• 문화기술의 융합
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• 제3권2호
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• pp.21-30
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• 2017

본 연구는 뇌혈관질환자의 년간 총직접비용에 대하여 조사하였다. 본 연구를 위하여 2012년 한국의료패널 조사자 중 2012년 한 해 동안 뇌혈관질환으로 응급, 입원, 외래서비스를 1건 이상 이용하였다고 응답한 265명을 대상으로 하였다. 뇌혈관질환자 일반사항은 2012년에 한국의료패널 응답자 중 뇌혈관질환으로 응급, 입원, 외래서비스를 이용한 응답자의 비율이다. 연구방법은 응급, 입원, 외래서비스의 평균의료비와 가중평균을 적용하여 직접비용을 산출한 후 년간 총직접비용을 산출하였다. 연구결과는 뇌혈관질환자가 1인당 연 평균 본인부담 의료비 지출액은 약 561,934원이고, 남성은 669,557원, 여성은 448,696원이다. 건강보험 가입자의 경우 뇌혈관질환으로 인한 1인당 본인부담액은 평균 634,459원이고 의료급여 수급자는 160,236원이었다. 뇌혈관질환자가 265명의 연 평균 총직접비용은 약 162,165,690이고, 남성은 193,223,955원, 여성은 129,486,685이다. 건강보험가입자의 경우 뇌혈관질환으로 인한 1인당 총직접비용은 평균 183,095,125원이고 의료급여 수급자는 46,241,705원이었다. 가구소득별로 보면, 가구 소득 3분위에 속한 환자는 672,268원으로 가장 높게 나타났으며, 5분위에 속한 환자는 108,970,650원 으로 뇌혈관질환자의 총직접비용이 가장 낮았다.

• Parasites, Hosts and Diseases
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• 제53권5호
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• pp.553-559
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• 2015

Research on micro-level assessment of the changes of socio-economic status following health interventions is very scarce. The use of household asset data to determine wealth indices is a common procedure for estimating socio-economic position in resource poor settings. In such settings information about income is usually lacking, and the collection of individual consumption or expenditure data would require in-depth interviews, posing a considerable risk of bias. In this study, we determined the socio-economic status of 213 households in a community population in an island in the north-western Tanzania before and 3 year after implementation of a participatory hygiene and sanitation transformation (PHAST) intervention to control schistosomiasis and intestinal worm infections. We constructed a household 'wealth index' based housing construction features (e.g., type of roof, walls, and floor) and durable assets ownership (e.g., bicycle, radio, etc.). We employed principal components analysis and classified households into wealth quintiles. The study revealed that asset variables with positive factor scores were associated with higher socio-economic status, whereas asset variables with negative factor scores were associated with lower socio-economic status. Overall, households which were rated as the poorest and very poor were on the decrease, whereas those rated as poor, less poor, and the least poor were on the increase after PHAST intervention. This decrease/increase was significant. The median shifted from -0.4376677 to 0.5001073, and the mean from -0.2605787 (SD; 2.005688) to 0.2605787 (SD; 1.831199). The difference in socio-economic status of the people between the 2 phases was highly statistically significant (P<0.001). We argue that finding of this study should be treated with caution as there were other interventions to control schistosomiasis and intestinal worm infections which were running concurrently on Kome Island apart from PHAST intervention.

• Journal of Preventive Medicine and Public Health
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• 제22권4호
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• pp.542-554
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• 1989

The skyrocketing inflation of medical costs has become a major health problem among most developed countries. Korea, which recently covered the entire population with National Health Insurance, is facing the same problem. The proportion of health expenditure to GNP has increased from 3% to 4.8% during the last decade. This was remarkable, if we consider the rapid economic growth during that time. A few policy analysts began to raise cost containment as an agenda, after recognizing the importance of medical cost inflation. In order to Prepare an appropriate alternative for the agenda, it is necessary to find out reasons for the cost inflation. Then, we should focus on the reasons which are controllable, and those whose control are socially desirable. This study is designed to articulate the theory of medical cost inflation through literature reviews, to find out reasons for cost inflation, by analyzing aggregated data with a deterministic model. Finally to identify determinants of changes in both medical demand and service intensity which are major reasons for cost inflation. The reasons for cost inflation are classified into cost push inflation and demand pull inflation, The former consists of increases in price and intensity of services, while the latter is made of consumer derived demand and supplier induced demand. We used a time series (1983-1987), and cross sectional (over regions) data of health insurance. The deterministic model reveals, that an increase in service intensity is a major cause of inflation in the case of inpatient care, while, more utilization, is a primary attribute in the case of physician visits. Multiple regression analysis shows that an increase in hospital beds is a leading explanatory variable for the increase in hospital care. It also reveals, that an introduction of a deductible clause, an increase in hospital beds and degree of urbanization, are statistically significant variables explaining physician visits. The results are consistent with the existing theory, The magnitude of service intensity is influenced by the level of co-payment, the proportion of old age and an increase in co-payment. In short, an increase in co-payment reduced the utilization, but it induced more intensities or services. We can conclude that the strict fee regulation or increase in the level of co-payment can not be an effective measure for cost containment under the fee for service system. Because the provider can react against the regulation by inducing more services.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.421-425
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• 2012

Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.

