• Health Policy and Management
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• v.20 no.1
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• pp.1-18
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• 2010

This article examines social determinants of population health in OECD countries, where life years, infant mortality, and PYLL are used as proxy variables of health. The unit of analysis is a country which is the OECD affiliate. A panel regression estimation is chosen as a method, using OECD Health Data. The results are: the increasing national health expenditure affected positively to improve population health. Education was rather a significant determinant of health than income level. The government direct investment for public health did not contribute positively to enhance population health. The expansion of health care coverage was working positively for improving health, but with a time lag. The supply of doctors was a most influential determinant of health. In case of Korea, the coverage expansion of health care was the most important determinant of health. The supply of doctors was, however, not a positive factor for better health, which is different result with the case of OECD countries.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.300-308
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• 2013

Objectives: The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review. Methods: The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients ($R^2$) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost. Results: Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%). Conclusions: As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.

• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.144-152
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• 2022

Objectives: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries. Methods: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection. Results: A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (β=-0.672, -0.445, and -0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (β=-0.215 and -0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (β=-0.423). A national Bacillus Calmette-Guérin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (β=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (β=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (β=-0.362 and -0.449, respectively). Conclusions: These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19.

• Asia-Pacific Journal of Business
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• v.15 no.1
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• pp.87-98
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• 2024

Purpose - The purpose of this research is to explore the determinants of marriage intention for Korean youth. Because Korean society is under the population decline, inspecting influential attributes become worthy. Design/methodology/approach - This study employed Korean Youth panel data. The determinants of marriage intention include subjective health, leisure time, Schwabe index, culture recreation ratio, and Engel coefficient. This study performed binary logistic regression to test the hypotheses. Findings - The results indicate that subjective health and leisure time positively impact on the likelihood of marriage intention. However, culture recreation ratio and Engel coefficient negatively affect the likelihood of marriage intention. Schwabe index exerts no significant effect on marriage intention. Research implications or Originality - The results could become useful information to build policy to solve the population decline problem

• Health Policy and Management
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• v.11 no.2
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.

• Health Policy and Management
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• v.19 no.4
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• pp.33-52
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• 2009

Health promotion policies have needed to assess in detailed and evidence-based work to set a policy goal and clear future directions of health promotion in Korea. To identify the major factors related with health promotion, we assessed the associations between public health outcome (potential years of life loss, PYLL) and national health determinants. For this purpose, we used a pooled cross sectional time-series regression analysis with corrected fixed effect models involving sixteen member countries of the Organisation for Economic Cooperation and Development during the period 1970 to 2001. The PYLL was positively associated with tobacco and alcohol consumption (model 1 and 2) and calories intake (model 2 and 3) while the PYLL was negatively associated with GDP, fruit and vegetable intake (model 2), number of doctors (model 3), coverage rates of health care security, and elderly population rates (model 4). In conclusion, health behaviors related with tobacco, alcohol, and nutrition were significant health determinants for health outcome. Overall analysis results of this study will provide a guidance toward improved macro- and micro-policy development for future health promotion policy in Korea.

• The Korean Journal of Health Service Management
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• v.10 no.2
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• pp.83-97
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• 2016

Objectives : This study analyzed the factors that determine the use and type of medical examination services (MES) to develop a model explaining the use behavior of MES which could consequently contribute to policy implications for medical examinations. Methods : Based on Anderson's healthcare utilization model, the MES utilization model was developed by including the perceived needs for MES. The data were collected from an online survey of a population aged 20-39 years and from a telephone survey of a population aged 40 years or older, respectively. Chi-Square tests and hierarchical logistic regression analyses were done with SAS version 9.3. Results : Generally, as health status became lower, the use of MES increased. However, patients with two or more chronic diseases were less likely to use private MES compared to patients with one chronic disease. The perceived needs for MES were only related to the use of service and not to the choice of the MES type. Conclusions : There were different results for the significant determinants between the use of the MES and the choice of the MES type. The healthcare industry needs to aware of consumer needs to provide MES based on empirical findings.

• Health Policy and Management
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• v.17 no.4
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• pp.31-53
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• 2007

The purpose of a national health care system is to improve health care outcome among population. The objective of the study was to explore the determinants of health outcome in the 24 OECD countries between two health care financing systems. The study employed the pooled time series and cross-sectional analysis with tax-funded and social insurance-funded countries over the period of 1980 to 1999 using OECD Health Data 2002. The study revealed that health expenditure per capita, physicians per 1,000 of the population and calorie intake were positively significantly associated, smoking rate was negatively associated with health outcome while controlling all variables in the tax-funded countries. But in the insurance-funded countries, health expenditure per capita and the number of physicians were not statistically significant factors explaining health outcome. Only the calorie intake was positively associated with, and smoking rate, alcohol consumption per capita, and total nitrogen oxide emission per capita were negatively significantly associated with health outcome. In conclusion, healthy life style factors were much more important to improve health outcome in the both systems.

• Health Policy and Management
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• v.5 no.1
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• pp.1-30
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• 1995

This study was conducted to investigate the distribution of private medical practitioners' income from the medical insurance and its determinants. Total amount of the medical service fee paid by the medical insurance to 1,268 private clinics(767 in Taegu and 510 in Kyungpook that had been in practice at least for one year) in 1993 was compared by the characteristics of practitioner, clinic, patient and population. The practitioners in 40-49 years of age and 6-10 years inpractice had the highest income. Total income of a clinic was increased with the number of physicians, employees and equipments. The largest income differentials were observed among obstetrics and gynecology clinics and the least differentials were among pediatrics clinics. The characteristics of practitioner, clinic and population accounted for 41.7% of the total variance of income. The important determinants of income were specialty of the clinic, age of the practitioner and number of the employee and equipments. The large income differentials among clinics imply a skewed distribution of patients and thus long waiting time, inefficient utilization of manpower and inadequate quality of care. Effective measures to reduce the income differentials need to be developed.