• 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 Korean society of Dental Hygiene
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• v.15 no.1
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• pp.19-29
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• 2015

Objectives: The purpose of the study is to investigate the related factors to dental care utilization, oral health behaviors, and oral health status in immigrant workers in Korea. Methods: The subjects were 504 foreign immigrant male workers over 20 years old who visited Daegu labor consultation center for oral health survey and oral examination. The questionnaire included 5 questions of socioeconomic characteristics, 8 questions of oral health practice behavior, 6 questions of dental clinic visit, 8 questions of social relations and Korean language proficiency. The question for health behavior was measure by body mass index(BMI). Social relations and Korean language proficiency instrument was modified by Seol from "Family welfare survey in Korean international marriage" and scored by Liker 5 scale. Results: The oral health examination of the immigrant workers was as follows: decayed teeth - 76.6%, filling teeth - 27.4%, missing teeth - 69.8%, dental caries experience above five or more - 60.2%, periodontal pocket tissues - 58.9%. Simplified Oral Hygiene Index was very poor and accounted for 49.0%. Dental care utilization experience was closely associated with social relation indexes including attendance in family events, household stuff help, financial help and counseling for hard work(p<0.01). Dental care utilization experience proportionally increased with proficiency in Korean literacy including speaking, listening, and writing abilities of Korean language(p<0.01). Conclusions: In order to improve the oral health condition of the immigrant workers, it is important to provide social network, Korean language proficiency support, and health insurance coverage through economic burden reduction by the Korean government.

• 한국노년학
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• v.37 no.2
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• pp.281-291
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• 2017

The present study aimed to investigate the rate of unmet healthcare needs for elderly over the age of 65 years, as well as analyze the relevance between employment status and unmet healthcare needs due to financial reasons. With regard to the study method, a logistic regression analysis was performed to investigate the correlation between employment status and unmet healthcare needs due to financial reasons, targeting 5,528 subjects over the age of 65 years. The results showed that the rate of unmet healthcare needs was 18.9%, in which the rate of unmet healthcare needs due to financial reason was 8.1%. The rate of unmet health needs was higher for temporary workers(ORs=1.75) than for retirement workers. However, the rate of unmet healthcare needs caused by financial reasons was higher among day workers(ORs=1.92). In conclusion, in order to prevent unmet healthcare needs for senior Korean patients, it is necessary to not only improve the income security system for the elderly, but also improve the occupational form and level of income of these economically active citizens, considering the increase in average life expectancy. Moreover, it is also necessary to reinforce health insurance coverage systems for settling medical expenses.

• The Journal of Korean Medicine
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• v.41 no.1
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• pp.1-10
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• 2020

Objectives: This study investigated the financial performance of Korean Medicine hospitals in Korea in order to understand the current status of hospital management and improve its efficiency. Methods: Financial statements of 24 medical corporations, 19 juridical foundations and 18 school hospitals from 2016 to 2018 were obtained from the secondary data published by the Health Insurance Review and Assessment Service, the National Tax Service and the Korea Advancing Schools Foundation. Financial performance was measured on 6 dimensions: liquidity, profitability, activity, growth, cost and productivity (investment efficiency) by analyzing 8 financial indicators: Liability to Total Assets, Net Profit to Patient Service Revenues, Total Assets Turnover, Growth Rate of Patient Service Revenues, Operating Expenses to Patient Service Revenues, Value Added to Patient Service Revenues, Value Added to Total Assets, and Value Added to Personnel Expenses. Results: Korean Medicine hospitals showed lower Liability to Total Assets, Liquidity and Value Added to Total Assets than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than those of Western Medicine hospitals do. The net profit decreased significantly (-50.8%) in 2018 whereas Patient Service Revenues increased (6.9%) for the same period due to Operating Expenses increase and Non-Operating loss. Conclusions: These findings suggest that the Korean Medicine hospital sector in Korea needs to improve liquidity and financial structure and to enhance profitability by reducing Personnel Expenses and generating Non-operating revenues in order to improve its investment efficiency and competitiveness.

• Health Policy and Management
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• v.27 no.4
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• pp.296-303
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• 2017

Background: This study purposed to analyze regional factors related to gastric cancer screening rate provided by national cancer screening program in Korea. Methods: The unit of analysis was administrative districts of si gun gu level. Dependent variable was regional gastric cancer screening rate provided by national cancer screening program, and regional variables were selected to represent the regional characteristics such as demographic, health behavior and status, socioeconomic, and health resource. Tobit regression was applied for the analysis. Results: Analysis results showed that gastric cancer screening rate was varied depending on regions from 47.8% to 69.1%. Tobit regression showed that gastric cancer screening rate had negative relationships with smoking rate, financial independence rate, and National Health Insurance premium per capita. And regional gastric cancer screening rate had positive relationships with sex ratio and number of gastric cancer screening center. Conclusion: Regional characteristics should be considered in establishing regional policies for increasing the gastric cancer screening rate.

