• Safety and Health at Work
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• 제9권4호
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• pp.462-467
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• 2018

Background: This study was conducted to investigate the effects of work on medical expenditures by the elderly. Methods: Data pertaining to individuals aged 65 or older collected by the Korean Health Panel 2008-2013 were used. The effects of work on medical expenditures were analyzed in a panel tobit model adjusted for several variables of demographic factors, socioeconomic factors, and health factors for health care. Data were also analyzed based on age groups (65-74, $75{\leq}$), type of work (waged or self-employed), and working time (daytime work or night time work). Results: Among the elderly older than 65 years, 34-37% were workers. Work among the elderly reduced medical expenditures relative to nonworking elderly. Specifically, medical expenditures were lower in individuals older than 75 years, as well as among those who were self-employed insured and had medical aid insurance and those who exercised. However, medical expenditures were higher among females, married individuals, those with a higher household income, and those with a chronic disease. Elderly wageworkers showed reduced medical expenditures than nonworking elderly and elderly daytime workers did. Conclusion: The elderly population's work, especially wage work and daytime work, reduced medical expenditures relative to no work. These results provide valuable information for policymakers by indicating that work was associated with lower medical expenditures than no work. If elderly work is to be encouraged, it is necessary to provide a variety of high-quality wage work.

• 한국치위생학회지
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• 제20권5호
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• pp.665-674
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• 2020

Objectives: This study investigated the perception and educational needs of the health care professionals in wake of the fourth industrial revolution. Methods: This study was conducted among 115 students from the Department of Dental Hygiene and 122 dental hygienists from Gwangju and Jeonnam, from June 25 to September 20, 2020. The questionnaire consisted of one question on the perception of the concept of the fourth industrial revolution and two questions on the influence of the fourth industrial revolution. It contained a total of eight questions on the desired education hours and education expenditure. Results: The degree of perception of the concept and influence of the fourth industrial revolution was 3.20 for both dental hygiene students and dental hygienists; the average of the two groups was the same. Regarding the educational experience, 'no experience' was the most marked response among both dental hygiene students and dental hygienists and no statistically significant difference was observed (p>0.05). Conclusions: As demanded by the changing times, it is necessary to identify the differences in educational demands of the two groups, develop educational programs according to the fourth industrial revolution, as demanded by the changing times, and apply educational programs that fit the educational needs of each group.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.614-627
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• 1993

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

• 대한가정학회지
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• 제31권4호
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• pp.115-132
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• 1993

This study was designed with the purpose to analyze the factor structure of family life events and to clear the influence of related variables on family life events. The frequence of experienced events and the degree of importance of events which were the constituent components of family life events was estimated by the 650 married woman in Kangju. The results were as follows: 1. 15 factors of family life events derived by factor analysis: F.1「Expenditure and economic loss」, F.2「Growth and change of children」, F.3「Change of family structure」, F.4「Family's change」, F.5「Change of life level」, F.6「Family's social problem」, F.7「Need of care」, F.8「Family's health」, F.9「Marital relationship」, F.10「Family's social damage」, F.11「Breach with acquaintance」, F.12「Financial difficulties」F.13「Husband's problem」, F.14「Housewives' social activity」, F.15「Kinship's support」. 2. There frequence of experienced family life events such as expenditure and economic loss and breach with acquaintance was highest. 3. The degree of importance about experienced family life events such as growth and change of children was highest. 4. Age, family life cycle have significantly differenced on the degree of importance and the frequence of experienced events. 5. Education's level, family size, income, housewives' employment and family structure have differently differenced on the degree of importance and the frequence of experienced events according event factor.

• 가정과삶의질연구
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• 제21권4호
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• pp.103-116
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• 2003

The purpose of this study was to examine the economic status of retired elderly households. This study especially looked for the differences in the economic status among retired elderly households and the level of subjective financial strain. The data were drawn from the data of 2000 Korean Labor and Income Panel Study (KLIPS) conducted by the Korea Labor Institute. The major findings are as follows: 1) The levels of income in the retired households were found to be lower than those of the employed elderly households, and the transfer income took the biggest portion out of 5 income types reflecting high economic dependency. 2) The levels of expenditure were found to be similar to the minimum living cost, and the food cost at home was 41.9% of the expenditure. 3) About 40% and 27.3% of households reported that they felt financial strain due to food expenditures at home and health care respectively. 4) Ninety percent of all assets were found to be real estate, reflecting the lack of asset liquidity. Further, retired elderly households were classified as 'not at all strained financially', 'moderate', 'seriously strained', and 'extremely strained' groups according to their subjective assessment. The last two groups showed the lower level of income and expenditures than the first two groups. In particular, 26.5% of retired elderly households belonged to 'extremely strained' group and showed very serious economic problems.

• Journal of Hospice and Palliative Care
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• 제14권4호
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• pp.212-217
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• 2011

