• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.327-335
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• 2014

Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

• 대한안전경영과학회지
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• 제14권1호
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• pp.87-93
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• 2012

The purpose of this study suggests a personalized algorithm of physical activity energy expenditure prediction through comparison and analysis of individual physical activity. The research for a 3-axial accelerometer sensor has increased the role of physical activity in promoting health and preventing chronic disease has long been established. Estimating algorithm of physical activity energy expenditure was implemented by using a tri-axial accelerometer motion detector of the SVM(Signal Vector Magnitude) of 3-axis(x, y, z). A total of 10 participants(5 males and 5 females aged between 20 and 30 years). The activities protocol consisted of three types on treadmill; participants performed three treadmill activity at three speeds(3, 5, 8 km/h). These activities were repeated four weeks.

• 농촌의학ㆍ지역보건
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• 제35권1호
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• pp.77-88
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• 2010

이 연구는 고혈압, 당뇨병, 이상지질혈증으로 지출된 진료비 중 과체중 및 비만의 기여분을 추계하기 위한 질병비용연구로서 국민건강보험공단의 건강검진 및 건강보험급여 자료를 활용한 연구이다. 연구결과 2005년 현재 고혈압, 당뇨병, 이상지질혈증 때문에 지출된 총 진료비 중 과체중 및 비만의 기여분은 각각 4,561억원(4,328억원-4,805억원), 2,823억원(2,487억원-3,176억원), 165억원(147억원-183억원)이었고, 이를 모두 합하면 7,549억원(6,961억원-8,164억원)이었다. 이는 해당 연도의 고혈압 총 진료비의 34.6%(32.9%-36.5%), 당뇨병 총 진료비의 32.5%(28.6%-36.6%), 이상지질혈증 총 진료비의 19.4%(17.3%-21.6%)를 차지한다. 또한 이 세 가지 질병의 총 진료비를 기준으로 했을 때 과체중 및 비만이 기여한 금액은 33.3%(30.7%-36.0%)에 해당하였다. 이는 과체중과 비만을 예방한다면 고혈압, 당뇨병, 이상지질혈증으로 지출되는 총 진료비의 33.3%를 감소시킬 수 있다는 의미이며, 향후 만성질환 예방과 관련하여 과체중 및 비만의 예방관리사업이 얼마나 중요한가를 시사해 주는 것이다.

• 보건행정학회지
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• 제11권4호
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• pp.1-20
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• 2001

Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.

• 보건행정학회지
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• 제30권1호
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• pp.126-130
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• 2020

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2018 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. The households experienced the catastrophic health expenditure 2.08% in 2018 using the NaSTaB data. Trend analysis was significant with the decreasing trend (Annual Percentage Change [APC], -4.88; p<0.0001) in the proportion of households with the catastrophic health expenditure. On the other hand, the results of the HIES showed 2.92%, and KHP showed 2.48% of households experienced the catastrophic health expenditure in 2016. The trend was significantly increased in HIES (APC, 1.43; p<0.0001) and KHP (APC, 6.68; p<0.0001). Therefore, this suggests that further interventions to alleviate the burden of catastrophic health expenditure to the low-income group are needed.

• 대한물리치료과학회지
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• 제15권1호
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• pp.21-28
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• 2008

The purposes of this study are to quantify energy expenditure by measuring oxygen consumption while performing occupational therapy activities most commonly used for adult hemiplegia patients, to recommend a optimal dosage of exercise by comparing energy expenditure according to the recovery stage, and to suggest a precaution in the treatment of patients with cardiac disorders. According to Brunnstrom recovery stages in hand function, subjects were allocated to group I(3rd and 4th Brunnstrom recovery stages) and group II(5th and 6th Brunnstrom recovery stages). Outcome measures included oxygen consumption, energy expenditure rate, and heart rate during each activity and in recovery period after the activity. Occupational activities including sanding activity, putty activity, and skateboard activity were carried out for all patients. In sanding and putty activities, there were significant differences of oxygen consumption and energy expenditure during the activity between groupⅠandⅡ(p<0.05), but there were not significant differences of oxygen consumption, energy expenditure and heart rate in the recovery period(p>0.05). In skateboard activity, there were no significant differences in oxygen consumption, energy expenditure and heart rates between the two groups during the activity and in the recovery period(p>0.05). The findings indicates that cardiovascular demands for basic activities usually peformed for a treatment may be depended on the physical recovery of patients with hemiplegia. Therefore, therapeutic activities for patients should be selected with the great care.

