• Health Policy and Management
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• v.26 no.4
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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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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Health Policy and Management
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• v.20 no.1
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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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• v.9 no.2
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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.

• Korean Journal of Health Education and Promotion
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• v.31 no.3
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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.

• The Korean Journal of Health Service Management
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• v.12 no.2
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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.

• Research in Community and Public Health Nursing
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• v.9 no.2
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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.

• Korean Journal of Social Welfare
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• v.56 no.3
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• pp.113-133
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• 2004

Although National Health Insurance(NHI) in the South Korea has guaranteed access to health insurance coverage to virtually all the people, a significant portion of out-of-pocket spending can create substantial financial burdens for some beneficiaries, particularly those with low incomes. Previous studies have estimated the magnitude of out-of-pocket spending by types of chronic illness or in- and out-patients. Prior estimates, however, have not given a complete picture of the impact of health care costs on lower-income populations. The result from this study shows that 20 percent of beneficiaries in the lowest-income quintile spent more than twelve percent of their household equivalent income out-of-pocket health services, whether they were enrolled in a Health care services or not. In comparison, the beneficiaries in the highest-income quintile level spent only 2 percent of their income out-of-pocket on health care. Also, the regression analysis suggests that age, household income, number of chronic illness, type of hospital in addition to the number of usage may affect the size of out-of-pocket spending.

• The Korean Journal of Health Service Management
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• v.10 no.3
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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.

• Korean Journal of Social Welfare
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• v.63 no.1
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• pp.137-158
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• 2011

This study explore nonlinear relationship between volunteer time spending and psychosocial well-being among the old adults, on the ground of Socioemotional Selectivity Theory. This is secondary analysis using the 2009 National Old Aging Volunteer Survey data including 645 cases. The simple and multiple line graph method are implemented. As a result, this paper shows a nolinerar relationship which the low level of psychosocial well-being at non volunteer status is increasing to the paticular time spending, and then decreases after high level participation like U-shape. Male, over the 75 and not good health status has showed lower level of volunteer time spending. It can be founded that volunteering activity contributes to improve a psychosocial well-being in old life, but the desirable volunteer time spending is medial about 100-200 yearly not over the 700.