• Health Policy and Management
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• v.29 no.3
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• pp.374-378
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• 2019

After the announcement of Moon Jae-in Government's plan (Moon's Care) for Benefit Expansion in National Health Insurance in August 2017, it is necessary to monitor the effects of the policy, especially household out-of-pocket payments (OOP). This paper aims to observe the current status and trend of OOP in Korea. Current health expenditure (CHE) was 144.4 trillion won in 2018, which accounts for 8.1% of gross domestic product (GDP) increased 9.7% from the previous year. Although GDP's share of CHE has been close to the average of the Organization for Economic Cooperation and Development (OECD) countries, the public fund's share was 59.8% of the total in 2018, which was lower than the OECD average of 73.5%. OOP's share was 32.9% in 2018, which decreased from 37.4% in 2008. The share of OOP of non-covered services was 20.0% in 2018, which decreased from 22.9% in 2008. The share of cost-sharing with third-party payers was 12.9% in 2018, which decreased from 14.5% in 2008. The OOP of non-covered services was significantly decreased in hospital and inpatient curative care, but the OOP of non-covered services was significantly increased in the medical clinic. The effect of Moon's Care was not showed in OOP through the results of 2017 and 2018, but further monitoring is needed because the Moon's Care is progressing and the observational period is short.

• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.96-110
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• 2021

Korea is faced with the challenge of adapting to the world's fastest - growing low birthrate, aging society, and low growth with low interest rate era. With low fertility and aging population, the factors of financial income of health insurance are decreasing, and the increase of public interest in health, high cost medical technology and the development of medicine are leading to increase expenditure of health insurance. In this study, I will examine the strengthen protection of health insurance, financial stabilization, and fairness of medical care. First, the present status and limitations of health insurance were identified through domestic policy report, domestic and foreign literature, and precedent research. Second, the foreign health insurance policy measures to stabilize the finances were examined separately. Based on this study, in order to maintain sustainable health insurance through reinforcement and financial stabilization of health insurance, the current financial income structure of health insurance must be renovated. It will be necessary to expand government subsidies and discover new tax revenues. In addition, a policy to save finances by reorganizing the medical bill payment system and medical delivery system will also be needed.

• Research in Community and Public Health Nursing
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• v.13 no.4
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• pp.795-807
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• 2002

Objectives: The purpose of this study was to develop a community-based nursing center model that can provide health promotion for infants and toddlers as well as a research and practice site for nursing faculty and students. Methods: Review of current health care system and health promotion programs, and workshops with brain-storming were carried out to identify needy areas of services to be provided by the nursing center. Finally, the community nursing center model was developed through expert consultation and filed visits. Results: The services and programs were developed for infants and toddlers residing in Seoul area. These services and programs include growth and developmental screening, environment and health problem assessment, infant stimulation and parent education, and self-help group. Full-time and part-time staff nurses and nurse practitioners will provide those services and offer home visiting if needed. Database system, health information system, and trainers' training programs were developed as well. Conclusion: The nursing center model developed in this study will ensure clients direct access to nursing care and increase of autonomy and accountability of nursing practices. The nursing center model focused on disease prevention and health promotion will enhance the quality of life of the infants, toddlers and their families as well as to decrease national health care expenditure.

• Health Policy and Management
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• v.26 no.4
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• pp.305-314
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• 2016

Background: The purpose of this study is to examine the characteristics of and factors associated with long-term care (LTC) utilization under public long-term care insurance (LTCI) among end-of-life older adults in Korea. Methods: Using a 5% sample of older people aged 65 or older and their health and LTC insurance data, two-part model analyses were conducted. We compared LTC uses and their determinants during the last year of life among decedents in the year 2010 with those of survivors. We also compared the medical uses of the same sample with their LTC uses. Results: The end-of-life elderly were more likely to use LTC, and their expenditure on LTC was higher than their counterparts. Whether or not older people used LTC during their last year of life was significantly affected by age, sex, health insurance, household income, and living alone; however, LTC costs of the decedents were only affected by functional status, which may have been due to the reimbursement scheme of the current LTCI, which is mainly based on functional dependency level. For the survivors, having chronic diseases significantly increased the likelihood of LTC use, which was not the case for the decedents. End-of-life elderly with relatively low social economic status were more likely to use the LTC other than medical services, while the health conditions affected their medical uses most significantly. Conclusion: The study findings provide key information for predicting demand related to the increasing LTC needs of Korean older people at the end of life.

• Journal of Nutrition and Health
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• v.29 no.8
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• pp.899-907
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• 1996

This study was conducted to examine how Korean women mange energy metabolism during lactation. Eighteen women recruited were healthy, had normal pregnancies and were required to breast-feed their babies exclusively for at least 12wks. During the study period, all subjects were visited and interviewed five times : 3d, 9d, 4wk, 8wk, and 12wk lactation. Body composition variables were analyzed by a bioelectrical impedance method, energy intakes were assessed by using the inventory-weighing method, energy expenditure were determined by recording daily activities, and milk energy output was investigated from the amount of milk production and the gross energy content of milk. The subjects consumed less energy than current recommended allowance all over the study period, but compatible with fairly adequate lactational performance. They responded the additional energy stress of lactation by enhancing metabolic efficiency, increasing energy intakes, reduction physical activities and mobilizing body reserves. Another finding in this study was that the reduction in body fat-free mass may be the one way that women meet the energy demands of lactation like the reduction in body fat mass. The results from this study suggest that current recommended additional energy need during lactation, 2.09MJ/d(500kcal/d), is too high for healthy Korean women. Our data also indicate that the changes of body composition and energy balance at earlier postpartum are extremely different from those at later periods.

