Introduction: Previous studies on occupational health focussed predominately on the occurrence of occupational diseases. Relatively few studies have measured how employment is associated with the use of healthcare services. This study investigates the association between employment and the extent and range of healthcare use, such as medical expenditures, of women in South Korea. Methods: We analyze data of the Korean Health Panel, an ongoing longitudinal national representative survey, from 2008 to 2017, to identify the status of economic activity of women by year and age group. We estimate the association between female employment status and medical expenditures by using random effect panel Tobit models. Furthermore, we investigate the association between employment status and the range of healthcare services in biomedicine and traditional Korean medicine (KM) by conducting conditional fixed-effects logistic regression analyses. Results: For women aged between 25 and 65 in 2017, the majority of them were employed or self-employed. (The proportion of employment of self-employment equals 64.80%). In addition, working women spent 11.6% less on healthcare than nonworking women, and self-employment lowered the healthcare expenditure by 13.1%. Neither work nor the type of work is related to the types and range of healthcare service use. Being employed or self-employed is negatively associated with women's expenditure on healthcare. Conclusions: The findings show that employment is associated with less spending on healthcare. They imply that employment has a positive impact on women's health.
Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.
Objectives: We tried to confirm physical activity of 1,000 Kcal per week was a meaningful point in controlling coronary artery disease risks in female older adults. Methods: Participants were 66 female older adults recruited from senior welfare center. Participants were provided with accelerometer (e-step, Kenz, Japan) for measuring daily energy expenditure. Graded exercise test was done for measuring aerobic fitness. Blood glucose and lipid were analyzed. Framingham risk score was calculated based on blood glucose, blood lipid, and smoking. These variables were compared between the group expended more than 1,000 Kcal/week and the group with energy expenditure below 1,000 Kcal/week. Results: The group expended over 1,000kcal/week showed to be superior to the counterpart group in following variables; AC(Abdominal Circumference), %BF, $HR_{rest}$(resting heart rate), $VO_{2peak}$, FBG, LDL-C, TG, BDI-II, QOL, AR(Absolute Risk), RR(Relative Risk). Conclusions: The group expended over 1,000 Kcal/week was likely to have less probability in CAD than group expended less than 1,000 Kcal/week. The result of this study suggests the important role of active daily life that can be replaced with that of regular exercise especially for those who are not available to do structured exercise.
Recently it has been encouraged in developed countries that labor force participation of the elderly is one of the means to cut down the cost of social welfare for them. However, empirical studies have rarely explored how work in later life contributes to national economy. Especially, even though 56.6 percent of elderly workers aged 65 and older engaged in agriculture and forestry in Korea, their contribution has been socio-economically overlooked. This study aims at examining the effect of farming labor in later life on social welfare expenditure. For this purpose, social welfare expenditure was defined as social benefits provided for the elderly by the social security in public sector and measured as transportation allowance, pension, livelihood aid, medical aid, and health insurance in 2003. Data were obtained from National Health Insurance Cooperation and 37 town/village offices and analyzed by 3 age groups; 65~74, 75~84, and 85 and over using SPSS/PC windows program. Results showed that both livelihood and medical support in all age groups were expended more to non-farm than to farm workers. The amount differences per person between them were 113,959~361,132 won in livelihood support and 15,644~51,418 won in medical support. Also, participation in farming influence reduction of livelihood expenditure for the group 65~74 and 75~84 and that of medical expenditure only for the group 65~74. Based on these results, it was estimated the amount of social welfare expenditure reduced by farming labor in later life. The limit of this study and the policy implications of the results are discussed.
This study is an empiriacl analysis of effects of government intervention on the health care delivery system in Korea. The purposes of this study are to find out the effects of government intervention on the per capita national health expenditure(per capita NHE), crude mortality rate(CMR), and institutional efficiency. Here, the institutional efficiency is defined as a formula shown below: log$\frac{100-curde mortality rate }{per capita NHE}$$\times$100. The formula indicates that the instiutional efficiency increases if the CMR and/or per capita NHE goes down. In the meantime the government intervention is measured by six independent variables: I) the degree of social developments, ii) the numberr of physicians per 100, 000 population, iii) the proportion of specialists among the total physicians, iv) the proportion of public expenditure among the NHE, v) the proportion of public beds to the total number of beds, vi) the proportion of physicians working at the public sector to the total number of physicians. In the above six independent variables iv), v) and vi) are the ones that reflect the degree of government intervention. In actual calculation, the two independent variables v) and vi) are integrated into a new variable based on one to one correspondence. The materials used are the time-series data from 1970 through 1990 in Korea. A path analysis and the time-series regression analysis were adopted to estimate and examine the causal relationship between variables involved. And decomposition of the effect of causal relationship is made to find net effect, direct and indirect effect. The major findings are as follows; 1. The effect of public expenditure, number of physicians per 100, 000 population, the proportion of specialists among the total physicians and social development shows a positive relationship with per capita NHE. Only if the government intervention would be counted, the effects of the number of physicians and the proportion of specialists succeed in containing per capita NHE. 2. In additionn to the above four variables, one additional variable, per capita NHE, was also responsible for the reduction of CMR. The factor of social development found to be the most potent predictor of the CMR reduction. However, the CMR reduction due to government intervention was negligible. 3. Meanwhile, the above four variables were found to was have negative effects on the institutional efficiency. The reverse is true when the government intervention is counted. For example, the number of physicians and the proportion of specialists have played a positive role in raising institutional efficiency via goverment intervention. This comes from the factual effect that the increment of institutional efficiency via the reduction of per capita NHE is bigger than via the reduction of CMR.
