• Journal of Preventive Medicine and Public Health
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• v.56 no.4
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• pp.291-302
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• 2023

Objectives: Disability weights require regular updates, as they are influenced by both diseases and societal perceptions. Consequently, it is necessary to develop an up-to-date list of the causes of diseases and establish a survey panel for estimating disability weights. Accordingly, this study was conducted to calculate, assess, modify, and validate disability weights suitable for Korea, accounting for its cultural and social characteristics. Methods: The 380 causes of disease used in the survey were derived from the 2019 Global Burden of Disease Collaborative Network and from 2019 and 2020 Korean studies on disability weights for causes of disease. Disability weights were reanalyzed by integrating the findings of an earlier survey on disability weights in Korea with those of the additional survey conducted in this study. The responses were transformed into paired comparisons and analyzed using probit regression analysis. Coefficients for the causes of disease were converted into predicted probabilities, and disability weights in 2 models (model 1 and 2) were rescaled using a normal distribution and the natural logarithm, respectively. Results: The mean values for the 380 causes of disease in models 1 and 2 were 0.488 and 0.369, respectively. Both models exhibited the same order of disability weights. The disability weights for the 300 causes of disease present in both the current and 2019 studies demonstrated a Pearson correlation coefficient of 0.994 (p=0.001 for both models). This study presents a detailed add-on approach for calculating disability weights. Conclusions: This method can be employed in other countries to obtain timely disability weight estimations.

• Journal of the Korea Convergence Society
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• v.8 no.1
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• pp.221-229
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• 2017

The purpose of this study is to identify the convergence factors affecting the unmet health needs of the indigent elderly. The data the study is the Korean medical panel of 2011 and the parameters belonging to each factors were selected based on the Anderson model. We analyzed the general characteristics using frequency analysis and the correlations between variables using cross analysis. Finally, logistic regression analysis was conducted to examine the factors affecting unmet health needs. The indigent elderly with no education and elementary school graduates were 1.5 times more likely to experience unmet health needs than the poverty elderly with high school graduates. The indigent elderly who does not work for income, who were employers and self-employeds were 1.5 times more likely to experience unmet health care need than unpaid family workers. The indigent elderly with disabilities in activites of daily living were 2.9 time more likely to experience unmet health care needs than the indigent elderly with no disability in activites of daily living. The results of this study confirm that the increase in the economic burden of medical care for the indigent elderly can lead to the unmet health needs.

• Health Policy and Management
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• v.28 no.4
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• pp.369-377
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• 2018

Background: Catastrophic health expenditure (CHE) occurs when medical expenditure of a household passes over a certain ratio of household income. This research studied the effect of gender on CHE based on Korea Health Panel data. Methods: This study implemented binary logistic regression model to figure out whether gender affects CHE and how different gender groups show pattern of CHE process. With gender, age, marital status, income level, economic activity, membership of private insurance, existence of chronic disease, and self-rated health were included in the model. Results: Results showed that females faced CHE 1.5 times more than males (odds ratio, 1.241). Also, main determinants of CHE in female groups were marital status, while age and economic activity status were significant in male groups. Subgroup analysis displayed that married female under 35 years old are located in intersectionality of CHE including pregnancy and delivery, multiple health risk behaviors, mental stress, and relatively vulnerable social status due to lower income. Meanwhile, both gender above 50 years old faced remarkably high chance of CHE, which seems to be caused by complex health risk behaviors and chronic diseases. Conclusion: Such results implied not only that gender is an important determinant of CHE, but also other determinants of CHE differ according to gender, which suggests a necessity of gender-based CHE support and rescue policy.

• Health Policy and Management
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• v.24 no.3
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• pp.219-227
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• 2014

Background: Current trends in Korea population aging with advances in public health and clinical medicine foretell rises in the prevalence of not only chronic diseases but also patients with multimorbidity. One important aspect in analyzing multimorbidity is to define the list of chronic diseases included when calculating multimorbidity index. The objective of this study is to describing the effect of multimorbidity on healthcare cost in Korea using US Office of the Assistant Secretary of Health (OASH) list. Methods: We analyzed the Korea Health Panel Data representing non-institutionalized Korean adult populations aged 20 and more. We calculated multimorbidity index based on OASH list and estimated the prevalence and healthcare cost for each OASH chronic disease. Results: In 2011, 15.2 million (39.6%) Koreans aged 20 and more were living with chronic condition. The health care cost due to chronic diseases, accounted for 80.2% of the overall healthcare costs and the prevalence of chronic conditions, the prevalence of multimorbidity and healthcare cost increased with ages. In the analysis using OASH list, 40% of the adult population over the age of 20 and 66.7% of the population over the age of 65 was affected with multimorbidity. In most of diseases in OASH list, prevalence of mulitmorbidity was high and healthcare cost increased with multimorbidity. Conclusion: OASH chronic disease list that accounts for 72.4% of prevalence and 86.7% of healthcare cost of persons with chronic conditions in Korea. OASH chronic disease list would be a useful and representative indicator for studying multimorbidity.