• 보건행정학회지
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• 제33권2호
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• pp.166-172
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• 2023

Background: To improve the support low-income individuals' medical expenses, it is necessary to think about ways to enhance the Catastrophic Health Expenditure Support Program. This study proposes expanding support criteria and changing the income standard. Methods: This study conducted simulations using national data from the National Health Insurance Service. Simulations performed for people who have used health services (n=172,764) in 2022 to confirm the Catastrophic Health Expenditure Support Program's size based on changes to the subject selection criteria. Results: As a result of the simulation with expanded criteria, the expected budget was estimated to increase between Korean won (KRW) 13.2 (11.5%) and 138.6 billion (37.4%), and the number of recipients increased between 41,979 (48.9%) and 150,317 (76.1%). The results of the simulation for the change in income criteria (applied to health insurance levels below the 50th percentile) estimated the expected budget to increase between KRW -8.9 (-7.8%) and 55.6 billion (15.0%) and the number of recipients to increase between -8,704 (-10.1%) and 41,693 (21.1%) compared to the current standard. Conclusion: The 2023 Catastrophic Health Expenditure Support Program's criteria were expanded as per the 20th Presidential Office's national agenda to alleviate the burden of medical expenses on the low-income class. In addition, The Catastrophic Health Expenditure Support Program needs to be integrated with other medical expense support policies in the mid- to long-term, and a foundation must be prepared to ensure the consistency of each system.

• 보건행정학회지
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• 제30권1호
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• pp.62-71
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• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• 보건행정학회지
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• 제24권1호
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• pp.47-55
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• 2014

Background: Korea is considered to have an integrative health system where both western medicine and Korean (traditional) medicine are officially recognized and provided. Although Korean medicine has been covered by National Health Insurance over 20 years, equity in the utilization of Korean medical care has rarely been examined. Methods: We examined medical care utilization and expenditure of outpatient Korean medicine using panel fixed effects model to remove selection bias. Then we compared it with pooled ordinary least square (OLS) model. This study used Korea Health Panel data, which provides accurate information on out-of-pocket health care payment, including non-covered medical services. Results: Principal findings indicate that the frequency of the utilization of Korean medicine is related with unobservable individual choices different from western medicine, so the panel fixed effect model is appropriate. But pooled OLS model is better fitted for the expenditure of Korean medicine, after controlling for western medical care expenditure. After adjusting for the selection bias, socioeconomic status (income, education) was significantly associated with the expenditure of Korean medicine, but not with the frequency of the utilization of Korean medicine. Conclusion: This study shows that expenditure of Korean medicine utilization is inequitable across socioeconomic groups, which implies that health insurance coverage of Korean medicine is not sufficient.

• 보건행정학회지
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• 제31권1호
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• pp.140-144
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• 2021

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2019 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of households with catastrophic healthcare expenditure. The households experienced a catastrophic health expenditure of 2.44% in 2019 using the NaSTaB data. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -4.49; p<0.0001) in the proportion of households with catastrophic health expenditure. Also, the results of the 2017 KHP and the 2016 HIES showed 2.20% and 2.92%. The trend was significantly increased in the KHP (APC, 1.79; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, this study suggests that further public healthcare interventions to alleviate the burden of catastrophic health expenditure, especially for low-income households, are needed.