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.
Obesity increases the risk of knee and to a lesser extent hip OA, which combined affect a large percentage of middle-aged and elderly adults and which are major source of disability, and factor of drop a lowering in the physical exercise ability. Energy expenditure from physical activity accounts for up to 30% of total energy expenditure, it can have a significant impact on energy balance. We studied a exercise therapy that improved long-term weight management and produced additional benefits - loss of joint pain, improved joint mobility, and this exercise program will enhance the weight loss and health benefits from physical activity in the treatment of obese patients with osteoarthritis.
The purpose of the study was to examine the characteristics and economic status of deficit households. The data for this study were from The Household Income and Expenditure Survey in 2000, 2005, and 2010 conducted by the National Statistics Office (NSO). Deficit households were defined by those who had expenditures higher than their income. Among total households, the proportion of deficit households was 26.84% in 2000, 28.14% in 2005, and 27.15% in 2010. The average propensity to consume was 132.1 in 2005, which was higher than those in 2000 and 2010. Deficit households were classified into five types using cluster analysis: 1)overall-overconsumption group(33.07%), 2)basic needs group(26.33%), 3)transportation expenditure-dominated group(6.73%), 4)education expenditure-dominated group(27.63%), 5)health care expenditure-dominated group(6.24%). The overall-overconsumption group was the largest group of total households and the portion of this group among total households decreased by 4.97%p from 2005 to 2010. However, the education expenditure-dominated group increased by approximately 7.6%p over the period. It was also found that households in 2000 and 2010 were more likely to be in all five groups than households in 2005. Other major determinants of households with deficit were gender, age, number of family members, education level, dual income, home ownership, vehicle ownership, and income class.
The objectives of this study were analysis of patient\`s characteristics and market segmentation in oriental medical care and western medical care. This study focused on medical utilization using Anderson's health utilization model. The source of data was 1998 National Health and Nutrition Survey which Korean Institute For Health and Social Affairs carried out. A stratified multistage probability sampling design was used in this survey. The analysis was conducted using the statistical software package SPSS version 10.0 and Answer Tree 2.1 which is one of data mining methodology. The results were as follows ; 1) 44.9% of respondents reported visiting oriental medical center within recent two weeks. 3.4% of them used oriental medical care. The group of age, kind of disease and medical expenditure are associated with the difference western and oriental medical utilization rate. 2) There were several factors related to utilization of oriental medical care according to decision tree. Especially, important factors that patient chose his medical center were kinds of disease, kinds of common medical use, and expenditure. 3) in the results of CART analysis, market of oriental medical care were classified by seven categories. The major groups who have a preference for oriental medicine were those musculo-skeletal, cerebra-vascular disease, or chronic headache patients, and they had a preference fur oriental medical care in common use. These results show that oriental and western medical market were divided into various areas by market segmentation.
Objectives : This paper recommends a global budget based payment system for reimbursing oriental medical services in the national health insurance. Methods : We analyzed previous research outcomes related to oriental medical services and payment system We reviewed the experiences of other countries' global budget system in terms of their strength and weakness. In addition, we developed a reimbursement method for oriental medical services based on global budget. Results : Our reviews focused on global budget system of Germany, the Netherlands, the United Kingdom, Canada, France, and Taiwan. The estimation of global budget in the national health insurance was described in two scenarios. First scenario was to allocate oriental medical services in scale after signing a contract for global budget. In this case, 4.16% of the national health insurance expenditure was allocated for the oriental medical services. Second scenario was to estimate the global budget in a historical context. As a result, the first scenario in total budget was higher than the second, and we proposed a retrospective adjustment method for the gap between the budget and the actual expenditure Conclusions : The payment system for oriental medical services is recommended to shift from fee-for-service to global budget.
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