• Health Policy and Management
• /
• v.31 no.4
• /
• pp.385-386
• /
• 2021

The 2022 Presidential election is approaching. Because health policies are intimately connected to other policies and involve multiple stakeholders, it is difficult to promote policy changes. Hence, the presidential election, during which policymakers are replaced, is a great timing for making policy improvements. Several important policies have been introduced and promoted throughout the presidential election process. However, these policies have been implemented without going through sufficient discussion among the experts but rather through the voices of minority groups with stronger political will. This eventually posed an obstacle to the balanced development of the entire health care system. The current medical system faces challenges that need to be addressed in the medium and long term. In particular, we should be wary of the populistic approach. We look forward to seeing more policy commitments, proposed through the evidence-based policy process and sufficient amount of discussion among the experts.

• Health Policy and Management
• /
• v.28 no.4
• /
• pp.327-328
• /
• 2018

The quality of healthcare in Korea is very good, especially in life threatening disease. However, the level of healthcare research in Korea is not good relative to that of engineering. International university rankings also were showed that engineering was generally higher ranking than medicine. The reason of this phenomenon was deeply related to expenditure on research and development (R&D). Although Korea had a lot of gross domestic expenditure on R&D (GERD), 75% of GERD was from business enterprise that was related to engineering. Healthcare expenditure of R&D from business enterprise is small. Healthcare expenditure from government budget allocation on R&D (GBARD) was smaller than engineering. Higher education expenditure on R&D of GERD was also small and the quantity and quality of researcher in higher education was not enough. For Korea's healthcare to become the growth engine for future, GBARD should be invested heavily in the healthcare, a large part of the increased GBARD must be invested in higher education, and the higher education should invest to secure the higher quality researcher stably.

• Health Policy and Management
• /
• v.32 no.2
• /
• pp.123-124
• /
• 2022

With the inauguration of a new government, expectations for policy changes are also rising. In the hope that this will serve as an opportunity to improve health care policy, I would like to outline the principles strategies. First, considering the growing socioeconomic impact of the health care sector, the government's policy priorities should be notably increased compared to the past. Second, policy improvement measures based on evidence should be sought instead of dwelling on presidential pledges. While easing regulations, we should improve the quality of regulatory approaches. Therefore, it is a time when efforts are needed to strengthen the stability of policies in response to economic crises.

• Health Policy and Management
• /
• v.32 no.4
• /
• pp.345-346
• /
• 2022

2022 was a time when the global healthcare system was challenged and has grown in response to the coronavirus disease 2019 pandemic. In addition, various issues accumulated in the process of quantitative growth have emerged in the Korean healthcare system. For instance, problems of sustainability in health insurance finances and removing bubbles from excessive medical utilization should be urgently resolved as tasks that occurred in the process of expanding the coverage of the health insurance system. The deficit of applicants for the pediatrician residency program suggests that expanding health insurance coverage alone has limitations in providing essential medical services. There is a need to incentivize doctors who provide essential medical care services. In 2023, we hope that efforts to enhance and internally reinforce the healthcare system will be concentrated.

• Health Policy and Management
• /
• v.33 no.1
• /
• pp.1-2
• /
• 2023

As the industrial paradigm shift, often condensed as the "4th Industrial Revolution," gains momentum, there is a growing need to actively introduce digital healthcare into the medical field. The new administration announced its commitment to become a global leader in the biohealth and digital healthcare sector. To fulfill this pledge, preemptive policy leadership and attention from the government are required. The recent issue of legislating non-face-to-face medical care suggests that introducing digital healthcare goes beyond simply adopting new technologies. Incorporating digital healthcare involves changing the existing healthcare delivery process and coordinating the roles of stakeholders. To successfully change the structure of the medical industry, a mid- to long-term roadmap should be meticulously organized and promoted. Policy efforts are needed to resolve conflicts and lead to compromises through continuous communication with interest groups.

• Health Policy and Management
• /
• v.30 no.4
• /
• pp.451-459
• /
• 2020

Background: Although Korean government have been adopting several policies to expand coverage of National Health Insurance (NHI) program, the coverage rate is still below average across Organization for Economic Cooperation and Development countries. This study was to identify public perception on appropriateness of coinsurance rate and factors associated with coinsurance rate in National Health Insurance. Methods: For this cross-sectional study, 507 participants over aged 20 years were recruited from telephone surveys. Respondents experienced at least one and more visiting medical facilities due to medical problems in last 12 months. Demographic factors, socioeconomic positions, and experiences on medical utilization were measured in order to identify factors associated with perception appropriateness of coinsurance rate. Results: The 49.9% (n=209) of the public responded that the coinsurance rate of NHI program was appropriate. There were no differences in positive perception according to socio-demographic factors and experiences on medical utilization except for gender, residential area, and felt expensive when using medical services. People who felt burden of medical expenditure were more likely to perceive coinsurance rate inappropriate (odds ratio, 2.33; 95% confidence interval, 1.52-3.58) Conclusion: In spite of the relatively low coverage rate of NHI, this study identified that 49.9% of the public perceived the current coinsurance rate was adequate. However, people who felt the burden of medical expenditure were still had a negative perception of the coinsurance rate needed to decrease the coinsurance rate.

• Health Policy and Management
• /
• v.31 no.1
• /
• pp.125-139
• /
• 2021

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion: This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

• Health Policy and Management
• /
• v.33 no.3
• /
• pp.253-263
• /
• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• Health Policy and Management
• /
• v.31 no.3
• /
• pp.301-311
• /
• 2021

Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region. Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases. Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately. Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.

• Health Policy and Management
• /
• v.29 no.2
• /
• pp.160-171
• /
• 2019

Background: This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender. Methods: Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used. Results: There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women. Conclusion: This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.