• Journal of Digestive Cancer Research
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• v.1 no.2
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• pp.73-77
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• 2013

Gastrointestinal (GI) cancers are top priorities for cancer control in Korea. In terms of epidemiological, population-health and economic burden, GI cancers such as stomach, liver and colorectal cancers have been top four cancers in the nation during the past decade and this trend is likely to continue in the near future. In order to reduce the great burden of GI cancer in Korea, the nation might need the following strategies: (1) to put more focus on primary prevention on infection/diet and related research; (2) to improve screening rates for colorectal and stomach cancers, and conduct more cost-effectiveness analysis of these screening programs, e.g., Fecal Occult Blood Test vs. colonoscopy; (3) to establish a more consistent and integrative cost-effectiveness analysis system for new cancer treatments and anticancer drugs; and (4) to place more emphasis on hospice and other palliative care of GI cancer, as well as on the etiology, staging and treatment of pancreas cancer with its poor survival rate.

• Health Policy and Management
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• v.27 no.2
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• pp.139-148
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• 2017

Background: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. Methods: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. Results: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. Conclusion: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.

• Journal of Home Health Care Nursing
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• v.10 no.1
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• Journal of Korean Academy of Rural Health Nursing
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• v.3 no.2
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• pp.104-115
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• 2008

Purpose: A study of the family planning and Maternal-Child Health Services that disciplined itself in primary health care post form 1980 to 2009. Method: Investigation studies family planning in primary health care post and a change process of a Maternal-Child Health Services into case by case until 2009 from 1980. Results: Our country family planning business began at economic development dimensions in order to solve a poverty issue. This business goal were childbirth decrease of pregnancy possibility couple aged 19~49 and improve to mother and child health. For this goal, all kinds of health education included sex education and contraception education, contraception service, comprehensive maternal and child health service that management of front and back of childbirth etc. are provided. According to fail down a birthrate from 6.0(1962) to 1.25(2009), the nation reached to a dilemma called childbirth encouragement policy. Conclusions: Decrease of labor supply by low birthrate, decrease numerical an employed person by aging was brought a labor shortage and decrease of productivity of labor of industrial manpower. Deterioration phenomenon of financial income and expenditure by consumption and investment contraction caused decrease of slowdown of economic growth and potential growth rate, and a social cost burden is increased by deterioration financial old man support burden increase by this and pensions and health insurance, a sharp increase of social welfare cost etc. Now, in order to solve a low birth issue, the government establishes a whole nation forwarding system and establishes basic plan social low birth and advanced age, and to prepare for childbirth fault factors removal and advanced age society shall endeavor.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.434-441
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• 2010

Background: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. Methods: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. Results: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. Conclusion: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

• Health Policy and Management
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• v.24 no.3
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• pp.228-241
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• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

• The Korean Journal of Health Service Management
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• v.6 no.4
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• pp.143-152
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• 2012

This study analyzes Korea health panel data (2008) (beta version 1.2) of Korea Institute for Health and Social Affairs, and National Health Insurance Corporation to figure out determinants of healthcare expenditure. In result of Multiple Logistic Analysis, in-patents felt burden on the medical expenditure were 70.0%. As to the patients' payment of medical expenditure, patients over 65 years old had 4.765 times higher than those under 14 years, disabled patients 2.778 than non-disabled patients, chronic patients 1.632 times than non-chronic patients, patients belonging to 12 million won ~ 46 million won and under 12 million won in family income had 1.680 times and 2.168 times respectively than patients with over 46 million won, patients in professional recuperation facility 1.546 times than patients in hospital, patients in private medical institutions 1.700 times than patients in national and public medical institutions, patients using upper grade rooms 1.701 times than patients in non-upper grade rooms. As a health care safety net mechanism to protect people from medical expenditure burden, there is the patients' payment ceiling in the National Health Insurance System. Thus, in order to facilitate the patient's payment ceiling, it is required that the level of ceiling is to be specified according to the income level, and self-payment items is to be included.

• Health Policy and Management
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• v.28 no.3
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• pp.202-209
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• 2018

Health care has two different facets. One is commodity and another is a right of human being. Health care as a commodity is utilized by demand approach in market. Demand is determined by economic factors such as price and income. From the last third of the 19th century until the early 1920s, priority of sickness insurance was replacing the income that workers lost as a result of illness and injury. By the 1920s, the capacity of applied biological and medical science was remarkably developed. Development of medical science stimulated the cost of medical care, and the burden of increased medical care cost required new role of medical care security system. In 1942, Beveridge report was published in United Kingdom, and health care was considered as a right of human being. In 1948, United Nations declared heath care as a right in the Universal Declaration of Human Right. In most countries introduced new medical care security policy based on health care as a right. The viewing health care as a commodity must be shifted toward need based care as a right. Need were understood to rest on demographic, epidemiological, scientific, and medical knowledge factors. Bring needed care to the population could best be achieved institutionally by a hierarchy of provider organizations, guided by planning bodies, which would provide comprehensive benefits. In Korea, health care in social health insurance (SHI) is considered as a commodity not a right. However, health policies under SHI must be need approach based on health care as a right. Mismatch between health policies and ideology of SHI made big troubles. It is important to realize ideology of SHI for good health policies.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.589-599
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• 2001

The purpose of this study was to analyze the relation amongst health status, health care costs. health service utilization among the low income elderly who were 60 years of age or older, earning a half of the average Korean family income. The cross-sectional descriptive survey research we conducted used families randomly sampled nationwide. The data were collected from July 12 to August 7, 1999 and the total sample was 1.259 household members (421 households). These were the major findings. 1. As for the health status. 72.4% of respondents fell ill in the last 1 month; 54% of respondents had chronic disease. 2. As for the health care cost. the cost of hospitalization and the medical treatment were 1.069,000 won and 226.000won. respectively. 59.3% of respondents experienced a burden from the monthly health care expenses. 3. As for the health service utilization for the last 3months. 28.5% of respondents didn't utilize the health service. In addition, 22.2% of respondents gave up a medical treatment because of economic situation (88.8%). 4. The statistically significant determinants of health service utilization are old age, female, living with a spouse, unemployed state, medicare, and more days sick. 5. It is shown conclusively that equity and efficacy of the health care policy are to be considered for lower income older adult.

• The Journal of Korean Medicine
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• v.36 no.3
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• pp.98-110
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• 2015

Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.