• Health Policy and Management
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• v.13 no.2
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• pp.125-143
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• 2003

This study was conducted to estimate the future government budget in medical expenditures using for the low-income handicapped, because medical expenditures to the low-income handicapped is escalating in these days. It became a big problem not only to the central-government but also to the district-government because they have to subsidize a part of co-payment. This study was designed to project the future government budget using structural model. For the short-term projection, the structural model is stronger than the regression model. The data used for this study were the population projection data based on National Census Data(2000) of the National Statistical Office, the data of Ministry of Health & Welfare, and the data of National Health Insurance Corporation from November 2m to June 2001. The results of the study are summarized as follows: The future government budget in medical expenditures using to the low-income handicapped will be 15-18 billion Won in the year 2003, 16-23 billion Won in 2004, 18-30 billion Won in 2005, 19-38 billion Won in 2006 and 21-49 billion Won in 2007. It is predicted that they would be increasing rapidly. Therefore, the government budget in medical expenditures using for the low-income handicapped must be enlarged.

• Journal of Nutrition and Health
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• v.30 no.3
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• pp.277-285
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• 1997

The purpose of this study was to investigate the relationship among nutrient intake, life style, and serum lipids level in 108 healthy middle-aged men in Taegu. A convenient method was to assess nutritional intake. Anthropometric measuement of body weight and hight were measured and average energy expenditure was calculated. The mean body mass index(BMI) was 22.8$\pm$2.4 and it was in the middle of the mean BMI of Korean men. Obesity rate of study subject were 13.2%. Daily energy intake was not sufficient as 88.4% of recommended dietary allowances and the energy percentage of carboydrate, fat protein was 65 : 21 : 14. Mean intake of vitamin A, B1, C and Ca were lower than RDA. There was a highly significant negative correlation between the systolic blood pressure and calcium intake(r=-0.28, p<0.05). Smokers showed significantly higher blood glucose than non-smokers. Skipping meals and uneven diurnal distribution(no breakfast and large evening meals) are associated with high triglyceride level in this population. There was a highly significant correlation between body weight and plasma lipids. Energy expenditure was negatively correlated with plasma triglyceride level. Especially, atherogenic index was significantly lower in job-time physically active worker than that in sedentary worker. Above data provides valuable imformation to the community for program planning as well as to health providers who work individual male adults to meet their nutrition needs and to control blood lipids.

• Health Policy and Management
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• v.23 no.1
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• pp.90-100
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• 2013

Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3173-3177
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• 2016

Background: The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total case-load. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Materials and Methods: Using utilization and spending data accumulated at MOPH during 2008-2013, the cost to the public budget of cancer drugs was assessed per case and per drug type. Results: The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and Non-Hodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Conclusions: Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.

• The Korean Journal of Community Living Science
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• v.21 no.3
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• pp.379-393
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• 2010

The purposes of this study were to estimate the effect of related factors such as cultural values and individual characteristics to consumer attitude, and furthermore to estimate the effect of consumer attitude and related factors such as price perception and individual characteristics to consumption behavior(expenditure) of food away from home. To do this, the data was collected from college students and a 2 step approach by using LIMDEP program was applied to estimate the structural equation model. The results of this study were as follows: 1) Consumer attitude toward food away from home was found to be significantly influenced by some cultural values such as health, sensibility, socially responsible consumption and religion, and individual characteristics such as sex and pocket money. If they perceived more positively about the value of health, sensibility and religion, they would be likely to have more positive attitude, while they perceived more negatively about the value of socially responsible consumption, they would be likely to have more negative attitude. In addition, if they were females and had much more pocket money, they would be more likely to have more positive attitude. 2) Expenditure of food away from home was found to be significantly influenced by age and pocket money, while consumer attitude did not have a significant impact on expenditure of food away from home at the second stage in the structural equation model. It might imply that consumption behavior of food away from home for college students would be more constrained by individual characteristics such as sex and economic capital.

