scholarly journals The Factors Influencing and Characteristics of National Health Insurance Utilizations among the Elderly Cancer Patients.

2009 ◽  
Vol null (44) ◽  
pp. 29-48
Author(s):  
이용재
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanghee Lee ◽  
Yoon Jung Chang ◽  
Hyunsoon Cho

Abstract Background Cancer patients’ prognoses are complicated by comorbidities. Prognostic prediction models with inappropriate comorbidity adjustments yield biased survival estimates. However, an appropriate claims-based comorbidity risk assessment method remains unclear. This study aimed to compare methods used to capture comorbidities from claims data and predict non-cancer mortality risks among cancer patients. Methods Data were obtained from the National Health Insurance Service-National Sample Cohort database in Korea; 2979 cancer patients diagnosed in 2006 were considered. Claims-based Charlson Comorbidity Index was evaluated according to the various assessment methods: different periods in washout window, lookback, and claim types. The prevalence of comorbidities and associated non-cancer mortality risks were compared. The Cox proportional hazards models considering left-truncation were used to estimate the non-cancer mortality risks. Results The prevalence of peptic ulcer, the most common comorbidity, ranged from 1.5 to 31.0%, and the proportion of patients with ≥1 comorbidity ranged from 4.5 to 58.4%, depending on the assessment methods. Outpatient claims captured 96.9% of patients with chronic obstructive pulmonary disease; however, they captured only 65.2% of patients with myocardial infarction. The different assessment methods affected non-cancer mortality risks; for example, the hazard ratios for patients with moderate comorbidity (CCI 3–4) varied from 1.0 (95% CI: 0.6–1.6) to 5.0 (95% CI: 2.7–9.3). Inpatient claims resulted in relatively higher estimates reflective of disease severity. Conclusions The prevalence of comorbidities and associated non-cancer mortality risks varied considerably by the assessment methods. Researchers should understand the complexity of comorbidity assessments in claims-based risk assessment and select an optimal approach.


2020 ◽  
Vol 7 (2) ◽  
pp. 102-110
Author(s):  
RA Tuty Kuswardhani ◽  
I Nyoman Budiana

Social Security Administration Agency of Health has a National National Health Insurance formulary, but in reality patients do not get drugs according to the National Health Insurance National Formulary. Therefore, the aims of this study are to determine the legal protection of patients of the Social Security Administration Agency of Health for the elderly in curative therapy in hospitals according to the national formulary of National Health Insurance at Sanglah Hospital and Balimed Hospital, and to know the responsibilities undertaken by the Social Security Administration Agency of Health in fulfilling its obligations for patients the Agency for the Implementation of the Social Health Insurance of the elderly in curative therapy in accordance with the national formulary of the National Health Insurance. This study uses a participatory observational (empirical-observational) empirical legal research method. Sampling with purposive sampling and data collection techniques using triangulation techniques. In principle, legal protection must refer to legal certainty, fairness and benefits for the population participating in the Social Security Administration Agency of Health for the elderly so that it is not impressed that Balimed Hospital and Sanglah General Hospital and the Social Security Administration Agency of Health make a service to consumers who are not good. The legal responsibility that should be obtained by the participants of the Social Security Administration Agency of Health for the elderly in Balimed Hospital and Sanglah Hospital Denpasar which is currently not maximally received by patients participating in the Social Security Administration Agency of Health for the elderly at Balimed Hospital and Sanglah Hospital.


2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 55-55
Author(s):  
Ruey Kuen Hsieh ◽  
Yu-Lin Lin ◽  
Chao-Hsiun Tang

55 Background: Pain assessment and management had been adopted as an important criteria in hospital accreditation in Taiwan. National health insurance database may help to determine factors influencing patterns of strong opioid use in advanced cancer patients in their final 12 months of life. Methods: Cancer patients who died from cancer during 2008-2011 were included in the analysis. Data in prescription of strong opioids during their last 12 months of life were collected and analyzed using National Health Insurance Research Database (NHIRD). Patient’s characteristics, such as cancer types, birthdate and gender, as well as information on the provider’s characteristics, such as specialty, gender and age of the physician, the ownership and level of accreditation of the hospital, and the level of urbanization of the hospital where it is located, were also retrieved and included as the controlled variables in the analysis. Results: Of the 162,679 cancer deaths, 57,578 were prescribed strong opioids in their last year of life (35.4 percent). Strong opioid prescription steadily decreased with the corresponding increase in patient age. Besides there are difference in different cancer types. Association with prescription prevalence has also been noted among physician characteristics such as subspecialty, gender and age, as well among hospital characteristics, such as public vs private and accreditation level. Conclusions: There are significant difference in strong opioids prescription among different care providers for advanced cancer patients. Information from this study can guide further efforts in improving supportive care and education for advanced cancer care providers.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kwawukume Mawumenyo Aku ◽  
Kofi Akohene Mensah ◽  
Peter Twum ◽  
Peter Agyei-Baffour ◽  
Daniel Opoku ◽  
...  

Background. In the quest to prevent households from making catastrophic expenditures at the point of seeking healthcare, the government of Ghana introduced the National Health Insurance in 2003. However, people are reluctant to renew their membership. This study was, therefore, conducted to identify factors influencing the nonrenewal of National Health Insurance membership in the Ejisu-Juaben Municipality. Methods. A cross-sectional study was conducted among 427 respondents in the Ejisu-Juaben Municipality to ascertain factors influencing the nonrenewal of health insurance membership status. Data were entered and analyzed using Stata version 14. Univariate and multivariate analyses were performed to determine sociodemographic factors, household factors, and systemic factors influencing the nonrenewal of health insurance status. Statistical significance for all testing was set as p ≤ 0.05 . Results. Sociodemographic factors such as gender (AOR = 0.531; CI = 0.287–0.985) and educational level (AOR = 5.268; CI = 1.130–24.551)) were associated with the nonrenewal of health insurance membership. Income levels in Ghana Cedis were 500–1000 (AOR = 0.216; CI = 0.075–0.617) and 1001–2000 (AOR = 0.085; CI = 0.019–0.383). Systemic decision on factors such as clients’ satisfaction (AOR = 0.149; CI = 0.035–0.640), making copayment (AOR = 0.152; CI = 0,068–0.344), acquiring all prescribed drugs (AOR = 4.191; CI = 2.027–8.668), and awareness of mobile renewal (AOR = 3.139; CI = 1.462–6.739) was associated with nonrenewal of membership. Conclusions. The nonrenewal of health insurance membership was influenced by sociodemographic, household, and systemic factors. Therefore, the Municipal Health Directorate and the National Health Insurance Authority have to work on these factors to reach the target of 100% active coverage in the municipality.


Sign in / Sign up

Export Citation Format

Share Document