• 제목/요약/키워드: Equity in utilization

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1인 가구의 의료이용 형평성: 다인 가구와의 비교를 통하여 (The Equity in Health Care Utilization of One-Person Households: By Comparison with Multi-Person Households)

  • 나비;은상준
    • 보건행정학회지
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    • 제29권3호
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    • pp.288-302
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    • 2019
  • Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

뇌혈관질환 사망자 의료이용 변이의 분석 (A Study on the Variation in Meical Service Utilization of The Dead by Cerebrovascular Diseases Patients in Korea)

  • 홍월란;정두채
    • 한국병원경영학회지
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    • 제14권1호
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    • pp.36-61
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    • 2009
  • This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

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전북지역 거주 선천성기형 환자의 서울·수도권 의료이용에 관한 연구 (The Study on Medical Utilization in Seoul Metropolitan regios by Patients with Congenital Malformations Residing in Jeollabuk-do)

  • 정연자
    • 보건의료생명과학 논문지
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    • 제10권2호
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    • pp.275-283
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    • 2022
  • 본 연구는 전북지역 거주 선천성기형 환자의 서울·수도권 지역 의료이용 요인을 파악하고 주민들의 의료이용에 대한 지역적 형평성을 향상시킬 수 있는 방안을 제시하기 위하여 2016년부터 2020년도 퇴원손상심층조사 자료를 이용하여 카이제곱 검정과 로지스틱 회귀분석을 실시한 결과는 다음과 같다. 첫째, 연령은 19-44세가 서울·수도권 의료이용이 높았다. 둘째, 병상규모가 클수록 서울·수도권 의료이용이 높았다. 셋째, 주진단의 경우 호흡기계통의 선천성기형에서 서울·수도권 의료이용이 높았다. 넷째, 입원환자가 수술을 시행하고 중증도가 높을수록 서울·수도권 의료이용이 증가하였다. 이러한 결과를 바탕으로 의료이용에 대한 지역적 형평성을 위해서는 정부가 주도하는 보건의료정책 및 의료계획이 수반되어야 할 것이다.

의료이용의 형평성에 관한 실증적 연구 -공.교 의료보험 피부양자를 대상으로- (Equity in the Delivery of Health care in the Republic of Korea)

  • 명지영;문옥륜
    • 보건행정학회지
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    • 제5권2호
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    • pp.155-172
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    • 1995
  • This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.

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Capital Structure and Financial Performance: A Case of Saudi Petrochemical Industry

  • ALI, Anis;FAISAL, Shaha
    • The Journal of Asian Finance, Economics and Business
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    • 제7권7호
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    • pp.105-112
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    • 2020
  • The study investigates and measures the impact of capital structure, profitability and financial performance on the success of the business organization. Capital structure of the business organization refers to the proportion of external funds and internal funds, i.e., debt and equity. In Saudi Arabia, petrochemicals companies are working on equity, but financial performance reflects negative trend for the period 2004 to 2016. The research is based upon secondary data available on the websites of petrochemicals companies of Saudi Arabia. Financial Ratio variability analysis and Trend Indices of financial ratios (TICBI) measure and compare the financial variability and sensitivity of financial ratios of the business organization. Correlation between Trend Indices (TICBI) of independent variable and dependent variables are to be calculated to know the impact of changes in debt equity on other dependent variables. The results reveal the unexpected performance of petrochemicals companies due to under-utilization of the resources caused by low demand and lower prices of the products governed by some internal and external factors. The study finds that size, demand, cost of production, profitable streams of products, and low cost capital in external funds are the factors responsible for overall growth development of the petrochemicals industry of Saudi Arabia.

지역의료보험의 실시에 따른 의료이용변화 분석 : 소득계층별 의료필요충족도를 중심으로 (Effects of Regional Health Insurance on Access to Ambulatory Care)

  • 배상수
    • 보건행정학회지
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    • 제2권1호
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    • pp.167-203
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    • 1992
  • The effects of regional health insurance on access to ambulatory care are examined in this paper. Access is measured as use-disability ratios. The data are collected in a household interview survey at Hwachon county before and after the introduction of regional health insurance. Before the introduction of regional health insurance, low-income class has less contacts with physicians than high-income class. This disparity in accessibility among economic classes is reduced with the health insurance coverage, but not removed, even after adjusting for health need.

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한국 저소득층 주민의 보건의료서비스 이용행태와 그 영향요인에 관한 연구 (A Study on Health Service Utilization and it's Determinants in the Low Income Family in Korea)

  • 임미영;하나선
    • 지역사회간호학회지
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    • 제13권2호
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    • pp.272-279
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    • 2002
  • Objectives: The purpose of this study was to analyze health service utilization, and its related factors in low income families who earned half of the average Korean household income. Methods: This was a cross-sectional descriptive survey study in which a nationwide randomization sampling technique was used. The data were collected from July 12 to August 7, 1999, and the total sample size was 5,819 individuals, belonging to 1.753 households. Results: 1) In the utilization of health services for the last 3months, the pharmacy was the type of service that was the most utilized (32.0%), and the health center was the one that was the least utilized (10.3%). About 29% (29.2%) of the respondents could not utilize the health service at all. and 19.8% of the respondents terminated their medical treatments half way to completion because of financial difficulty (89.4%). 2) Analysis of the data using logistic regression showed that living with spouse, level of education, occupation, and income had statistically significant effects on health service utilization. Conclusion: The parameters of health care policies are equity and efficacy for health status, and the health service utilization by low income families. The conclusive resolution for these is the improvement of public health centers for an increased utilization rate of their services.

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도시공원 분포의 형평성 분석에 관한 연구 - 성남시 사례를 중심으로 - (The Social Equity of Urban Park Distribution in Seongnam City)

  • 신지영
    • 한국환경복원기술학회지
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    • 제12권2호
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    • pp.40-49
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    • 2009
  • Urban park facilities and services offer a number of opportunities to fulfill individual, social, economic, and environmental benefits. Urban parks, provided through political measures as public goods, require balanced distribution in order to ensure social equity. The primary objectives of this study are to analyze the accessibility of urban parks and to examine whether urban parks are distributed equitably. GIS and statistical methods were used to investigate correlations between accessibility to neighborhood parks and socioeconomic status. As results, percentage of low-income population within the city was negatively related to park accessibility. Low-income dominated residential area, such as Sujeong-gu and Jungwon-gu have large low-income communities and less park accessibility compared with Bundang-gu, which are dominated by high-income residents. So, results from this study indicate that urban parks are not distributed equitably within Seongnam city. Therefore, creative strategies to provide urban parks for areas in need through the utilization of vacant lots, abandoned sites, and schools sites are necessary. Furthermore, budgetary priorities should be set to create new parks and revitalizing parks within the city's older neighborhoods are also needed.

전국 저소득층노인의 보건의료이용과 영향요인 분석 (A Study on Health Service Utilization for the Low Income Elderly in Korea)

  • 임미영;유호신
    • 지역사회간호학회지
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    • 제12권3호
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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.

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일개 지역사회 중심 가정간호사업소의 운영실태 및 운영방안 (A Study on the Operating Status of Community-based Home Health Care Centers)

  • 이은희;박성애
    • 간호행정학회지
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    • 제17권2호
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    • pp.180-188
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    • 2011
  • Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.