• Journal of Korean society of Dental Hygiene
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• v.20 no.2
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• pp.129-137
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• 2020

Objectives: Using the annual data from the 2016 Korean Health Panel, this study aims to identify the factors that affect the dental utilization and expenditure of patients with chronic diseases, and to provide basic data to explain the inequality gap in dental utilization. Methods: The dental utilization and expenditure of 3,557 patients with chronic diseases were analyzedfor frequency using the SPSS Windows version 23.0 (SPSS Inc. IL, USA). Analysis of the factors that affect dental utilization and expenditure were performed using a multiple regression analysis. The level of statistical significance was 0.05. Results: The frequency of dental utilization in patients with chronic diseases was high for subjects who were younger than 65 years and those whose education level was below high school. The frequency of dental utilization was relatively lower for subjects who did not have disabilities and those with healthier subjective health status. The dental expenditure of patients with chronic diseases was higher in subjects who were younger than 65 years and those with greater household income. Conclusions: The above findings suggest that a plan is needed to control dental utilization by efficiently managing chronic diseases, and that a policy-based plan is needed to devise ways to supplement the uninsured medical expenses of dental care.

• Health Policy and Management
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• v.27 no.3
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• pp.199-210
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• 2017

Background: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public-private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. Methods: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. Results: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. 'Transfers from government domestic revenue' share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to 'compulsory contributory health financing schemes,' 'Transfers from government domestic revenue' share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. Conclusion: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.

• Communications for Statistical Applications and Methods
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• v.28 no.5
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• pp.447-462
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• 2021

In insurance, the surrender rate is an important variable that threatens the sustainability of insurers and determines the profitability of the contract. Unlike other actuarial assumptions that determine the cash flow of an insurance contract, however, it is characterized by endogenous variables such as people's economic, social, and subjective decisions. Therefore, a microscopic approach is required to identify and analyze the factors that determine the lapse rate. Specifically, micro-level characteristics including the individual, demographic, microeconomic, and household characteristics of policyholders are necessary for the analysis. In this study, we select panel survey data of Korean Retirement Income Study (KReIS) with many diverse dimensions to determine which variables have a decisive effect on the lapse and apply the lasso regularized regression model to analyze it empirically. As the data contain many missing values, they are imputed using the random forest method. Among the household variables, we find that the non-existence of old dependents, the existence of young dependents, and employed family members increase the surrender rate. Among the individual variables, divorce, non-urban residential areas, apartment type of housing, non-ownership of homes, and bad relationship with siblings increase the lapse rate. Finally, among the financial variables, low income, low expenditure, the existence of children that incur child care expenditure, not expecting to bequest from spouse, not holding public health insurance, and expecting to benefit from a retirement pension increase the lapse rate. Some of these findings are consistent with those in the literature.

• Health Policy and Management
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• v.26 no.2
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• pp.95-106
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• 2016

A new manual of System of Health Accounts (SHA) 2011, was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. This offers more complete coverage than the previous version, SHA 1.0, within the functional classification in areas such as prevention and a precise approach for tracking financing in the health care sector using the new classification of financing schemes. This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 1970-2014 constructed according to the SHA2011. Data sources for public financing include budget and settlement documents of the government, various statistics from the National Health Insurance, and others. In the case of private financing, an estimation of total revenue by provider groups is made from the Economic Census data and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. CHE was 105 trillion won in 2014, which accounts for 7.1% of Korea's gross domestic product. It was a big increase of 7.7 trillion won, 7.9%, from the previous year. Public share (government and compulsory schemes) accounting for 56.5% of the CHE in 2014 was still much lower than the OECD average of about 73%. With these estimates, it is possible to compare health expenditures of Korea and other countries better. Awareness and appreciation of the need and gains from applying SHA2011 for the health expenditure classification are expected to increase as OECD health expenditure figures get more frequently quoted among health policy makers.

• Health Policy and Management
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• v.29 no.3
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• pp.374-378
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• 2019

After the announcement of Moon Jae-in Government's plan (Moon's Care) for Benefit Expansion in National Health Insurance in August 2017, it is necessary to monitor the effects of the policy, especially household out-of-pocket payments (OOP). This paper aims to observe the current status and trend of OOP in Korea. Current health expenditure (CHE) was 144.4 trillion won in 2018, which accounts for 8.1% of gross domestic product (GDP) increased 9.7% from the previous year. Although GDP's share of CHE has been close to the average of the Organization for Economic Cooperation and Development (OECD) countries, the public fund's share was 59.8% of the total in 2018, which was lower than the OECD average of 73.5%. OOP's share was 32.9% in 2018, which decreased from 37.4% in 2008. The share of OOP of non-covered services was 20.0% in 2018, which decreased from 22.9% in 2008. The share of cost-sharing with third-party payers was 12.9% in 2018, which decreased from 14.5% in 2008. The OOP of non-covered services was significantly decreased in hospital and inpatient curative care, but the OOP of non-covered services was significantly increased in the medical clinic. The effect of Moon's Care was not showed in OOP through the results of 2017 and 2018, but further monitoring is needed because the Moon's Care is progressing and the observational period is short.

• Journal of the Korea Society of Computer and Information
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• v.16 no.7
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• pp.183-190
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• 2011

Loan amount of housing mortgage is composed of various factors. This study paper studies focuses on estimating the determinants of a loan amount of housing mortgage. The region for analysis consist of seven groups, that is, metropolitan city (such as Busan, Daegu, Incheon, Gwangiu, Daejeon, Ulsan.) and Seoul. Analyzing period be formed over a 45 time points(2007. 01.~ 2010. 09). In this paper the dependent variable setting up loan amount of housing mortgage, explanatory(independent) variables are composed of the consumer price index, unemployment rate, average monthly household income per household, expenditure rate of health care, composite stock price index and overdue rate of household loans for commercial bank. In looking at the factors which determine loan amount of housing mortgage, evidence was produced supporting the hypothesis that there is a significant positive relationship between the consumer price index and unemployment rate. The study also produced evidence supporting the view that there is a significant negative relationship between expenditure rate of health care. The study found that average monthly household income per household, expenditure, composite stock price index and overdue rate of household loans for commercial bank were not significant variables. The implications of these findings are discussed for further research.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.44-55
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• 2019

Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.

• KDI Journal of Economic Policy
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• v.32 no.1
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• pp.51-68
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• 2010

We use data from the Indonesian Family Life Survey (IFLS) to examine the relationship between child health and household economic resources, and find that economic resources as measured by equivalized expenditure have a statistically significant positive effect on child health and protect children from acute health conditions. We make additional use of the data (where extensive data on children's nutrition, household sanitation, the utilization of medical care, and family health status are available) to assess the mechanisms through which economic resources may affect child health. We find evidence that economic resources have a sizable and significant effect on these potential intermediary factors, and that they, particularly household sanitation, partly explain the protective role of economic resources in child health.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Korean Journal of Social Welfare
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• v.48
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.