• 보건행정학회지
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• 제26권4호
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• pp.333-342
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• 2016

Background: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. Methods: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. Results: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. Conclusion: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.

• KDI Journal of Economic Policy
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• 제30권2호
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• pp.99-128
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• 2008

민간보험은 공적보험과 보완적인 관계를 형성함에도 불구하고 우리나라의 민간보험은 소득계층에 따른 접근성 차이로 인한 사회적 불평등, 도덕적 해이로 인한 공적보험 재정악화 등의 우려를 낳고 있다. 그러나 이에 관한 실증적 분석은 그간 이루어지지 못하여 정책적인 방향을 정립하는 데 장애가 되어 왔다. 본 연구는 건강보험공단, 심사평가원, 민간보험사, 행정자치부 주민등록세대정보 등의 관련 정보를 종합하여 이에 대한 실증분석을 시도했다. 그 결과, 우리나라의 민간보험 가입률은 전 국민의 64%에 달하고 있으며, 고소득층과 저소득층 간에 민간보험 가입률의 차이가 나타나지 않았다. 이는 공적보험의 보장성이 미흡한 상황에서 저소득층 역시 갑작스런 의료지출에 대비하고 있으며, 민간보험이 의료접근성의 계층화를 초래하지 않고 있다는 것을 시사한다. 또한 민간보험 가입자는 평균적으로 미가입자에 비해 의료이용량이 높지 않았으며, Two-Part Model을 통해 다양한 변수를 통제했을 경우에도 동일한 결과가 나타났다. 연령대에 따른 차이로 미루어 이러한 결과는 노동시장과 연관된 한시적인 성격일 것으로 추측되나, 현재로서는 민간보험 가입에 따른 도덕적 해이가 강하게 나타나고 있다는 근거는 발견되지 않았다.

• 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.

• The Journal of Asian Finance, Economics and Business
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• 제9권2호
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• pp.71-79
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• 2022

The aim of this study is to see how government spending on education, health, and social security affects ratios in Indonesia. The third sector has a critical role to play in reducing the dependency ratio. It also aims to lower unemployment and poverty rates. This study uses the GMM panel data model. This model can determine the dynamic response of the ratio that comes from a number of variables. This study uses data from 33 provinces from 2010 to 2018. The results show that government spending in the education and health sectors has a positive effect on the dependency ratio, both in the short and long term. Social security has a significant effect on the dependency ratio in the long term, but not in the short term. Government spending in the education sector and health sector and social security sector have a positive and significant effect on disease and illness. The study's findings show a high level of poverty with a large standard deviation. The high ratio value is due to the large number of restrictions placed on a number of regions. Each province has made a significant contribution to overcoming these challenges, particularly in terms of the comparative ratio.

• 보건교육건강증진학회지
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• 제31권3호
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• pp.83-95
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• 2014

Objectives: This study was to examine the experts perception on the operation of the national health promotion fund and related policies, and to obtain the perspective on the improving governance of the fund. Methods: Experts opinion survey was recruited 120 experts who were public health officials, and members of board in academic societies related to health promotion and health policy, and 60 experts participated in the survey. Results: Most health care experts agreed that the current allocation of health promotion fund was not optimal with its lack of allocation on promoting healthy lifestyle and R&D for health promotion, while the majority of the fund was being spent on supporting national health insurance. Thus, establishing governance system and control tower for the fund was viewed as critical. Also the status of deliberation committee should be raised to higher position where it can hold practical authority to plan and evaluate fund spending. Conclusions: The priority of health promotion fund spending should be more on improving health such as modifying life-style and spreading healthy habits, rather than on disease management or subsidizing health insurance. It is recommended that change from to environment in health promotion policy regime is required to establish effective governance system for the fund operation.

• 보건의료산업학회지
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• 제12권2호
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• pp.89-99
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• 2018

Objectives : To compare the degree of achievement of Universal Health Coverage (UHC) among 39 developing countries in Africa and to investigate the correlation between health care financing and the UHC index. Methods : For data, 14 UHC indexes were used in 2015 supplied by the World Health Organization (WHO). In addition, this study used a 10% of threshold point corresponding to the catastrophic health expenditures and a 25% of threshold points as a health care financing index. Results : It was found that there were significant difference among Least Low Developed Countries (LLDCs), Other Low Income Countries (Other LICs), Lower Middle Income Countiies (LMICs), Upper Middle Income Countires (UMICs) to compare the average value by nation on the UHC index. This study showed that the UHC index of LLDCs was lowest, but the average value was higher as it moved towards LMICs and UMICs. In addition, it was found that there was an average value difference among the groups like LLDCs, Other LICs, LMICs and UMICs. As a result of comparison, it was found that the spending of household health expenditure increased as LLDCs moved towards UMICs when the burden of household health expenditure was 25%. Conclusions : This study aimed to compare the UHC indexes of African nations and to investigate the correlation between the degree of spending of total expenditure on health and burden of household health expenditure and UHC, and its effect.

