• Journal of Preventive Medicine and Public Health
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• 제28권2호
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• pp.347-363
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• 1995

The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. Consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series analysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis. so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.

• 보건행정학회지
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• 제25권3호
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• pp.152-161
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• 2015

We analyze the determinants of obesity and the chronic diseases using the Korea Health Panel data. Also we analyze the effect of obesity and the chronic diseases on the health care expenditures. Through this study, to reduce the health care expenditures, we suggest the policy implication that might curb the obesity and the chronic diseases. We estimate the determinants of obesity, the chronic diseases, and the health care expenditures using 2SLS (two stage least squares) estimation method under the simultaneous equations framework. Result says that obesity and chronic diseases significantly have positive effects on the health care expenditures. Also the determinants of the health care expenditures that have positive effects are age, income and health care utilization variables.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.237-248
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• 2013

Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

• 보건행정학회지
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• 제26권4호
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• pp.390-398
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• 2016

Background: This study aims to analyze the impact of levels of health care coverage on the trajectory of self-rated health, comparing the near-poor which tends to be excluded in traditional health care systems with the upper middle class. Methods: The study participants were 3,687 people who sincerely responded questions regarding health care expenditures, unmet medical needs, and self-rated health in the Korea Health Panel data in 2009-2012. Results: The higher health care expenditures and the presence of unmet medical needs were significantly associated with the lower level of self-rated health. However, both factors did not significantly predict the steeper decline in the self-rated health. The results from multiple group analyses showed that health care expenditures and unmet medical needs had greater impact on the near-poor compared to their higher income counterparts. Conclusion: Public health care coverages need to be enhanced as well as reducing health care expenditures and unmet medical needs.

• 대한치과의사협회지
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• 제54권11호
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• pp.840-849
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• 2016

The purpose of this study was to examine dental care utilization and expenditures among children aged 0 to 19 years using Korea Health Panel Survey (KHPS) data in 2008 - 2013. Weighted estimates were nationally representative and statistical significances were analysed by $x^2$ test or adjusted Wald test using STATA 13 software. While dental care utilization increased steadily among children from 2008 through 2013, less than one-third the children received dental care in 2013. Compared with 2008, the proportion of restorative care, oral surgery, preventive care decreased and the proportion of orthodontic care, prosthetic care increased. While the proportion of amalgam markedly decreased, the proportion of resin increased. This study highlight socioeconomic disparities in dental utilization and expenditures among children. Especially the findings provide a baseline assessment for examining trends on dental care for children in the future.

• 보건행정학회지
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• 제18권4호
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• pp.23-48
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• 2008

Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.

• Journal of Preventive Medicine and Public Health
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• 제9권1호
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• pp.31-37
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• 1976

This study was conducted for the purpose of obtaining basic information on the patterns of medical care expenditures, and identifying some determinants of medical care expenditures in the rural Korea. Nine guns were chosen from the eight provinces, excluding Cheju island. One gun in each province and two villages were selected from the each myon or ub within the selected guns. The total number of households was 1,789 and the sample size was 9,826 non-institutionalized people. Followings are the major findings of the study : 1) Medical care expenditures increase proportionally with age in terms of cost per patient, per episode of illness, per treated case, and per person. Averagely, it cost 2,756 won per patient, 2,614 won per spell of illness, 4,361 won per treated case, and 413 won per person. 2) Medical care expenditures increase proportionally with educational level of patients. College graduates spent the most, 4,726 won per patient, 5,987 won per treated case, and 670 won per person. 3) The male spent a little more than the female in terms of per patient, per episode, and per person. For example, a male spent 23 won more than a female. 4) Those who were suffering from illnesses longer than 1 year spent three times more than that had illnesses of less than 1 year duration. 5) The simple correlation coefficient between activity restriction and medical care expenditures was the highest among others, 0.491. The next was 0.294 between duration of illness and medical care expenditures. 6) Attempts are made to identify the explanatory variables in medical care expenditures. Thirty one per cent of the variances in tile expenditures can be accounted for by the selected 15 predictors. Those predictors belonged to clinical renditions, such as activity restriction, duration of illness, and nature of conditions, are proved to be the most potent independent variabes. Level of education and monthly family income are also significant in terms of beta coefficient. Further studies are called for to unreveal the determinants of medical expenditures.

• 한국치위생학회지
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• 제20권5호
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• pp.611-621
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• 2020

Objectives: This study aimed to verify the impact of dental health care insurance coverage policy by analyzing the changes in dental care utilization and expenditures over 5 years from 2012 to 2016, when the dental health insurance coverage expansion policy was implemented. From the national cohort data collected by the Korea Health Panel Survey, a retrospective study was conducted for all household members using dental services. Methods: This study statistically verified the difference in the dependent variables by frequency analysis, chi-square test, t-test, and one-way analysis of variance (SPSS version 22, IBM Co. USA, p<0.05). Results: The annual utilization rate steadily increased from 23.4% to 26.1% between 2012 and 2016. Although there were differences in utilization rates by gender, age, and income level, patients kept using the dental services in 2016 regardless of the type of health insurance. The average annual copayment for patient expenditures (out-of-pocket amount) increased from ￦463,844 to ￦537,401 in 2012 and 2016, respectively. Of the dental care expenditures over 5 years, the ratio of uninsured expenses by the elderly decreased from 38.5% to 25.9%, and the national health insurance service coverage increased from 40.3% to 49.1%. Conclusions: Although this policy did not reduce overall patient expenditures, it has been found that there was a positive effect on the elderly and low-income groups; it increased the utilization and access to dental services.

• 보건행정학회지
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• 제14권2호
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• pp.99-116
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• 2004

This study estimates the determinants of national health expenditures of OECD countries using panel regression method. The data used are OECD Health Data(2003) covering 33 countries and from 1970 to 2001. This study shows several important different results compared to the previous studies. Further this study estimates the determinants of Korean case using data from 1m to 2000, and compare with the results of OECD panel. The main findings are as follows. The income elasticity of health expenditures is estimated below 1.0, but is shown above 1.0 when the different health systems of each country are controlled. The women's labor participation influences strongly positive effect on the health expenditures. The diffusion of new technologies is positively related with the increasing expense. The increasing government expenditures have a tendency not to contain health expenses, but to increase expenses. The expansion of public health insurance holders is containing the expenses, and the increasing number of doctors is pushing expenditures. This implies the health expenditures are influenced more by the induced demand of providers rather than the moral hazard of patients. However, the above result is opposite in Korean case. The existence of primary care doctors affects slightly up warding rather than containing expenditures. Finally the determinants are seriously depending upon which factors are included in the model and which statistical model is chosen. Therefore it must be cautious to interpret the results of statistical model.

• 보건행정학회지
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• 제14권4호
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• pp.75-87
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• 2004

The purpose of this paper is to compare the amount of household health expenditures (HHE) and the proportion of health care expenditure to the household expenditure by ability to pay(ATP) levels. This study has focused on the influence of household ATP on HHE, estimating elasticity of health care expenditures for different ATP groups. For the empirical analysis, the Urban Households Survey Data of 2002 have been used. Our principal findings show that HHE are sensitive to changes in household ATP levels and that the group which is most responsive to changes in A TP level is the lower ATP group. These suggest that as households have less ATP, households with lower ATP reduce expenditures on health care in a proportional manner than those with higher ATP.