• Child Health Nursing Research
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• v.24 no.3
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• pp.329-336
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• 2018

Purpose: This study analyzes the effects of smoking behaviors of women of reproductive ages in terms of maternal conditions and conditions arising during the perinatal period in Korea. Methods: We used the National Health Insurance Corporation's medical panel data. Subjects included 382 individuals suffering from maternal conditions and conditions arising during the perinatal period from 2013 to 2014. A t-test was used to analyze the individual differences between maternal conditions and conditions arising during the perinatal period-A hierarchical regression analysis was performed in two steps to measure the effects of smoking behaviors on diseases. Results: The amount and duration of smoking are significant factors causing maternal conditions and conditions arising during the perinatal period. In the regression analysis, the explanatory power of model was significantly increased by adding smoking behavior to the maternal conditions and conditions arising during the perinatal period. Smoking behavior during pregnancy displayed a significant influence on diseases. Conclusion: Results of this study showed that the effects of smoking behavior on maternal conditions and conditions arising during the perinatal period were significant. Therefore it is necessary to develop a smoking cessation education program for pregnant women in Korea.

• Korean Journal of Health Education and Promotion
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• v.30 no.1
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• pp.13-25
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• 2013

Objectives: This study was performed to investigate the influence of family factors on drinking and smoking of middle-aged men. Methods: This study used data from the fourth-wave of the Korean Welfare Panel Study, which was collected by the Korean Institute for Health and Social Affairs and the Social Welfare Research Center of Seoul National University. This study was conducted on 3,084 men who were between 30 and 59. Results: The family factors, except for living with children, affected drinking, heavy drinking, smoking, and current smoking, after controlling for age, education, employment status, and family income. Marital status had statistically significant influences on heavy drinking, smoking, and current smoking. Living without family had influences on drinking, and heavy drinking. family satisfaction affected heavy drinking, smoking, and current smoking. The effects of family conflicts were also statistically significant. Conclusions: Based on the results, this paper can suggest that the projects of moderation in drinking and smoking are required to consider family factors more and the plan of building up family resources should be considered in the whole aspects of the society.

• Journal of Preventive Medicine and Public Health
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• v.50 no.6
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• pp.393-400
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• 2017

Objectives: To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods: This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results: The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions: The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

• Health Policy and Management
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• v.26 no.3
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• pp.185-194
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• 2016

Background: The purpose of this study is to forecast changes in the prevalence of chronic diseases and health expenditure by age group. Methods: Based on the Future Elderly Model, this study projects the size of Korean population, the prevalence of chronic diseases, and health expenditure over the 2014-2040 period using two waves (2012, 2013) of the Korea Health Panel and National Health Insurance Service database. Results: First, the prevalence of chronic diseases increases by 2040. The population with hypertension increases 2.04 times; the diabetes increases 2.43 times; and the cancer increases 3.38 times. Second, health expenditure on chronic diseases increases as well. Health expenditure on hypertension increases 4.33 times (1,098,753 million won in 2014 to 4,760,811 million won in 2040); diabetes increases 5.34 times (792,444 million won in 2014 to 4,232,714 million won in 2040); and cancer increases 6.09 times (4,396,223 million won in 2014 to 26,776,724 million won in 2040). Third, men and women who belong to the early middle-aged group (44-55 years old) as of 2014, have the highest increase rate in health spending. Conclusion: Most Korean literature on health expenditure estimation employs a macro-simulation approach and does not fully take into account personal characteristics and behaviors. Thus, this study aims to benefit medical administrators and policy makers to frame effective and targeted health policies by analyzing personal-level data with a microsimulation model and providing health expenditure projections by age group.

• Health Policy and Management
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• v.24 no.3
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• pp.228-241
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• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.4
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• pp.239-244
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• 2014

This research was carried out for the purpose of providing basic data to establish a policy for improving health and medical service inequality in the disabled's households, by analyzing it according to composed groups through the application of data about the panel survey of the employment for the disabled, from 2010 to 2012. The results of analysis showed that as for Gini's coefficient, disabled women, the disabled without participation in economic activities, the disabled in their 40s, physically handicapped people and severely disabled people had more and more inequality in expenditure of health care expenses, and inequality in North Gyeongsang Province continued to be on the rise. As for the entropy coefficient, disabled women, the disabled without participation in economic activities, the mentally disabled and severely disabled people had more and more inequality in consumption of health care, and the inequality got severe in Ulsan and North Gyeongsang Province. And as for the decomposition of factors by composed group, inequality in health care expenses were higher inside a group than between groups. Based on these results, research limitations and implications were suggested.