• 지역사회간호학회지
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• 제9권2호
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• pp.410-424
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• 1998

The purpose of this study was to determine the relationship between social support and health behavior in girl high school students in all girl schools. The subjects were 190 girls in 2 Kunsan schools. The instruments used for this study were the social support scale developed by Park(1985) and the health behavior scale developed by Walker etc(1987). As modified by Lee & Han(1996). The data were analysed by correlation coefficient, regression coefficient using an SAS program. The results of this study were as follows: 1. The mean score of social support was 3.96 and the mean score of health behavior was 3.33. 2. 1) General characteristics were related to the degree of social support: personality, spending money, friend number, exercise(p<0.05). 2) General characteristics were related to the degree of health behavior: personality, spending money, friend number, exercise, stress(p<0.05). 3. The hypothesis of this study, 'The higher the degree of social support perceived by the student, the higher the degree of health behavior' was supported(r=0.5730, p=0.0001). For these subjects, there was a significant relationship between social support and the degree of health behavior. Nurses should plan interventions in promotion health behavior with social support as a significant factor in adolescents. If so, their coping ability and well- being may be promoted.

• 한국사회복지학
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• 제56권3호
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• pp.113-133
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• 2004

본인부담과 관련한 이전의 연구들을 살펴보았을 때 외래와 입원 또는 상병별로 환자개인의 본인부담이 진료비에서 차지하는 비율을 파악하여 우리나라 건강보험이 안고 있는 보장기능의 취약성을 거론하거나 이와는 반대로 의료수요의 가격탄력성을 측정, 소비자의 도덕적 해이의 가능성을 지적하는데 초점을 맞추고 있음을 알 수 있다. 그러나 현재 환자본인이 부담하여야 하는 진료비규모를 파악하여 평균 본인부담액의 실제규모와 본인부담률을 밝히는 동시에 만성질환 보유여부, 의료보장의 종류, 또는 의료서비스 기관에 따른 본인부담의 비형평성 문제에 대하여 직접적으로 논의하는 작업은 극히 미미한 실정이다. 높은 본인부담의 결과로 경제적으로 취약하거나 만성질환에 시달리는 계층이 가장 큰 피해를 입게 된다는 점에서 이에 대한 심도 있는 임상적 및 정책적 논의는 절실하다. 이러한 맥락에서 본 연구는 의료서비스에 대한 계층간 본인부담의 차이가 형평성에 미치는 영향을 분석하고 이에 관련된 정책적 함의를 도출하는데 그 목적이 있다. 본 연구의 결과에서 소득 5분위 대비 최하위 계층의 경우 월등히 높은 만성질환 유병률을 보이고 있음에도 불구하고 최상위층의 6배가 넘는 과중한 본인부담을 안고 있음이 밝혀졌다. 또한 최종적인 회귀분석모형 분석결과는 의료이용 빈도 이외에 환자본인의 인구학적 특성, 가구소득, 만성질환 수, 보험의 종류, 상용치료기관의 종류가 본인부담의 규모를 결정짓는데 있어 영향을 미치는 결정적 요인들로 드러났다.

• 보건의료산업학회지
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• 제10권3호
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• pp.199-211
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• 2016

Objectives : This study compared the influencing factors on life satisfaction after retirement between public pension and specific corporate pension recipients. Methods : This study used the fifth year data of 2013 from the raw data of the Korean Retirement and Income Study collected by the National Pension Research Institute. The data analysis in this study was done with the chi-square test, t-test, and linear regression using SPSS ver. 22.0 to verify the relevance between the general characteristics of pension recipients. Results : This study shows that there was a difference in expenditures and health care costs between public pension and special corporate pension recipients. The influencing factors on life satisfaction for public pension recipients were the level of spending, whether there were limitations in daily life and social activity, whether recipients had financial assets and health care costs while for specific corporate pension recipients, they were education level, level of spending and chronic diseases. Conclusions : A health policy that maximizes life satisfaction and takes into account the type of pencion needs to be considered and implemented.

• 한국사회복지학
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• 제63권1호
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• pp.137-158
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• 2011

본 연구는 사회정서적선택이론을 바탕으로 노년기 자원봉사시간과 심리사회적 안녕감의 비선형성을 탐색하고, 노인의 성별, 고령화정도 및 건강상태에 따라 어떠한 특징을 보이는지를 분석한다. 분석은 2009년도 전국노인자원봉사실태조사 자료 645사례에 대한 2차 분석이며, 단순선도표 및 다중선도표를 활용한 기술적 분석을 수행한다. 연구결과, 자원봉사에 참여하지 않은 상태(0시간)의 노인은 낮은 심리사회적 안녕감을 보이며, 보통수준에서 자원봉사에 참여한 노인은 높은 수준의 안녕감을, 이후 높은 강도의 참여시간부터는 다시 낮아지는 U자형의 비선형적 관계를 보인다. 남성노인, 75세이상 고령노인, 주관적 건강상태가 좋지 않은 노인이 보다 낮은 시간대에서 긍정적혜택을 경험한다. 본 연구를 통해 노년기 자원봉사 참여가 비참여에 비해 심리사회적 안녕감을 향상시키는데 기여하나, 활동은 년 100-200시간 미만의 보통수준으로, 700시간 이상을 넘지 않아야 함을 발견한다.