• 제목/요약/키워드: Medical Expenditure

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Effects of Health Care Expenditure on the Infant Mortality Rate and Life Expectancy at Birth in Korea

  • Rhee, Hyun-Jae
    • International Journal of Contents
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    • 제8권3호
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    • pp.52-56
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    • 2012
  • This study examines whether the infant mortality rate and life expectancy at birth are affected by health care expenditure in Korea. It can be provisionally concluded that the infant mortality rate tends to be affected by the health system itself in the long-run, whereas life expectancy at birth is immediately affected by health-related facilities such as the number of physicians and number of hospital beds in the short-run. Therefore, the health-related system should be well established to improve the infant mortality rate. On the contrary, physical capital such as life-prolonging medical technologies has to be accumulated to improve life expectancy at birth.

국민의료비 결정요인 및 영향력 분석 (The Determinants of National Health Expenditure: A Decision Tree Analysis)

  • 이견직;정영호
    • 보건행정학회지
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    • 제12권3호
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    • pp.99-111
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    • 2002
  • This paper draws the determinants of National Health Expenditures(min) and collectivizes OECD countries which are positioned by same conditions using the decision tree analysis. Major findings are summarized as follows. We find that the power of influence of income level on NHE has been 58.35% in 1985, 65.37% in 1990, 66.90% in 1995, and 66.47% in 1997. The power of influence of public share in NHE has been on the increase during that period: 19.50% in 1985, 19.91% in 1990, 22.81% in 1995 and 26.88% in 1997. The two factors(income level, public share) tells for the most part of NHE: 77.85% in 1985, 85.28% in 1990, 89.71% in 1995, 93.35% in 1997. Our results support the hypothesis that NHE could be explained mostly by the income level and show that public share is negatively correlated with the growth of NHE.

한국 도시근로자가계의 과소비와 영향변수-재정비율분석을 중심으로- (Overspending of Wage-earner Households in Korea -Application of Financial Analysis-)

  • 박명희
    • 대한가정학회지
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    • 제34권5호
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    • pp.209-222
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    • 1996
  • The purpose of this study is to apply ratio analysis, which indicates the rate of income to total expenditure, to examine wage-earners' overspending in Korea. We use the Family Income and Expenditure Survey produced by National Statistical Office Republic of Korea and total sample size is 40,691 including households complete income reported. Through the t-test, among 17 expenditure categories, overspenders is likely to spend more on housing, apparel, medical, education, and leisure expenditures more than non-overspenders significantly. Interestingly, overspenders have more income, but less financial assets than non-overspenders. To analyze the effect of socio-demographic variables on overspending, ordinary least square is utilized. The results shows that the more educated, larger family size, and older consumer tend to overspend. The results of study are leaded into two aspects. First, overspending can be solved by consumer education with efficient financial management practice. Second, overspending may be not solved unless policies in various ways enhance the overall quality of living to lessen each household's budget constraints.

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의료보험(醫療保險) 실시이후(實施以後) 지역주민(地域住民)의 의료기관이용행태(醫療機關利用行態) 변화(變化) 추이(推移)와 그 요인(要因)에 관한 조사연구(調査硏究) (Analysis on the trends and causes of inhabitant's behavioral changes in medical institutions's utilization after enforcement of regional medical insurance. (pilot-project area of regional medical insurance; mainly Kun-wi and Kwang-hwa county))

  • 박정연
    • 한국보건간호학회지
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    • 제3권2호
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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.

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Peripheral Serotonin: a New Player in Systemic Energy Homeostasis

  • Namkung, Jun;Kim, Hail;Park, Sangkyu
    • Molecules and Cells
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    • 제38권12호
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    • pp.1023-1028
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    • 2015
  • Whole body energy balance is achieved through the coordinated regulation of energy intake and energy expenditure in various tissues including liver, muscle and adipose tissues. A positive energy imbalance by excessive energy intake or insufficient energy expenditure results in obesity and related metabolic diseases. Although there have been many obesity treatment trials aimed at the reduction of energy intake, these strategies have achieved only limited success because of their associated adverse effects. An ancient neurotransmitter, serotonin is among those traditional pharmacological targets for anti-obesity treatment because it exhibits strong anorectic effect in the brain. However, recent studies suggest the new functions of peripheral serotonin in energy homeostasis ranging from the endocrine regulation by gut-derived serotonin to the autocrine/paracrine regulation by adipocyte-derived serotonin. Here, we discuss the role of serotonin in the regulation of energy homeostasis and introduce peripheral serotonin as a possible target for anti-obesity treatment.

지역쇠퇴 유형별 의료이용행태 영향요인: 도시쇠퇴 지표와 의료취약지 지표를 활용하여 (Factors Influencing Medical Care Utilization according to Decline of Region: Urban Decline Index and Medical Vulnerability Index as Indicators)

  • 정지윤;정재연;윤인혜;최화영;이해종
    • 보건행정학회지
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    • 제32권2호
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    • pp.205-215
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    • 2022
  • Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

Do Fraud Investigations Impact Healthcare Expenditures of Medical Institutions?: An Interrupted Time Series Analysis of Healthcare Costs in Korea