• Quality Improvement in Health Care
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• v.22 no.1
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• pp.29-37
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• 2016

Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.291-300
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• 2012

Objectives: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. Methods: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. Results: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). Conclusions: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

• Horticultural Science & Technology
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• v.33 no.1
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• pp.133-142
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• 2015

This study aimed to identify the exercise intensity associated with four common physical activities for adults (running, skipping rope, walking, and muscle strength exercises) and two horticultural activities (creating a vegetable bed and garden maintenance). For this experiment, 19 males (mean age: $25.8{\pm}2.3$ years) randomly participated in the activities at a glasshouse at Konkuk University. Each of the six activities lasted for 5 minutes; the subjects rested for 5 minutes during intervals between the activities. A portable metabolic analyzer was used to store the oxygen and energy consumption values obtained upon measurement of each activity. In addition, a wireless heart rate monitor was used to measure the subjects' heart rate. According to the results, the four types of physical activities and two horticultural activities carried out by the subjects are moderate- to high-intensity activities [i.e., $3.8{\pm}0.9$ to $9.9{\pm}2.1$ metabolic equivalents (METs)]. Running ($9.9{\pm}2.1$ METs) and skipping rope ($8.8{\pm}2.2$ METs) were categorized as high-intensity physical activities, whereas creating a vegetable bed ($5.0{\pm}1.2$ METs), walking ($4.9{\pm}0.8$ METs), muscle strength exercises ($4.5{\pm}1.3$ METs), and garden maintenance ($3.8{\pm}0.9$ METs) were classified as moderate-intensity physical activities. The exercise intensities of horticultural activities in this study were similar to those of walking and muscle strength exercises. Therefore, participating in these horticultural activities is expected to garner health benefits similar to those reaped from the physical activities described in the current study.

• Journal of Food Hygiene and Safety
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• v.27 no.4
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• pp.339-348
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• 2012

The purpose of this study is to predict the economic size of foods-for-elderly market, which will be valuable information for establishing related policy and backup system. After setting the scope of related industry, detailed information for current market situation was investigated and a systematic forecast for market changes in the future was performed. Economic growth, changes in consumer expenditure and economic status of the elderly, current subscription of medical insurance and saving for pension were reflected. In addition, a survey toward related firms was completed and changes in aged population and incidence of chronic disease in the elderly were taken into account. Results show that the annual growth rate of the market was predicted to be the minimum 4.54% through the maximum 8.32% from 2010 to 2025 and its market size was forecasted to be the minimum 7,073 ten million won through the maximum 10,976 ten million won. It is expected that the market of foods-for-elderly will grow rapidly with development of foods technology and fast increase of aged population. Especially, growth of health functional foods and foods for special dietary uses for elderly will be distinguished. However, it seems that related firms are on the hedge, watching current trend of the related industry. This may results in insufficient supply against the demand. Therefore, policy for foods-for-elderly should be introduced and systematically administered, including R&D support, standardization and authentication for foods-for-elderly, construction of related database system.

• Journal of Pharmacopuncture
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• v.20 no.4
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• pp.235-242
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• 2017

Irisin is a novel hormone like polypeptide that is cleaved and secreted by an unknown protease from fibronectin type III domain-containing protein 5 (FNDC5), a membrane-spanning protein and which is highly expressed in skeletal muscle, heart, adipose tissue, and liver. Since its discovery in 2012, it has been the subject of many researches due to its potent physiological role. It is believed that understanding irisin's function may be the key to comprehend many diseases and their development. Irisin is a myokine that leads to increased energy expenditure by stimulating the 'browning' of white adipose tissue. In the first description of this hormone, increased levels of circulating irisin, which is cleaved from its precursor fibronectin type III domain-containing protein 5, were associated with improved glucose homeostasis by reducing insulin resistance. Irisin is a powerful messenger, sending the signal to determine the function of specific cells, like skeletal muscle, liver, pancreas, heart, fat and the brain. The action of irisin on different targeted tissues or organs in human being has revealed its physiological functions for promoting health or executing the regulation of variety of metabolic diseases. Numerous studies focus on the association of irisin with metabolic diseases which has gained great interest as a potential new target to combat type 2 diabetes mellitus and insulin resistance. Irisin is found to improve insulin resistance and type 2 diabetes by increasing sensitization of the insulin receptor in skeletal muscle and heart by improving hepatic glucose and lipid metabolism, promoting pancreatic ${\beta}$ cell functions, and transforming white adipose tissue to brown adipose tissue. This review is a thoughtful attempt to summarize the current knowledge of irisin and its effective role in mediating metabolic dysfunctions in insulin resistance and type 2 diabetes mellitus.