Despite well-known benefits of physical activity for older adults, most older adults remain significantly underactive. The purpose of this study was to examine the effects of an inclusive, choice-based physical activity promotion program to increase lifetime physical activity levels of seniors on physical activity & health-related quality of life outcomes in older adults. The physical activity promotion program guided participants to choose activities that took into account their health, preferences, and abilities. It offered information on ways for them to exercise safely, motivate themselves, overcome barriers, and develop a balanced exercise regimen. A six-month comparison-group trial was conducted with older adults in community senior center. Changes in self-reported physical activity & health-related quality of life(SF-36) by group & within group were evaluated using t-test. Of 30 subjects, 22(73%) completed the trial. Subjects were aged 63 to 75 years(mean=$68.36{\pm}4.02$); 86% were female. The intervention group increased estimated caloric expenditure by 1975 calories/week in moderate intensity activities(MET${\geq}3.0$; p=.008), and by 2312 calories/week in physical activities of any intensity(p=.005). Between-group analyses showed that the changes were significantly different in both measures(p=0.17; p=032). The intervention group also significantly better scores on general health perception(p=.031) & vitality(p=.002). Individually tailored programs to encourage lifestyle changes in seniors may be effective and applicable to health care and community settings.
This study compared one-child households' economic structures between those who determined not to have more children and those who have a birth plan. This study examined the demographic characteristics and economic variables such as income, consumption expenditures, assets. debt, and a subjective evaluation of future economic status. Especially, it compared the effects of socioeconomic variables on expenditures on a child between low-fertility and birth-planned households. From a questionnaire completed by a husband or wife of one-child households, 154 low-fertility households and 201 birth-planned households were obtained. A t-test, chi-square test, multiple regression analysis and a dummy variable interaction technique were used. The findings of this study are as follows: First, low-fertility households were older, had higher income, and had more educated, employed wives. Their marital duration was longer, and their child was older than those of birth-planned households. Second, low-fertility households had higher consumption expenditures than did birth-planned households. Especially, expenditures of apparel and shoes, health care, education, and entertainment were significantly higher for low-fertility households. Also, low-fertility households spent more than did birth-planned households on a child. However, low-fertility households had significantly more debt than did their counterparts, and their expectation level of future economic status were lower than that of birth-planned households. Third, the effects of socioeconomic variables on expenditures on a child were different between low-fertility and birth-planned households. Age, education level, husband's occupation, wife's employment status, income, net asset, and subjective evaluation of future economic status showed significant differences. Income elasticity of expenditure on a child was significantly higher for low-fertility households than their counterparts.
This study investigated Korean and Chinese female college students' retirement attitudes. Considering the fact that the two countries are experiencing dramatic increases in elderly population, retirement planning is a significant social issue. Even though Korea and China share similar cultural backgrounds, economic systems and governmental retirement policies have been developed in different ways. The purpose of this research was to compare retirement attitudes and related factors between Korean and Chinese female college students. Based on a survey with 214 female college students (130 Koreans and 84 Chinese), differences and similarities in retirement attitudes and related factors were identified. On average, Chinese female college students showed more positive attitudes towards retirement than Korean students. The levels of thinking about retirement and worrying about finances in retirement were greater for Korean students than Chinese students. More Korean students anticipated that their actual retirement age will be earlier than their desired retirement age. Korean students believed that they should start retirement planning at an earlier age than Chinese students' retirement planning age. Korean students anticipated that the cost for food and housing as the major expenditure category in retirement while Chinese students anticipated cost for health care as the major expenditure category. Korean students who worry about finances in retirement, and those who anticipated that they will retire earlier than their desired age showed negative retirement attitudes when controlling other factors. Implications for retirement planning and education were presented based on the research findings.
This study is to investigate how the expenditures for hypertension is affected by socioeconomic, health care resources, and health behavior factors with a special emphasis on geographic variations and to provide the data about regional management for hypertension. To analyze, we combined a unique data set including key indicators from Medical Service Usage Statistics 2012 by Region by National Health Insurance Corporation, Annual Community Health Survey 2012 by Korea Centers for Disease Control and Prevention and other government organizations at the 247 small administrative districts. We found that the average expenditures of hypertension in 249 small districts is 62,000 won and coefficient of variation is 30.0. Major factors of differences in hypertension expenditure is population density, marital status, household income, number of hospital per 100 thousand, medical expenses outside the jurisdiction, drinking rate, moderate and over-intensity physical activity, and hypertension diagnosis rate. The results of decision tree was that there were significant differences between regions in hypertension diagnosis rate, household income, marital status, number of hospital per 100 thousand, obesity rate, drinking rate. This study concluded that determinants of geographic variations in hypertension spending are not only health resources and socioepidemic characteristics but health behaviors.