• Journal of the Korea Convergence Society
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• v.10 no.9
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• pp.343-349
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• 2019

This study used data from the 3rd and 11th year of the Korean Welfare Panel to evaluate the effects of the Long-Term Care Insurance(LTCI) system on the consumption and expenditure of LTCI users' households. The study consisted of program group using LTCI and control group not using. Chi-square and t-test were used for the characteristic differences among the groups, and the difference of consumption expenditure was identified by multiple regression analysis. As a result, LTCI had a statistically significant effect on the health care costs of LTCI users' households, resulting in an increase in health care costs(${\beta}=3.06$). However, there was no statistically significant effect on the total cost of living, basic cost, education cost, and recreation/entertainment cost. Therefore, in order to show the effect of LTC system, we should try to reduce of self-pay and improve the contents and quality of the service of the LTC system.

• Safety and Health at Work
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• v.9 no.4
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• pp.462-467
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• 2018

Background: This study was conducted to investigate the effects of work on medical expenditures by the elderly. Methods: Data pertaining to individuals aged 65 or older collected by the Korean Health Panel 2008-2013 were used. The effects of work on medical expenditures were analyzed in a panel tobit model adjusted for several variables of demographic factors, socioeconomic factors, and health factors for health care. Data were also analyzed based on age groups (65-74, $75{\leq}$), type of work (waged or self-employed), and working time (daytime work or night time work). Results: Among the elderly older than 65 years, 34-37% were workers. Work among the elderly reduced medical expenditures relative to nonworking elderly. Specifically, medical expenditures were lower in individuals older than 75 years, as well as among those who were self-employed insured and had medical aid insurance and those who exercised. However, medical expenditures were higher among females, married individuals, those with a higher household income, and those with a chronic disease. Elderly wageworkers showed reduced medical expenditures than nonworking elderly and elderly daytime workers did. Conclusion: The elderly population's work, especially wage work and daytime work, reduced medical expenditures relative to no work. These results provide valuable information for policymakers by indicating that work was associated with lower medical expenditures than no work. If elderly work is to be encouraged, it is necessary to provide a variety of high-quality wage work.

• Korea Journal of Hospital Management
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• v.23 no.2
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• pp.18-27
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• 2018

Purposes: This study aims to investigate the policy effect of mandatory application of DRG for 7 disease groups in general and tertiary hospitals. Methodology: As DRG was fully implemented in July 2013, this study compares two periods before and after the change(from July 2012 to June 2013, and from July 2013 to June 2014). The benefit claim data of the National Health Insurance Service was used for the comparison. Target patients were those who visited general or tertiary hospitals between July 2012 to June 2014. For pharmaceutical consumption, Interrupted Time Series (ITS) analysis was used to see the effect of DRG mandatory application. Findings: The number of drugs prescribed per patient and pharmaceutical expenditure both showed significant reduction compared to before the DRG implementation. Practical Implications: This study used 2 sets of 1 year period data from before and after the full implementation of DRG to analyze pharmaceutical consumption. When the comparison data accumulates further, it would be possible to conduct more diverse analysis to assess policy effect and to provide way forward for the future.

• The Journal of Korean Medicine
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• v.32 no.1
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• pp.97-108
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• 2011

Objective: This study aimed to analyze the utilization of Oriental medical services and its determinants among the elderly. Method: Data from a Korean longitudinal study of aging was used. Regression analysis was used to find the determinants of the utilization of medical care. Results: People with low education and low income were more likely to use Oriental medical services. Determinants of using Oriental health service were sex, marriage, income, subjective health condition, activity restriction due to pain, and chronic disease. Among them, only subjective health condition and activity restriction due to pain were significant determinants of frequency of and expenditure on Oriental medical services. Especially, activity restriction due to pain was a significant factor in the use of Oriental medical services, but not in the use of Western medical services. Conclusion: Treatment related to pain was closely associated with Oriental medical services. These treatments need to be developed with scientific and clinical evidence.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.