• KDI Journal of Economic Policy
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• v.9 no.3
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• pp.45-66
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• 1987

본고(本稿)의 목적(目的)은 우리나라의 국민의료비추계치(國民醫療費推計値)를 제시하고 OECD제국(諸國)의 자료(資料)를 이용하여 국제비교(國際比較)에 의한 추이분석(推移分析)을 행함에 있다. 이를 위하여 우선 각국 의료비(醫療費)의 결정요인(決定要因)에 대한 최근의 논쟁(論爭)을 재조명(再照明)하고 "각국간(各國間)의 소득격차(所得隔差)로서 의료비변동(醫療費變動)을 충분히 설명할 수 있으며 의료비의 소득탄력도(所得彈力度)는 1보다 크다"는 Newhouse의 주장을 검증(檢證)하였다. 그 결과 소득수준(所得水準)이 각국의 의료비 변동을 설명하는 중요한 변수(變數)임을 확인할 수 있었다. 그러나 소득수준이 높다고 해서 반드시 국민의료비(國民醫療費)의 GNP비율(比率)이 제고(提高)되지는 않는다는 점이 국제비교결과(國際比較結果) 밝혀졌다. 이는 소득 이외에도 의료비지불제도(醫療費支拂制度)등 제도적(制度的) 요인(要因)이 의료비 변동에 영향을 준다는 점을 시사해 준다. 한국의 의료비(醫療費)는 비교적 급속히 증가하고 있는데 우리나라의 의료비동향(醫療費動向)은 소득(所得) 이외에도 고령인구비율(高齡人口比率) 및 의료보험제도(醫療保險制度)의 실시(實施) 등을 가지고 유의(有意)하게 설명할 수 있었다. 국민의료비(國民醫療費)의 지속적인 고율성장(高率成長)은 국민개보험(國民皆保險)을 앞두고 국민의료비(國民醫療費)의 안정화노력(安定化努力)을 요청하고 있는바 이 점에 있어서는 호주, 덴마크, 노르웨이 등 최근 의료비증가율(醫療費增加率)이 진정되고 있는 국가들로부터 지불제도(支佛制度)의 개선을 중심으로 유익한 교훈을 얻을 수 있다.

• Journal of Digital Convergence
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• v.17 no.4
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• pp.203-210
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• 2019

This study analyzed the size and influence factors of annual average health expenditure according to job type. Using data from the Korea Health Panel (2012), the final analysis was conducted on adults aged 20 years or older, excluding the missing data. Data analysis was done by logistic regression analysis to analyze the factors affecting medical expenditure. As a result of the study, Model 1 showed higher expenditure on medical expenses by skilled workers in agriculture and forestry fishery than those in simple labor. Model 2 was analyzed as having a positive effect on the increase of medical expenditure by the simple worker in the sales of the occupation, statistically significant by sex, marriage, income level and chronic disease. Therefore, it would be necessary to establish social security and health care & welfare policies, in order to grasp the disease with a high frequency rate according to occupation status and activate the physical examination and preventive actions.

• Therapeutic Science for Rehabilitation
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• v.12 no.1
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• pp.51-63
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• 2023

Objective : This study aimed to analyze the association between lifestyle and medical expenses of older adults with mental illness using claims data. Methods : We conducted secondary data analysis using the older adult cohort database provided by the Korea National Health Insurance Service. The lifestyle and medical expense variables were extracted from the cohort database. We used a generalized linear model to examine the association between lifestyle and medical expenses. Results : In total, 32,853 records were extracted. The results showed that smokers had medical expenses (estimate = -218,255, p = .037). As the number of days of walking increased, medical expenses significantly decreased (estimate = -58,843, p < .0001). Furthermore, as the number of days of drinking decreased, medical expenses increased (estimate = 692,289, p < .0001). Conclusion : This study analyzed the estimates of medical expenses according to lifestyle among older adults with mental illness. Smoking and exercise were negatively associated with medical expenses. These results suggest the importance of a healthy lifestyle for older adults with mental illness. In addition, this study can be used as clinical evidence for lifestyle management programs to improve physical and mental health.

• Korean Journal of Social Welfare
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• v.56 no.3
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• pp.5-35
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• 2004

This research is about the change of the occupation and the income of the subscriber of the medical expenditure due to the economic influence on them. The data of this study are based on 4,215 of medical cost payers among respondents of the survey on "Health and Retirement", which was the fourth additional research of Korea Labor and Income Panel Survey. The main findings of this study are as follows: First, the average medical cost is 5.5% of the income. The ratio of the medical cost to an earned income is highly different between low-income group and high income group. For the low income group, the medical cost reaches up to 1/3 of the total family income. That proves that the medical cost si a heavy burden on them. The group with the high medical expenditure seems to be supported by their own private property and other family members whenever it is needed. But it doesn't show the exact sources of the property, which includes the fund from the interests and real estates. On the other hand, only 14.4% of the subscribers changed their job status on the 5th year, and 85.6% of those kept their job status until the 5th year from the 4th year. This shows that the amount of the medical cost could be the important factor for them to change their job; for example, it is crucial whether the medical expenditure is over the average rate or not. Furthermore, the change of the occupation caused by the medical cost has the negative influence on the gross income. It makes the economic conditions of the family get worse. Therefore, the health insurance in Korea is lack of the compensational function, which substitutes the family income reduced by the change of the job status due to the high medical cost.

• Journal of Hospice and Palliative Care
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• v.21 no.1
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• pp.23-32
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• 2018

Purpose: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. Methods: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). Results: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P<0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P<0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P<0.001). Palliative care was associated with decreased hospital cost by 28.71% (P<0.001). Conclusion: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.