• 대한가정학회지
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• 제28권1호
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• pp.89-104
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• 1990

This study was a succession of the paper of Reference 1), and was an attempt to quantify the Level of Need of Living through the relation bet ween Ds(Degree of Sufficietncy) and Di(Degree of Importance). The relation formula was: Level of Need of Living=Di×(5-Ds)＋Di×lrl. From the caculated values, some indicators of highest and lowest Level of Need of Living could be cleared and by them the Level of Consumers' Life and Conciousness could be presumed. The main results are as follows. 1. The Level of Need of Living that the indicators of the equity of income allocations, social mobility, judicial equality, and residential amenity showed was the highest, and that of the life of planned expenditure, the development of transportation, the longevity, an the high level of education was the lowest. 2. The rural residents showed the highest Level of Need on the indicators of medical care, culture and basic living expenditures. 3. The higher the perception of social class and the satisfaction of living was, the lower the Level of Need Living was. 4. In general, it was presumed that the Level of Consumer's Life was in the term of sufficiency of the second need, which durable electric consume products were purchased under the intended conciousness of consumers to be as like as others.

• 대한물리치료과학회지
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• 제25권1호
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• pp.75-84
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• 2018

Background : In order to recognize the problems of current Korean physical therapy which does not conform to the current trend of modern society and to suggest improvement directions, we will establish a law for exclusive use of physical therapy that can guarantee the health rights of the people and contribute to the development of Korean physical. Methods : Korea's current physiotherapy system is compared with OECD member countries and WCPT member countries, and considering the expected effects and necessities that arise when the sole law is enacted, the sole law for the global trend is presented. Result : If the sole law is enacted and the physical therapist is treated solely, the effect is as follows. 1. Provision of high-quality physiotherapy services through establishment of physical therapy expertise 2. Convenient service provision 3. Reduced treatment costs due to reduced National Health Insurance fiscal expenditure 4. contributing to the improvement of medical welfare for the elderly and the disabled 5. Decreased unemployment rate due to job creation.

• KDI Journal of Economic Policy
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• 제32권1호
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• pp.51-68
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• 2010

본 연구는 가계 내 경제적 자원이 자녀의 건강에 미치는 영향을 분석한다. 경제적 자원과 건강 간의 관계는 두 변수 상호 간의 영향으로 인해 분석이 용이하지 않다. 그러나 성인의 건강이 노동공급 등을 통해 경제적 자원에 영향을 미치는 것과는 달리, 자녀의 건강은 경제적 자원에 미치는 영향이 적으므로 가계의 경제적 자원이 자녀의 건강에 미치는 영향은 분석이 상대적으로 용이하다. 인도네시아 자료(Indonesian Family Life Survey)를 이용하여 분석한 결과, 가계의 경제적 자원이 자녀의 건강에 통계적으로 유의한 수준에서 긍정적인 영향을 끼치는 것으로 나타났다. 또한 경제적 자원이 자녀의 건강에 영향을 끼치는 경로는 영양상태, 의료서비스의 이용, 가계의 위생상태 등인 것으로 나타났다. 따라서 저소득 가구 자녀의 건강증진을 위해서는 의료서비스의 이용 증대뿐만 아니라 가구의 위생상태 등을 개선하는 정책 또한 중요한 것으로 판단된다.

• 한국지역사회생활과학회지
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• 제21권1호
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• pp.53-69
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• 2010

The purpose of this study was to find how financial structures differ from the family life cycle. The data was drawn from the 2002 Korean Labor and Income Panel Study conducted by the Korea Labor Institute, and 1,957 households. The level of total income and subcategories of income were found to be significantly different from the family life cycle and showed tendencies to increase up to the period of child birth and then sharply dropped down during the retirement period. Household consumption expenditures in total and subcategories showed a U shape by family life cycle and were also found to be significantly different from the family life cycle. The consumption expenditure of dining out showed the highest level at the beginning of family establishment, whereas medical cost showed the highest level for later years. The level of total assets increased gradually from the family life cycle and a little decreased for the later years, and the level of real estate assets showed the highest ratio(90% over) out of total asset components of family life cycle.

• 대한예방한의학회지
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• 제21권1호
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• pp.57-66
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• 2017

Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.

• 대한가정학회지
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• 제47권1호
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• pp.25-43
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• 2009

The purpose of this study was to find how economic structures differ among four different household groups('enough', 'so so', 'a little difficult', 'very difficult') classified by subjective evaluation on their economic conditions. The data were drawn from 2004 Korean Labor and Income Panel Study conducted by Korea Labor Institute, and $X^2$-test and F-test were utilized by SPSS for Windows 10.0. The major findings were as following. First, the economic levels of household groups of 'enough' and 'so so' showed to be higher than the average. This result implies that households tend to evaluate by themselves their economic conditions comparing to the others. Second, the deviations of average economic levels among four different household groups were relatively bigger in household economic elements of liquid asset, monthly savings and insurance than the others, and relatively smaller in household economic elements of total expenditure, especially expenditures in food at home, education, medical, communication than the others. Third, the households of 'a little difficult' and 'very difficult' showed undesirable economic structures resulting from lack of savings and insurance for their future.