The skyrocketing inflation of medical costs has become a major health problem among most developed countries. Korea, which recently covered the entire population with National Health Insurance, is facing the same problem. The proportion of health expenditure to GNP has increased from 3% to 4.8% during the last decade. This was remarkable, if we consider the rapid economic growth during that time. A few policy analysts began to raise cost containment as an agenda, after recognizing the importance of medical cost inflation. In order to Prepare an appropriate alternative for the agenda, it is necessary to find out reasons for the cost inflation. Then, we should focus on the reasons which are controllable, and those whose control are socially desirable. This study is designed to articulate the theory of medical cost inflation through literature reviews, to find out reasons for cost inflation, by analyzing aggregated data with a deterministic model. Finally to identify determinants of changes in both medical demand and service intensity which are major reasons for cost inflation. The reasons for cost inflation are classified into cost push inflation and demand pull inflation, The former consists of increases in price and intensity of services, while the latter is made of consumer derived demand and supplier induced demand. We used a time series (1983-1987), and cross sectional (over regions) data of health insurance. The deterministic model reveals, that an increase in service intensity is a major cause of inflation in the case of inpatient care, while, more utilization, is a primary attribute in the case of physician visits. Multiple regression analysis shows that an increase in hospital beds is a leading explanatory variable for the increase in hospital care. It also reveals, that an introduction of a deductible clause, an increase in hospital beds and degree of urbanization, are statistically significant variables explaining physician visits. The results are consistent with the existing theory, The magnitude of service intensity is influenced by the level of co-payment, the proportion of old age and an increase in co-payment. In short, an increase in co-payment reduced the utilization, but it induced more intensities or services. We can conclude that the strict fee regulation or increase in the level of co-payment can not be an effective measure for cost containment under the fee for service system. Because the provider can react against the regulation by inducing more services.
Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.
Many countries have tried to reform financing systems toward UHC and paid attention to the function of strategic purchasing. This study was performed to examine theoretical foundations and the function of strategic purchasing. And we examined the functions of strategic purchasing in Korea based on the framework proposed by Preker(2005). For this purpose, we reviewed literature related to purchasing. we defined the strategic purchasing as strategic activities to provide health care services people need within a given budget, which is carried out by certain organizations, purchasing organizations. These activities include selecting appropriate providers, designing and operating the payment system, setting the price, and determining the target populations and their needs etc. The relationships among government, purchasers and healthcare providers can be explained by the principal-agent theory. In addition to Preker's framework, we emphasized the importance of the infrastructure such as decision making support systems, information systems, health care resource management systems, or expenditure monitoring systems. The National Health Insurance Service and the Health Insurance Review & Assessment Service play major roles in performing strategic purchasing.
the purpose of this study is to investigate the effect of household type on human capital enhancement expenditures and to compare the difference in these expenditures between female-hemale-headed and married-couple households. Data for this study were from the 1990-91 Consumer Expenditure Survey(CES) and consisted of a sample of 7,225 married-couple and 1,391 female-headed households with children under age 18. The dependent variable to measure human capital expenditures was the sum of four sub-components-education reading leisure and health care expenditures. Tobit analysis with a dummy variable for household type was used to identify the effect of household type on the dollars spent on human capital expenditures. The effect of household type was significant in human capital expenditures indicating that female-headed households spent significantly less for this category than did married-couple household holding other factors constant. the findings of this study suggested that income from a public assistance program was associated with lesser expenditures on human capital while social security income source was associated with greater human capital expenditures, It was also found that the addition of family members between ages of 6 and 17 positively affected human capital expenditures. Understanding these factors is useful for family resource management professionals who work with female-headed households.
A study on the status of sickness and medical care of insured and non-insured groups of employee and his family in Naju fertilizer company, in the year of 1973, was carried out. The results obtained are as follows: 1. 66.8% of all employee was subscribed in this medical insurance program. No woman employee was subscribed and the rate of subscription was increased from 16.1% to 92.0% by age increases. 2. Also, as of period of service, the rate of subscription was increased from 11.3% to 89.4% by the period gets longer. 3. Employee who reside within boundary of the company (76.2%) subscribed more than that whom reside outside boundary (63.9%). 4. Rate of subscription was also indreased by family size becomes larger. In case of single, it was only 19.6% but in the case of family size became more than 6, it increased to 87.4%, 5. As of amount of monthly income, although no one had subscribed those who get less than 30,000 won a month. Subscriber, increased by monthly income get greater. 6. Subscribed family reside within company boundary utilized hospital 35.5 times a year whereas non-subscribed family reside within these utilized 12.5 times. And, subscribed family reside outside boundary utilized hospital 32.2 times a year and non-subscribed family utilized 9.6 times. Regardless of resident area, family who subscribed to this program utilized hospital more often than non-subscribed family. 7. The utilization of the hospital became gradually frequent from 15.6 times to 36.5 times per family by family size became larger. but in non-subscribed group, although it was increased from 8.3 times to 16.5 times per family, it was droped to the least 6.9 times at 2 person family. 8. 17,496 hospital visits were made by all employee and his family in the year 1973. 86.9% of them was made by subscribed group and the rest (13.1%) was made by non-subscribed group. Observing of the type of these sickness by the classification of WHO, only three types of VII (26.7%), XVII (25.0%) and IX(19.3%) were made more often by non-subscribed group while the others were made more by subscribed group. 9. Anual average medical expenditure per family was 13,098.9 won for subscribed family while it was 3,076.1 won for non-subscribed family. 10. Anual average hospital visits per capita was 6.5 times for subscribed groups and 3.4 times for non-subscribed group. Anual average medical expenditure per capita was 2,580.8 won for subscribed group while it was 1,061.0 won for non-subscribed one.
The purpose of this study is to investigate the effect of private insurance revenues and household spending on household income inequality. To this end, we conducted a concentration index and concentration curve analysis for the income level of medical panel survey data in 2015. The main results are as follows. First, the household income concentration ratio is 0.3580, which means that income is concentrated in the high income group, and the degree of inequality is considerably large. Second, although the portion of the private insurance benefits was small on the high-income household, it helped to strengthen the benefits concentration on this group. Third, the low income group has a large self-pay medical expense. Finally, the index of the income excluding the burden of the total medical expenses in the household income was 0.3676, so that even accounting for medical expenses, the income was concentrated in the high income class. Therefore, private insurance benefits and medical expenses were all contributing factors to the inequality of household income, and this study provides the essential materials for research and policy planning which could lead to the convergence of different fields.
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