• Health Policy and Management
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• v.34 no.3
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• pp.319-333
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• 2024

Background: This study aims to identify the factors that influence the incidence of catastrophic health expenditure (CHE) for the elderly living alone and to discuss how to manage CHE for the elderly living alone. Methods: This study utilizes 6th (2016), 7th (2018), and 8th (2020) data from the Korean Longitudinal Study of Aging to identify the incidence rate of CHE among the elderly living alone and conducts a panel logit analysis. The dependent variable is the incidence of CHE (thresholds: 10%, 20%, 30%), and the independent variables include demographic factors (gender, age group, region), socioeconomic factors (education level, economic activity status, income quintile, financial support rate from children), health-related factors (subjective health status, regular exercise, smoking, drinking, number of chronic diseases), and healthcare coverage factors (type of health insurance, private health insurance). Results: Descriptive statistics classified by gender show that female elderly living alone are more vulnerable than male elderly living alone in terms of disease prevalence and socioeconomic status. In addition, the incidence of CHE is higher for elderly women living alone than for elderly men living alone across all thresholds. The main results of the panel logit analysis show that higher education, income quintile, and financial support rate from children are associated with lower odds of CHE, while poorer subjective health and a higher number of chronic diseases are associated with higher odds of CHE. Medical aid recipients are less likely to incur CHE than those covered by national health insurance. Conclusion: The implications of this study are as follows. First, vulnerable elderly living alone with multiple chronic diseases and low income and education levels are more likely to incur CHE. Second, it is necessary to review policies such as a CHE support program and chronic disease management programs focused on vulnerable elderly individuals living alone. Third, the CHE support program should be operated in a patient-centered manner, with consideration given to a customized system for selecting and supporting elderly individuals living alone who are in need.

• The Journal of the Korea Contents Association
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• v.17 no.7
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• pp.610-621
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• 2017

Medical cost for elderly is increasing with ageing society and putting more and more burden on both individuals and government. To find a solution to reduce medical cost among elderly and to propose implication/suggestion to central government and a local government, different degree of medical cost burden by type of household and factors that affect increased medical cost are investigated based on elderly in Suwon city in this article. According to the research result, 59.3% of respondents felt medical cost burdensome. Also, according to the multiple regression performed to understand factors that increases medical cost by type of household, subjectively felt health status was found to be a statistically significant factor commonly in three groups which are living household with adult child, living household with spouse only, living household alone. And the degree of medical cost was higher in living household with spouse only, more higher in living household alone. And socioeconomic status and health status, health status, and health status and private insurance, medical security system were found to be significantly related to medical cost burden to household type of the elderly.

• Journal of Digital Convergence
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• v.13 no.10
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• pp.425-436
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• 2015

This study is to investigate how the expenditures for hypertension is affected by socioeconomic, health care resources, and health behavior factors with a special emphasis on geographic variations and to provide the data about regional management for hypertension. To analyze, we combined a unique data set including key indicators from Medical Service Usage Statistics 2012 by Region by National Health Insurance Corporation, Annual Community Health Survey 2012 by Korea Centers for Disease Control and Prevention and other government organizations at the 247 small administrative districts. We found that the average expenditures of hypertension in 249 small districts is 62,000 won and coefficient of variation is 30.0. Major factors of differences in hypertension expenditure is population density, marital status, household income, number of hospital per 100 thousand, medical expenses outside the jurisdiction, drinking rate, moderate and over-intensity physical activity, and hypertension diagnosis rate. The results of decision tree was that there were significant differences between regions in hypertension diagnosis rate, household income, marital status, number of hospital per 100 thousand, obesity rate, drinking rate. This study concluded that determinants of geographic variations in hypertension spending are not only health resources and socioepidemic characteristics but health behaviors.

• Journal of Digital Convergence
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• v.15 no.12
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• pp.625-633
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• 2017

The purpose of this study is to investigate the effect of private insurance revenues and household spending on household income inequality. To this end, we conducted a concentration index and concentration curve analysis for the income level of medical panel survey data in 2015. The main results are as follows. First, the household income concentration ratio is 0.3580, which means that income is concentrated in the high income group, and the degree of inequality is considerably large. Second, although the portion of the private insurance benefits was small on the high-income household, it helped to strengthen the benefits concentration on this group. Third, the low income group has a large self-pay medical expense. Finally, the index of the income excluding the burden of the total medical expenses in the household income was 0.3676, so that even accounting for medical expenses, the income was concentrated in the high income class. Therefore, private insurance benefits and medical expenses were all contributing factors to the inequality of household income, and this study provides the essential materials for research and policy planning which could lead to the convergence of different fields.

• The Journal of the Korea Contents Association
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• v.10 no.5
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• pp.303-313
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• 2010

The purpose of this study is to evaluate the performance efficiency and productivity change of the regional public hospital in Korea. We use DEA(Data Envelopment Analysis) for CCR, BCC model, and MPI(Malmquist Productivity Index). DEA is a useful nonparametric technique for measurement of efficiency of a DMU(Decision Making Unit) and MPI is a evaluation method to measure DMU's productivity change. We utilize 34 regional public hospital's time-series data over 6 years from 2003 to 2008.The results of this study were as follows. First, technical efficiency(TE) shows that approximately 3.6% of inefficiency exists on the regional public hospitals and it reveals that the cause for technical inefficiency is due to scale inefficiency. Second, MPI's results show that regional public hospital made effort to improve total factor productivity change to raise technical efficiency. In order to raise efficiency, the regional public hospitals should deploy internal innovation and the government should support welfare policies.