• Journal of Preventive Medicine and Public Health
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• 제46권1호
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• pp.1-9
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• 2013

Objectives: We examined the association between social expenditures of the local government and the mortality level in Korea, 2004 to 2010. Methods: We used social expenditure data of 230 local governments during 2004 to 2010 from the Social Expenditure Database prepared by the Korean Institute for Health and Social Affairs. Fixed effect panel data regression analysis was adopted to look for associations between social expenditures and age-standardized mortality and the premature death index. Results: Social expenditures of local governments per capita was not significantly associated with standardized mortality but was associated with the premature death index (decline of 1.0 [for males] and 0.5 [for females] for each expenditure of 100 000 Korean won, i.e., approximately 100 US dollar). As an index of the voluntary effort of local governments, the self-managed project ratio was associated with a decline in the standardized mortality in females (decline of 0.4 for each increase of 1%). The share of health care was not significant. Conclusions: There were associations between social expenditures of the local government and the mortality level in Korea. In particular, social expenditures per capita were significantly associated with a decline in premature death. However, the voluntary efforts of local governments were not significantly related to the decline in premature death.

• International Journal of Contents
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• 제9권1호
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• pp.42-48
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• 2013

This research explores the convergence of health care expenditure in Korea with different income groups and the world level by applying different concepts of convergence, including growth rates, trends, differences as well as rationality and statistical variation of health care expenditure. The empirical evidence shows that, in general, the health care expenditure in Korea seems to be on the right track in terms of both level and difference, given the fact that convergence exists with the expenditures of the high income group and the world level. It is also worth mentioning that the Korean public health care system has been performing much better than its private health care counterpart. Such a result suggests that the private health care system has to be more elaborately and systematically managed through the establishment of an operational policy to stimulate an increase in private health care expenditure.

• 한국콘텐츠학회논문지
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• 제22권1호
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• pp.484-492
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• 2022

본 연구는 베이비부머세대의 과부담 의료비에 미치는 요인을 파악하기 위하여 한국의료패널조사 2017년 원자료를 분석자료로 이용하여, 베이비부머세대 808명을 최종 분석대상으로 하였다. 분석은 빈도분석, 교차분석, 로지스틱 회귀분석을 실시하였고, 모든 검증은 p=.05를 유의수준으로 하였다. 베이비부머세대의 교육수준, 배우자 유무, 의료보장형태, 가구소득, 음주여부, 흡연여부, 주관적 건강상태, 외래진료여부, 입원진료여부가 통계적으로 유의한 차이가 있었다. 베이비부머세대의 평균 질환수는 8.14개 이었고, 남자 7.97개, 여자 8.99개 이었다. 외래 진료평균횟수는 16.81회 이었고, 남자 14.81회, 여자 26.89회 였다. 과부담 의료비 발생률 중 지불능력 40% 이상은 남자 15.3%, 여자 26.3% 였다. 과부담 의료비 지출에 미치는 영향 요인은 남자는 민간보험가입여부, 가구소득, 음주여부, 입원진료여부 이었고, 여자는 민간보험가입여부, 가구소득, 음주여부였다.

• 보건행정학회지
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• 제20권1호
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• pp.37-63
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• 2010

Public expenditures on long-term care are a matter of concern for Korea as in many other countries. The expenditure is expected to accelerate and to put pressure on public budgets, adding to that arising from insufficient retirement schemes and other forms of social spending. This study tried to foresee how much health care spending could increase in the future considering demographic and non-demographic factors as the drivers of expenditure. Previous projections of future long-term expenditure were mainly based on a given relation between spending and age structure. However, although demographic factors will surely put upward pressure on long-term care costs, other non-demographic factors, such as labor cost increase and availability of informal care, should be taken into account as well. Also, the possibility of dynamic link between health status and longevity gains needs to be considered. The model in this study is cell-base and consists of three main parts. The first part estimated the numbers of elderly people with different levels of health status by age group, gender, household type. The second part estimated the levels of long-term care services required, by attaching a probability of receiving long-term care services to each cell using from the sample from current year. The third part of the model estimated long-term care expenditure, along the demographic and non-demographic factors' change in various scenarios. Public spending on long-term care could rise from the current level of 0.2~0.3% of GDP to around 0.44~2.30% by 2040.

• Journal of Preventive Medicine and Public Health
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• 제57권1호
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• pp.65-72
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• 2024

Objectives: Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019. Methods: Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE. Results: The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05). Conclusions: Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

• 대한가정학회지
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• 제35권4호
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• pp.229-242
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• 1997

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.

• 보건행정학회지
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• 제19권1호
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• pp.81-96
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• 2009

The expansion of long-term care hospitals (LTCHs) is expected to contribute to meeting the long-term care needs of the elderly with chronic diseases in a rapidly aging society. It is also expected to increase efficiency of health resource use and decrease elderly health expenditures by transferring patients from acute care hospitals (ACHs) to LTCHs. This study aimed to empirically examine how the expansion of LTCHs had influences on the length of hospitalization of the elderly in ACHs. Panel regression analysis was employed as an analytic tool using data of the National Health Insurance and the National Statistical Office from 2002 to 2006. The expansion of LTCHs was measured as location quotient (LQ) of LTCHs, denoting the share of LTCHs in a large city or province relative to the share of LTCHs at the national level. In addition, per capita GRDP (gross regional domestic product) and the proportion of population over 65 were included as control variables. The main findings are as follows. First, it was observed that LQ of LTCHs showed a statistically significant negative association with the length of hospitalization of the elderly in ACHs. Second, the negative correlation was evident among general hospitals with over 100 beds while it was not among hospitals with less than 100 beds. Third, LQ of LTCHs had more influences among the elderly over 85. In conclusion, the expansion of LTCHs seems to contribute to decrease in the inpatient cost of the elderly in ACHs and to increase efficiency in the utilization of health resources.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• 대한가정학회지
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• 제36권1호
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• pp.169-186
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• 1998

The purpose of the study is to examine the effects of wife's employment to the family expenditures. The data used in the study was 28,329 husband-wife families taken from 1994 Expenditure Survey of Urban Families. The results showed that total expenditure for employed-wife families was 1,171,651won, which is more than 1,078,788won for non-employed-wife families. After controlling other income(total family income minus wife's income), employed-wife families spent more than non-employ-wife famillies for all expenditure categories. Also, when family income and other characteristics to be constant, expenditures of employed-wife families were more on food way from home, domestic services, public transportation, personal care services, and fees, but less on food at home, utilities, health care, and communication, compared to those of non-employed-wife families. Families with high-income-employed wife spent more on clothing services, but less on education, than those with non-employed-wife families.

• 보건행정학회지
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• 제23권4호
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• pp.343-348
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• 2013

Background: Price control alone may not successfully restrain growth in health expenditures. This study aimed to propose fee adjustment model suitable for Korea reflecting health service volume and to clarify applicability of the model by comparing actual conversion factor with estimated conversion factor from simulation of this model. Methods: Fee adjustment model was developed based on Alberta's fee adjustment formula in Canada and 7 alternatives were assessed according to diversely applied parameters of the model. Results: Estimated conversion factors of the tertiary care hospital and the hospital were lower than actual conversion factors, since the utilization of heath service has been increased. However, there was no big difference between estimated conversion factors and actual conversion factors of the general hospital and the clinic. Eventually this fee adjustment model could estimate proper conversion factor reflecting health service volume. Conclusion: This model may be applicable to the mechanism as determining conversion factor between insurer and provider via negotiation and controling growth in health expenditures.