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JKM > Volume 39(3); 2018 > Article
Kim, Kim, and Han: An E-mail survey for expanding the basic benefit package of Korean medicine in Korean national health insurance

Abstract

Objectives

This study aimed to investigate the opinions of Korean medical doctors on how to elucidate possible remedial measures for expanding the health insurance benefits coverage item of Korean medicine (KM).

Methods

An online survey was conducted to all members who had registered e-mail address in the association of Korean medicine from 1 to 17 November, 2016. Statistical analysis was performed and odds ratio with 95% confidence interval were calculated by each subgroup.

Results

A total of 743 members answered the questions and the response rate was 4.1%. The priorities for expanding health insurance benefits were as follows: thermographic imaging, Sasang constitution typing test, and pulse wave among examinations; pharamacopuncture, embedding acupuncture, and acupotomy among procedures; Chuna manual therapy, manual therapy for meridian muscle, and Daoyin exercise therapy among manual therapies; low-frequency electrical therapy, traction, paraffin bath, and light therapy among physical therapies; and aromatherapy, enema therapy, and color therapy among activities of KM.

Conclusions

It should be covered by the national health insurance (NHI) of KM that thermographic imaging, pharmacoacupuncture, Chuna manual therapy, low-frequency electrical therapy, aromatherapy as a top priority. We also suggest that basic medical tests, such as blood, urine, or imaging, should be included in the coverage of the NHI of KM. It is necessary to review the expertise and public opinions about the plans and priorities for the conversion of the desired medical services to be covered by the NHI.

Fig. 1
Responses on extending health insurance benefits coverage items of Korean medical examinations.
jkm-39-3-51f1.gif
Fig. 2
Responses on extending health insurance benefits coverage items of Korean medical procedures
jkm-39-3-51f2.gif
Fig. 3
Responses on extending health insurance benefits coverage items of Korean medical manual therapies
jkm-39-3-51f3.gif
Fig. 4
Responses on extending health insurance benefits coverage items of Korean medical physical therapies
jkm-39-3-51f4.gif
Fig. 5
Responses on extending health insurance benefits coverage items of Korean medical activities
jkm-39-3-51f5.gif
Table 1
Characteristics of the Respondents
number (%) n=743

Sex male female TR NR

609(82.0) 134(18.0) 743 0

AG 20’s 30’s 40’s 50’s 60’s& over TR NR
83(11.2) 257(34.6) 261(35.1) 119(16) 23(3.1) 743 0

CE (yrs) <2 2–4 5–9 10–19 ≥20 TR NR
70(9.5) 137(18.5) 134(18.1) 256(34.6) 256(34.6) 740 3

Affiliation KMC KMH PMIor MH NH Univ Res Etc. TR NR
523(70.4) 82(11) 52(7) 30(4) 35(4.7) 9(1.2) 12(1.6) 743 0

Specialty GP SP TR NR
560(75.4) 183(24.6) 743 0
IM SC Acu RM OG PED NP E&D TR NR
74(40.4) 10(5.5) 31(16.9)25(13.7) 23(12.6) 5(2.7) 10(5.5) 5(2.7) 183 0

TR: total number of respondents, NR: number of no response, AG: age group, CE: clinical experience, yrs: years, KMC: Korea medicine clinic, KMH: Korean medicine hospital, PMI: public medical institution, MH: military hospital, NH: nursing hospital, Univ: university, Res: Research institute, GP: general physician, SP: specialist, IM: internal medicine, SC: Sasang constitutional medicine, Acu: acupuncture & moxibustion medicine, RM: rehabilitation medicine, OG: obstetrics & gynecology, PED: pediatrics, NP: neuropsychiatry, E&D: eye, ear, nose, throat department and dermatology

Table 2
Differences in Response Patterns by Subgroups on Extending Health Insurance Benefits Coverage Items of Korean Medical Examinations.
OR (95%CI)

