• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.239-250
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• 2012

In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for out-of-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level, benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.

• The Journal of the Korea Contents Association
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• v.18 no.4
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• pp.664-676
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• 2018

This study used raw data from the Korea Medical Panel Survey for 2014 to analyze the factors affecting the cost of medicine expenditure. A total of 3,107 people with medical expenses were selected for the final analysis. Analysis methods were frequency analysis, crossover analysis, regression analysis and t-test. The significance level of all tests was p = .05. The prescription cost was 72.4%, the minimum cost was 84 won, the maximum cost was 270,653 won, and the highest amount was 'over 3,000 won~less than 10,000 won' (31.7%). The general pharmaceuticals cost was 81.8%, the minimum cost was 800 won, the maximum cost was 2,718,000 won, and the highest amount was 'less than 20,000 won' (31.4%). The herbal medicine cost was 9.4%, the minimum cost was 4,000 won, the maximum cost was 2,700,000 won, and the highest amount was 'over 100,000 won' (37.8%). The medicines expenditure was the maximum cost was 2,760,093 won, and the highest amount was 'over 100,000 won' (27.0%). Factors affecting medicine expenditure were gender, marital status, income quintile, easement, and subjective health status.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

• Journal of Korean Physical Therapy Science
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• v.8 no.1
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• pp.735-744
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• 2001

After providing the purpose, scope and methods of present study in the first chapter. the second chapter discusses a theoretical overview on the social implication of medical expenditure and the medical insurance program for the aged population. In conclusion, to realize the reduction of aged population's medical expenditures, some possible plans are conceivable. Firstly, the payment level of medical insurance should be upgraded and the insurance coverage in oriental medicine treatment and the drug-store protection program need to be implemented. Secondly, the medical facilities and man-power have be expanded for the sake of reducing the social and geographical distances the aged population has to overcome to receive the medical benefits. Thirdly, the expansions of medical services for the home-stay aged are all the more required. Finally, a wide range of programs needs to be augmented to promote health for the aged population.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.347-363
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• 1995

The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. Consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series analysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis. so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.

• Journal of Biomedical Engineering Research
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• v.27 no.6
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• pp.301-309
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• 2006

The main purpose of this study is to derive a regression equation that predicts the individual differences in activity energy expenditure (AEE) using accelerometer during different types of activity. Two subject groups were recruited separately in time: One is a homogeneous group of 94 healthy young adults with age ranged from $20\sim35$ yrs. The other subject group has a broad spectrum of physical characteristics in terms of age and fat ratio. 226 adolescents and adults of age ranged from $12\sim57$ yrs and fat ratio from $4.1\sim39.7%$ were in the second group. The wireless 3-axis accelerometers were developed and carefully fixed at the waist belt level. Simultaneously the total calorie expenditure was measured by gas analyzer. Each subject performed walking and running at speeds of 1.5, 3.0, 4.5, 6.0, 6.5, 7.5, and 8.5 km/hr. A generalized sensor-independent regression equation for AEE was derived. The regression equation was developed fur walking and running. The regression coefficients were predicted as functions of physical factors-age, gender, height, and weight with multivariable regression analysis. The generalized calorie estimation equation predicts AEE with correlation coefficient of 0.96 and the average accuracy of the accumulated calorie was $89.6{\pm}7.9%$.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2003.11a
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• pp.15-23
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• 2003

Interest in the regulation of body weight and the pathological physiology of obesity has been rekindled by the cloning of the obese(ob) gene and identification of its product, leptin, in 1994. The first publication appeared in Nature and is a milestone of obesity research. The remarkable metabolic effects of leptin in rodents are: a) inhibition of food intake, b) stimulation of energy expenditure, and c) reversal of obesity. These effects, though mostly desirable, have not been fully demonstrated in humans. The central action of leptin in the regulation of body weight includes two pathways in rodents: a) When the body weight increasing, more leptin is secreted from adipose tissue, which acts on hypothalamus, probably through a POMC or MSH pathway via M4 receptor, initiates a series of response to obesity, i.e. sympathetic tone increased, energy expenditure enhanced and food intake reduced. b) When body weight reduced, leptin concentration decreased with the shrinkage of fat mass, which may also act on the hypothalamus, probably through a NPY-Y5 receptor pathway. Then a cascade of response to hungry was induced, i.e. increase of parasympathetic tone and food intake, decrease of energy expenditure and body temperature, as well as shut-down of the reproductive function.

• Health Policy and Management
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• v.10 no.3
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• pp.50-67
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• 2000

This study aims to estimate the consumption of antibiotics in Korea and to suggest the further studies. To measure the amount of antibiotics consumption, we referred to the statistic of NFHI(National Federation of Health Insurance) and a private institute of pharmaceutical information(Korea Intercontinental Medical Statistics; IMS Korea). There were 1,563 antibiotics produced in Korea in 1997. The total amount of antibiotics production was 1,197 billion won in 1997. Antibiotics accounted for 17.6% of the total pharmaceutical productions in 1997. Cephalosporins have taken the largest part of antibiotics production since 1992. The estimation using NFHI data showed that the total expenditure of antibiotics used in health facilities was 268 billion won, 608 billion won, 911 billion won in 1990, 1994, 1997 respectively. Tertiary hospitals spent 246 billion won, general hospitals 287 billion won, hospitals 78 billion won, clinics 300 billion won in 1997. The amount of expenditure and the intensity of antibiotics consumption in hospitals have increased more steeply than any other health facilities. The total expenditure of antibiotics consumption in health facilities and pharmacies was 778 billion won when estimated using the data from IMS Korea, and 999 billion won from NFHI. Cephalosporins was the fast growing antibiotics group in all of the market- hospitals, clinics, pharmacies since 1991. To measure the amount and patterns of antibiotics consumption more precisely, a pharmaceutical monitoring or surveillance system is needed.

• Journal of the Korean Home Economics Association
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• v.40 no.4
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• pp.139-152
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• 2002

This study was performed to estimate living cost for the elderly couple living in a city in Korea. Living cost means expenditure per month for elderly couple. It was assumed that the elderly couple will need different living cost according to their circumstances. The circumstances are health status, retirement status, and the level of living they want. The subjects were the elderly couple households over the age 65 of household head. Total number of subject was 1,649 households. Used data was Annual Report surveyed by National Statistical Office on the Family Income and Expenditure. Analysis of data was done through frequency, percentage, means, median using SAS Program. The results of this study were as follows: Their standard living cost was 844,980 won by pure relative standard line and 842,300 won by quasi relative standard lines. And minimum living cost was 713,400 won by the former, by the latter was 557,600 won (3/2 of median). And abundant Living cost was 1,068,020 won by the former, by the latter 1,263,450 won. The living cost of elderly households was about 81-83%, comparing with non-elderly households. Among the item of expenditure, the proportion of housing and medical care cost was larger than any other items.