Journal of Korean Public Health Nursing (한국보건간호학회지)

Korean Society of public Health Nursing (한국보건간호학회)
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A Financial Projection of Health Insurance Expenditures Reflecting Changes in Demographic Structure

인구구조의 변화를 반영한 건강보험 진료비 추계

  • Lee, ChangSoo (Department of Statistics and Actuarial Science, Soongsil University) ;
  • Kwon, HyukSung (Department of Statistics and Actuarial Science, Soongsil University) ;
  • Chae, JungMi (Health Insurance Review & Assessment Service)
  • 이창수 (숭실대학교 정보통계보험수리학과) ;
  • 권혁성 (숭실대학교 정보통계보험수리학과) ;
  • 채정미 (건강보험심사평가원, 숭실대학교 정보통계보험수리학과)
  • Received : 2016.10.25
  • Accepted : 2017.04.13
  • Published : 2017.04.30
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Abstract

Purpose: This study was conducted to suggest a method for financial projection of health insurance expenditures that reflects future changes in demographic structure. Methods: Using data associated with the number of patients and health insurance cost per patient, generalized linear models (GLM) were fitted with demographic explanatory variables. Models were constructed separately for individual medical departments, types of medical service, and types of public health insurance. Goodness-of-fit of most of the applied GLM models was quite satisfactory. By combining estimates of frequency and severity from the constructed models and results of the population projection, total annual health insurance expenditures were projected through year 2060. Results: Expenditures for medical departments associated with diseases that are more frequent in elderly peoples are expected to increase steeply, leading to considerable increases in overall health insurance expenditures. The suggested method can contribute to improvement of the accuracy of financial projection. Conclusion: The overall demands for medical service, medical personnel, and relevant facilities in the future are expected to increase as the proportion of elderly people increases. Application of a more reasonable estimation method reflecting changes in demographic structure will help develop health policies relevant to above mentioned resources.

Keywords

References

  1. Barbash, G. I., & Glied, S. A. (2010). New technology and health care costs-the case of robot-assisted surgery. New England Journal of Medicine, 363(8), 701-704. http://dx.doi.org/10.1056/nejmp1006602
  2. Chae, J. M., Choi, Y. J., & Choi, Y. M. (2015). A study of rationalization about health insurance benefit in korean medicine services (No. G000K31-2015-21). Seoul:Health Insurance Review & Assessment Service.
  3. Chang, Y. S., Kim, N. Y., Lee, S. Y., & Jin, D. L. (2010). Population policy of korea: the situation and prospects (No. 2010-30-10). Seoul: Korea Institute for Health and Social Affairs.
  4. Cho, Y. W., Hwang, J. T., & Cho, J. R. (2013). A study on forecasting medical expenses of health insurance and its applications. Seoul: Korea Insurance Research Institute.
  5. GBD 2013 Mortality and Causes of Death Collaborators. (2015). Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 385(9963), 117-171. http://dx.doi.org/10.1016/S0140-6736(14)61682-2
  6. Health Insurance Review & Assessment Service. (2007). Statistical Indicator of Medical Expenses. Seoul.
  7. Health Insurance Review & Assessment Service. (2014). Statistical Indicator of Medical Expenses. Seoul.
  8. Health Insurance Review & Assessment Service. (2015). Statistical Indicator of Medical Expense. Seoul.
  9. Hitiris, T., & Posnett, J. (1992). The determinants and effects of health expenditure in developed countries. Journal of Health Economics, 11(2), 173-181. https://doi.org/10.1016/0167-6296(92)90033-W
  10. Jang, I., & Park, E. (2013). The prevalence and factors of falls among the community-dwelling elderly. Journal of Korean Public Health Nursing, 27(1), 89-101. http://dx.doi.org/10.5932/jkphn.2013.27.1.89
  11. Jeong, H. S., & Song, Y. M. (2013). Contributing factors to the increases in health insurance expenditures for the aged and their forecasts. The Korean Journal of Health Economics and Policy, 19(2), 21-38.
  12. Jeon, B. M., & Lee, E. K. (2010). Financial prospects and policy projects of social insurance systems. Seoul: Korea Instutute of Public Finance.
  13. Jeong, H. S. (2015). A trend of healthcare insurance coverage and management of health insurance expenditure. Paper presented at the The 54th Korea Society of Health Policy and Administration Symposium.
  14. Jeong, H. S., Shin, J. W., Lee, J. H., & Chung, W. K. (2015). Method to project total health expenditure. Sejong: Ministry of Health and Welfare.
  15. Ki, S. D., & Kim, D. H. (2009). A study on estimating methodology of the automobile insurance rate using generalized linear models (No. 2009-05). Seoul: Korea Insurance Research Institute.
  16. Kim, J. S. (2011). Increase in health care expenditure for the old age group and efficient management program. Issue & Focus(114), 1-8.
  17. Lee, S. Y., Lee, D. H., & Jo, J. W. (2015). A study for mid and long-term medical expenditure in age above 65 years (No. 2015-1-0004). Seoul: Health Insurance Policy Institute.
  18. Mun, Y. H. (2005). The prevalence and associated factors of the in-home falls of the elderly. Journal of Korean Public Health Nursing, 19(2), 249-260.
  19. Ministry of Health and Welfare. (2015, October 22). A plan of policies to strengthen healthcare insurance coverage. Sejong.
  20. Oh, Y. S., & Yoon, S. J. (2015). A trend and sustainable medical policy agenda for national medical expenditure (No. 11-1040350-000098-01). Seoul: The Board of Audit and Inspection of Korea.
  21. Park, H. S., & Song, H. S. (2011). Long-term financial prospects. Seoul: Korea Institute of Public Finance.
  22. Park, I. S., Lee, D. H., Choi, J. H., Lee, S. Y., & Choi, K. C. (2011). A study on financial projection of health insurance reflecting environmental changes in medium to long term future(No. 2011-04). Seoul: Health Insurance Policy Institute.
  23. Park, S. J., & Kang, C. Y. (2014). A study of mid and long-term projection model for health insurance. Seoul: National Assembly Budget Office.
  24. Sakong, J., & Sohn, J. W. (1999). A study on determinants of the national health care expenditure of the OECD countries. The Korean Journal of Health Economics and Policy, 5(1), 1-23.
  25. Seo, N. K., Hwang, Y. H., Kang, T. U., Ahn, S. Z., Baek, S. C., & Lee, D. H. (2012). The forecasting of mid and long-term of national health expenditures (No. 2012-10). Seoul: Health Insurance Policy Institute.
  26. Seo, S., Park, B. H., & Choi, S. J. (2016). A study on the sociodemographic characteristics of adult users of korean traditional medicine. Journal of Korean Public Health Nursing, 30(1), 136-148. http://dx.doi.org/10.5932/jkphn.2016.30.1.136
  27. Shin, H. Y., Won, J. U., Chang, I. S., Choi, Y. h., Kim, T. E., & Seong, B. C. (2014). A study to reinforce base about social security's financial projection (No. 2014-58). Seoul: Ministry of Health and Welfare.
  28. Statistics Korea. (2015-a). Population Census (1993-2014). Retrieved October, 22, 2015, from http://kosis.kr/statisticsList/statisticsList_01List.jsp?vwcd=MT_ZTITLE&parentId=A#SubCont
  29. Statistics Korea. (2015-b). Population Projections for Korea(1960-2060). Retrieved October, 22, 2015, from http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B01001&conn_path=I3