• Journal of the Korean Home Economics Association
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• v.43 no.6 s.208
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• pp.113-131
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• 2005

The purpose of this study was to investigate older people's planning for estate distribution by examining the factors associated with their will-holding status. This study used data from the 1994 Assets and Health Dynamics among the Oldest Old (AHEAD) Survey, Wave One. The objectives of this study were (a) to establish profiles of older people who have a written will and to compare their financial portfolios across will-holding status; (b) to identify factors that influence the decision to make a will, and (c) to draw implications for family economists, financial educators, planners, and policy makers. The results suggested that a household's financial resources (i.e., liquid and illiquid assets, housing equity, and household income) positively influence the probability of having a will. Older people who resided in a community property state and who were in poor health were less likely to be will-holders than their counterparts, holding financial resources and other variables constant. Demographic characteristics such as age, education, and race, and behavioral characteristic also were significant determinants of the likelihood of having a will. Volunteer participation and charitable contribution, which are proxies for altruism, increased the likelihood of having a will. The probability of having a will also was higher among those who had life insurance and had gwen inter-vivos gifts of more than $\$5,000$ to their children or grandchildren in the past 10 years. On the other hand, the likelihood of having a will declined with increasing number of biological children. From the findings, implications for financial planners and educators were suggested along with directions for future research.

• 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.

• Journal of Korea Trade
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• v.25 no.5
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• pp.39-57
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• 2021

Purpose - This research uses ocean marine insurance (OMI) statistics, international emails, focus-group interviews, and surveys to fill the gap between the theory of behavioral insurance, particularly status quo bias (SQB), and the practice of OMI in Korea. The contractual forms of OMI, the oldest and most globalized form of commercial insurance, were developed in the UK as the Institute Cargo Clauses in 1906 and revised in 1963, 1982, and 2009. SQB has been academically explored, mostly in health insurance and the financial services sector, but never in OMI. Thanks to the availability of OMI statistics in Korea, we can conduct SQB research here for the first time in this field. Design/methodology - We show the existence of SQB in the OMI of Korea through Korean statistics between 2009 and 2018, email correspondence with experts in the UK, Germany, and Japan, focus-group interviews with Korean OMI underwriters, an in-depth interview with one underwriter, and a survey of 15 OMI insureds (company representatives). Findings - We find that Korean foreign traders rely on the old-type OMI contracts developed in 1963, whereas other industrialized countries use the newest type of OMI contract developed in 2009. With a simple loss ratio analysis during 2009-2018, we show that the behavior of insurers has little to do with rational profit maximization and is instead driven by irrational bias, as they forgo the more profitable contracts provided by the new clauses by keeping the old clauses. The consistent addiction to old types of contracts in the OMI market suggests strong SQB among Korean exporters, importers, bankers, or insurers, which we confirmed in our interviews and survey. Originality/value - This research has significant originality and academic value because it reports new findings with crucial implications for the development of efficient trade practices and policy. First, this research is based on actual statistics that have not been used in previous Korean research on OMI. Second, this research shows that all-risk OMI policies provide more value to insureds, in terms of coverage given premium, than partial coverage policies, which differs from arguments previously made in Korea. Third, this research reveals strong SQB in Korea, where foreign trade plays a pivotal role in economic growth. That bias could be attributable to uninformed traders, informed but idle insurers, or conservative bankers. Fourth, to further develop foreign trade, policy initiatives are needed to review the current practices of OMI contracts and move forward with the new contract forms. All of these findings and arguments are both new and important.

• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.51-59
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• 2019

Objectives: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. Methods: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. Results: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. Conclusions: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.

• The Journal of the Korea Contents Association
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• v.15 no.8
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• pp.313-325
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• 2015

This study aims to address factors affecting economic preparation of the elderly with industrial injury using Andersen model. In addition, it is also to explore differences in accordance with changes in the employment status between regular employees and non-regular employees. The authors analyze Panel Study of Worker's Compensation Insurance(PSWCI)'s 1st wave data in the logistic regression model. The authors found gender and education were related to economic preparation. In addition, earned income, national health insurance and the degree to which pain interferes with daily life and the lives caused by industrial accidents were associated with economic preparation. But national pension was not statistically significant to economic preparation. Based on the findings, the researchers addressed political implications to enhance financial security of injured workers.