KMC SP CE 20 yrs
Pulse wave test 1.01 (0.73, 1.40) 1.15 (0.81, 1.62) 0.60 (0.42, 0.88)*
Pulse wave velocity test 0.72 (0.51, 1.01) 1.32 (0.92, 1.88) 0.62 (0.42, 0.91)*
Penile tumescence test 0.71 (0.39, 1.29) 0.68 (0.32, 1.42) 0.29 (0.16, 0.53)*
Sasang constitution typing test 0.92 (0.67, 1.27) 1.00 (0.71, 1.40) 0.48 (0.33, 0.70)*
Body shape test 1.49 (0.75, 2.97) 0.49 (0.22, 1.12) 0.40 (0.22, 0.75)*
Digital infrared thermographic imaging 0.68 (0.50, 0.94)* 1.12 (0.79, 1.39) 1.47 (1.02, 2.12)*
Live blood analysis 0.92 (0.66, 1.30) 0.44 (0.36, 0.81)* 1.82 (1.17, 2.84)*
Muscle function analysis 0.68 (0.48, 0.95)* 0.76 (0.52, 1.11) 1.32 (0.87, 2.01)
Voice analysis 0.68 (0.36, 1.26) 0.87 (0.42, 1.8) 1.11 (0.50, 2.44)
Nothing to add 1.53 (0.86, 2.73) 1.03 (0.59, 1.81) 1.07 (0.57, 2.01)

OR: odds ratio, KMC: Korea medicine clinic, SP: specialist, CE: clinical experience, yrs: years

* statistically significant

Table 3
Differences in Response Patterns by Subgroups on Extending Health Insurance Benefits Coverage Items of Korean Medical Procedures
OR (95%CI)

KMC SP CE < 20 yrs
Acupuncture needle-thread insertion 0.93 (0.42, 2.08) 0.63 (0.24, 1.68) 0.35 (0.16, 0.76)*
Acupotomy 0.81 (0.57, 1.15) 0.89 (0.60, 1.30) 1.27 (0.83, 1.96)
Pharmacopuncture 1.00 (0.62, 1.62) 1.09 (0.65, 1.84) 0.84 (0.48, 1.49)
Gun pharmacopuncture 0.64 (0.36, 1.13) 0.36 (0.00, 0.03)* 1.05 (0.52, 2.15)
Embedding acupuncture 0.83 (0.60, 1.14) 0.90 (0.64, 1.28) 1.29 (0.88, 1.90)
Multiple maesik pharmacopuncture 1.70 (0.47, 6.08) 0.22 (0.03, 1.65) 1.56 (0.35, 7.00)
Nothing to add 1.02 (0.56, 1.83) 0.88 (0.46, 1.67) 1.32 (0.63, 2.76)

OR: odds ratio, KMC: Korea medicine clinic, SP: specialist, CE: clinical experience, yrs: years

* statistically significant

Table 4
Differences in Response Patterns by Subgroups on Extending Health Insurance Benefits Coverage Items of Korean Medical Manual Therapies
OR (95%CI)

KMC SP CE < 20 yrs
Daoyin exercise therapy 0.83 (0.60, 1.15) 0.91 (0.64, 1.30) 0.88 (0.60, 1.29)
Manual therapy for meridian muscle 0.81 (0.59, 1.11) 0.79 (0.56, 1.10) 1.48 (1.03, 2.14)
Chuna manual therapy 0.69 (0.44, 1.10) 0.81 (0.52, 1.27) 1.09 (0.66, 1.77)
Other manual therapy 1.16 (0.57, 2.35) 0.62 (0.27, 1.42) 0.39 (0.20, 0.75)*
Nothing to add 1.00 (0.51, 1.96) 1.32 (0.67, 2.57) 3.42 (1.04, 11.21)*

OR: odds ratio, KMC: Korea medicine clinic, SP: specialist, CE: clinical experience, yrs: years

* statistically significant

Table 5
Differences in Response Patterns by Subgroups on Extending Health Insurance Benefits Coverage Items of Korean Medical Physical Therapies
OR (95%CI)

KMC SP CE < 20 yrs
Meridian transcutaneous quick freezing therapy 0.56 (0.38, 0.81)* 1.22 (0.81, 1.84) 0.62 (0.41, 0.95)*
Paraffin bath 0.87 (0.62, 1.21) 1.30 (0.91, 1.84) 0.67 (0.46, 0.97)*
Low-frequency electrical therapy 0.82 (0.58, 1.15) 1.45 (1.00, 2.10) 0.45 (0.29, 0.70)*
Magnetic acupoint therapy 1.59 (1.00, 2.51) 0.48 (0.28, 0.82)* 0.61 (0.39, 0.96)*
Light therapy 0.59 (0.42, 0.84)* 1.21 (0.84, 1.76) 0.46 (0.32, 0.68)*
Hydrotherapy 0.93 (0.55, 1.58) 0.74 (0.40, 1.36) 0.45 (0.27, 0.77)*
Traction therapy 0.81 (0.59, 1.12) 1.34 (0.96, 1.88) 1.28 (0.89, 1.84)
Iontophoresis therapy of herbal medicine 0.84 (0.56, 1.26) 0.95 (0.61, 1.47) 0.83 (0.53, 1.32)
Korean medical speech therapy 0.47 (0.28, 0.78)* 1.62 (0.94, 2.78) 0.64 (0.36, 1.16)
Pressure therapy 0.75 (0.43, 1.29) 0.57 (0.28, 1.14) 0.60 (0.33, 1.08)
Nothing to add 1.42 (0.56, 3.58) 1.14 (0.47, 2.76) (0.55, 6.28)