목적: 본 연구는 완화의료 활성화 및 서비스 질 향상이라는 정책적 목표를 위하여 2005년부터 완화의료 전문기관에 지원된 운영비가 구체적으로 어떻게 사용되고 있는지 연도별, 지원 횟수별 그리고 종별로 현황을 파악하고, 지원사업의 효과성에 대해 평가하고자 하였다. 방법: 지원 대상 기관이 제출한 사업비 정산 보고서를 토대로 운영비의 비목별 사용 비율을 빈도분석 하였다. 연도별 추세를 파악하기 위해 선형회귀분석을 실시하였고, 지원받은 횟수별, 기관 종별에 따른 완화의료 전문 기관 운영비의 비목별 사용액에 차이가 있는지 알아보기 위해 추리통계방법인 Kruskal-Wallis Test와 Wilcoxon Rank-Sum Test를 이용하였다. 결과: 연도별 분석에서, 프로그램 운영비와 교육 훈련비 및 홍보비에 대한 지출 비율은 지속적으로 증가한 것으로 나타났다(P<0.001). 그러나 저소득층 지원비는 감소하는 추세를 보였다(P=0.024). 연도별 지원받은 횟수별 의료기관 종별에 관계없이 운영비의 절반가량을 인건비, 시설비, 장비비 등의 하드웨어 마련에 사용하고 있었다. 결론: 정부의 완화의료 활성화 지원사업은 장비와 시설 개선 그리고 서비스 질 향상을 위한 활동에 지원금이 꾸준히 사용되고 있음을 알 수 있다. 또한 당해 사업의 평가 기준이 기관의 운영비 사용 흐름에 영향을 주는 것으로 보이는데, 이에 따라 환자 가족을 위한 프로그램 운영과 전문가 교육 훈련에 대한 지출 비율이 늘어나고 있어 서비스 질 향상 위한 바람직한 변화로 보인다. 다만, 평가 기준 조정을 통해 감소하고 있는 저소득층 지원 비율을 향상시킬 필요가 있다고 판단된다.

• 한국컴퓨터정보학회논문지
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• 제16권7호
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• pp.183-190
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• 2011

주택담보 가계 대출은 그룹(지역)별, 시간별로 다양한 원인에 의해서 가계대출 결정요인이 이루어지고 있어 복잡성을 띠고 있다. 본 연구에서는 복잡성을 띠고 있는 주택담보 가계 대출에 관련된 제 변인들을 파악하기 위해 패널 데이터를 이용한 연구 모형을 설정하고 이를 통해 가계대출에 결정적으로 영향을 미치는 제 변인에 대하여 조사, 분석, 검증한다. 본 연구는 7 그룹(6개 광역시(부산, 대구, 인천, 광주, 대전, 울산) 및 서울)을 분석대상으로 하였다. 분석기간은 2007년 1월부터 2010년 9월 까지 자료를 이용하였고. 주택담보 가계 대출액을 종속변수로 설정하고 소비자물가지수, 실업률, 가구당 월평균가계소득, 보건의료비 지출률, 종합주가지수, 일반은행 가계 대출연체율을 설명(독립)변수로 투입하였다. 주택담보 가계 대출 요인을 추정한 결과 소비자물가지수와 실업률은 정(+)의 영향을 미치는 유의한 변인으로 나타나고 보건 의료비 지출률은 음(-)의 영향을 나타내는 유의적인 변인으로 나타났다. 그러나 가구당월평균 가계소득액, 종합주가지수와 일반은행 가계대출 연체율은 비유의적인 변인으로 나타나 주택담보 가계 대출에는 큰 영향을 주지는 않은 것으로 나타났다.

• 보건행정학회지
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• 제17권2호
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• pp.1-17
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• 2007

Limited coverage for health care services of National Health Insurance(NHI) in Korea has been ongoing policy issue but additional NHI financing through raising contribution or taxes in order to improve coverage faces substantial obstacles. Private health insurance(PHI) is often considered as an alternative financing source to improve coverage. Recent reform that attempted to stretch the role of PHI allowed life insurance companies to provide complementary PHI, indemnity plan which will pay for uncovered services by NHI and out-of-pocket spending for covered services. Although complementary PHI may relieve financial burden of patients, it may significantly raise NHI spending as well as total health expenditure since little out-of-pocket spending may increase utilization of health care. So far, there has not been enough discussion about concerns of potential adverse effect resulting from extended role of PHI. This study investigated potential increase of NHI spending followed by extension of complementary PHI through sensitivity analysis. The amount of NHI spending for services that would be covered by complementary PHI was calculated using 2005 NHI statistics and expected complementary PHI enrollment rate by age and sex. Expected utilization increases were obtained based on price elasticities$(-0.2{\sim}-0.5)$ from previous studies and expected coverage rate$(50{\sim}80%)$ of complementary PHI and then converted to monetary figures. Because coverage rate of complementary PHI has not been determined yet, we employed the sensitivity analysis using coverage rate of $50{\sim}80%$. Findings demonstrate that additional spending for health care services is expected to be $426{\sim}1,702$ billion won, corresponding amount payed by NHI $298{\sim}1,192$ billion won. In conclusion, since complementary PHI may raise NHI spending significantly, there should be an agreement whether this additional cost would be accountable and acceptable in our society. Potential inefficiency resulting from extended role of complementary PHI should be considered since public and private financing do not operate in isolation and there should be more discussion on proper role of PHI in Korea.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.9015-9019
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• 2014

The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.

• 농촌의학ㆍ지역보건
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• 제33권2호
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• pp.181-192
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• 2008

Objective: The use of complementary and alternative medicine (CAM) is common especially among patients with osteoarthritis The aim of this study was to investigate the utilization rate and expenditures of patients who use CAM. Method: Two hundred seventy four patients with osteoarthritis were interviewed by a telephone survey. A structured questionnaire about sociodemographic features and type, cost, satisfaction and reason of CAM utilization was used Results: Among 274 patients with osteoarthritis, 251 patients(91.6%) had used at least one type of CAM during six months. There was a significant difference in sex (female), age (70 years), medical security (insurance), educational level between the user and non-user of CAM. Hyperthermia was the most use. The average cost for CAM utilization was 120 thousands won/person during six months and there was no difference in sociodemographic features among the out-of-pocket cost of users. The scores of satisfaction for CAM use were ranged between 60-70. Conclusions: CAM became a popular source of health care because of elderly and lay referral system. And Korean spent a substantial amount of out-of-pocket money on CAM without benefit. Health care system and professionals should pay more attention to CAM, make a evidence for CAM.