLINE complete of EBSCOhost research database. The search period range covered between 1983 to October 19 2018. The results revealed 853 unique citations which globally stated about the potential impact of NHI implementation on doctors. The majority studies indicate that there is a relationship of the implementation of NHI, workload of doctors and quality of health care service. It can be concluded that NHI implementation requires a large quantity of human resources, especially doctors. Therefore, doctors are advised to adapt to their role and function in this era of NHI.

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