OR: odds ratio, KMC: Korea medicine clinic, SP: specialist, CE: clinical experience, yrs: years

* statistically significant

Table 6
Differences in Response Patterns by Subgroups on Extending Health Insurance Benefits Coverage Items of Korean Medical Activities
OR (95%CI)

KMC SP CE < 20 yrs
Enema therapy 0.82 (0.55, 1.21) 1.44 (0.96, 2.16) 0.43 (0.28, 0.65)*
Leech therapy 1.06 (0.58, 1.93) 0.83 (0.43, 1.61) 1.27 (0.61, 2.65)
Aromatherapy 0.79 (0.57, 1.08) 0.98 (0.70, 1.37) 0.84 (0.59, 1.22)
Color therapy 1.73 (0.94, 3.18) 0.49 (0.25, 0.99)* 0.53 (0.31, 0.93)*
Nothing to add 1.03 (0.75, 1.41) 0.92 (0.66, 1.30) (1.25, 2.72)*

OR: odds ratio, KMC: Korea medicine clinic, SP: specialist, CE: clinical experience, yrs: years

* statistically significant

참고문헌

1 Kim J. Challenges of Health Insurance Coverage: Coverage Expansion. Health Insurance Forum. 2007; 6:2. 37–59.


2 Heo S, Kim C. An Evaluation of Benefit Extension Strategies of the Korean National Health Insurance. Journal of Korean Academy of Health Policy and Management. 2009; 19:3. 142–65.
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4 Kim M. Comparison of the coverage rate of health insurance benefit items. KiRi Monthly Review of Aging. 2016; 1:19–21.


5 Kim J, Kim Y. The Benefits of the National Health Insurance and Oriental Medical Services. The Journal of Oriental Medical Preventive. 2007; 11:1. 139–51.


6 Nam J. The 3rd Korean medicine development plan and the futhre of Korean medicine. NIKOM Report of Korean Medicine Policy. 2016; 1:1. 17–23.


7 National Health Insurance Policy Institute. 2015 Survey on the cost of medical insurance. NHI;2016.
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8 Korea Health Industry Development Institute. 2014 Investigation of Korean medicine use and herbal medicine consumption. KHIDI;2015.


9 Korea Institute of Oriental Medicine. Suvey on Korean medical doctors’ awareness of Korean health insurance policy. KIOM;2017.


10 Kim Y. Record information contents of National Archives of Korea: A begning of the health insurance services for Korean medical services. 2007. Available at:URL:http://www.archives.go.kr/next/search/listSubjectDescription.do?id=007013


11 Han C. Ways to expanding the basic benefit package of Korean medicine in Korea national health insurance. NIKOM Report of Korean Medicine Policy. 2017; 2:1. 6–15.


12 Korea Health Industry Development Institute. Statistics of healthcare workers-licensed doctors of Korean medicine. 2015. Available at: URL:http://210.179.230.152:8083/statHtml/statHtml.do?orgId=358&tblId=DT_358N_E313&conn_path=I2


13 Publication committee for Yearbook of Traditional Korean medicine. 2016 Yearbook of Traditional Korean Medicine. Korean Institute of Oriental Medicine;2018.


14 National Development Institute of Korean Medicine. Final report of the study for expanding the basic benefit package of Korean medicine in Korea national health insurance. NIKOM;2016.


15 Division of Traditional Korean Medicine Policy, Ministry of Health & Welfare, Press release(9 Feb, 2017): Designated 65 institutions for Chuna therapy health insurance pilot project. 2017. Available at:URL:http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=3&CONT_SEQ=338360


16 Center for New Health Technology Assessment. NECA, Introduction of new Health Technology Assessment. Available at: URL:https://nhta.neca.re.kr/nhta/committee/nhtaU0201V.ecg


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