  • Kim, Seung Ju;Jang, Sung-In;Han, Kyu-Tae;Park, Eun-Cheol
    • 보건행정학회지
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    • 제28권2호
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    • pp.186-193
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    • 2018
  • Background: The aim of our study was to review the findings of health insurance fraud investigations and to evaluate their impacts on medical costs for target and non-target organizations. An interrupted time series study design using generalized estimation equations was used to evaluate changes in cost following fraud investigations. Methods: We used National Health Insurance claims data from 2009 to 2015, which included 20,625 medical institutions (1,614 target organizations and 19,011 non-target organizations). Outcome variable included cost change after fraud investigation. Results: Following the initiation of fraud investigations, we found statistically significant reductions in cost level for target organizations (-1.40%, p<0.001). In addition, a reduction in cost trend change per month was found for both target organizations and non-target organizations after fraud investigation (target organizations, -0.33%; non-target organizations of same region, -0.19%; non-target organizations of other regions, -0.17%). Conclusion: This study suggested that fraud investigations are associated with cost reduction in target organization. We also found similar effects of fraud investigations on health expenditure for non-target organizations located in the same region and in different regions. Our finding suggests that fraud investigations are important in controlling the growth of health expenditure. To maximize the effects of fraud investigation on the growth of health expenditure, more organizations needed to be considered as target organizations.

커널필터링 기법을 이용한 건강비용의 효과적인 지출에 관한 군집화 분석 (Clustering Analysis of Effective Health Spending Cost based on Kernel Filtering Techniques)

  • 정용규;최영진;차병헌
    • 서비스연구
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    • 제5권2호
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    • pp.25-33
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    • 2015
  • 데이터마이닝은 방대한 데이터를 기반으로 정보를 추출하는 방법으로 많은 분야에 적용하고 있으며 특히 보건의료 데이터를 다루는 기법으로 많이 활용 되고 있다. 하지만 데이터가 다양하고 방대해짐에 따라 데이터들을 완벽하게 다룰 수 있는 알고리즘이 개발되지 못한 현황이다. 따라서 본 논문에서는 군집화 알고리즘 중의 하나인 DBSCAN 알고리즘과 EM 알고리즘의 성능을 동일한 데이터에 대하여 분석을 시도하였다. 이를 위하여 DBSACN과 EM 알고리즘에 따른 변화를 Health expenditure 실험데이터의 결과를 기반으로 분석 하였고 더욱 정확한 실험과 더욱 정확한 결과를 알아내기 위하여 Kernel Filtering을 통하여 정확한 데이터분석을 시도하였다. 본 연구에서는 알고리즘의 기술적 성능을 비교한 것을 물론이고 성능을 높이기 위한 시도를 하였다. 이를 통하여 확장한 알고리즘에 따른 성능의 변화와 실험데이터의 적용결과를 기반으로 비교하고 이를 분석하게 되었다. 특히 의료기관을 이용하는 다양한 군집으로부터 데이터 레코드를 수집하여 의료 서비스에 대한 효과적인 비용 지출을 권장할 수 있도록 실험하였다.

비만 여성에서 휴대용 간접 열량계를 통한 실측 휴식 대사량과 예측 휴식 대사량의 비교 (Methodological Comparison between Measured and Predicted Resting Energy Expenditure in Korea Obese Women)

  • 송미영;박정미;김진아;고병표;이명종;김호준
    • 한방비만학회지
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    • 제5권1호
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    • pp.57-66
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    • 2005
  • Objectives : The purpose of this study is to examine accuracy of predicted resting energy expenditure (REE), relationship fat free mass (FFM) and REE. Methods : 60 normal, obese women $(body\;mass\;index\;{\geq}25kg/m^2)$ were recruited for this study, they had low calorie diet for 8 weeks. At week 0, 4, and 8, REE was measured by MedGem (indirect calorimeter), Bioelectrical impedance analysis (BIA) using Cunningham equation, and Harris-Benedict (H-B) equation, FFM was also measured by BIA. Results : The REE predicted by BIA was lower than the REE measured by MedGem (MG) in every measurement. The REE predicted by H-B equation predicted REE was lower than that of MG in the second measurement (p<0.01). The REE measured by MedGem was declined after 8 weeks, BIA and H-B equation predicted REE were declined after 4 weeks (p<0.01). H-B equation predicted REE had more significant correlation with the REE measured by MedGem than that of BIA. There was significant correlation between measured REE and FFM, but measured REE declined after 8 weeks, FFM declined after 4 weeks (p<0.01). We derived a prediction equation as follows : REE = 108.36+31.42 (FFM), $R^2=0.23$.

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Regulation of Systemic Energy Homeostasis by Peripheral Serotonin

  • Namkung, Jun;Oh, Chang-Myung;Park, Sangkyu;Kim, Hail
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제2권2호
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    • pp.43-45
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    • 2016
  • Whole body energy balance is achieved through the coordinated regulation of energy intake and energy expenditure in various tissues including liver, muscle and adipose tissues. A positive energy imbalance by excessive energy intake or insufficient energy expenditure results in obesity and related metabolic diseases. Although there have been many obesity treatment trials aimed at the reduction of energy intake, these strategies have achieved only limited success because of their associated adverse effects. Serotonin is among those traditional pharmacological targets for anti-obesity treatment because central 5-HT functions as an anorexigenic neurotransmitter in the brain. Thus, there have been many trials aimed at increasing the activity of 5-HT in the central nervous system, and some of the developed methods are already used in the clinical setting as anti-obesity drugs. However, recent studies suggest the new functions of peripheral serotonin in energy homeostasis ranging from the endocrine regulation by gut-derived serotonin to the autocrine/paracrine regulation by adipocyte-derived serotonin. Pharmacological inhibition of 5-HT synthesis leads to inhibition of lipogenesis in epididymal white adipose tissue (WAT), induction of browning in inguinal WAT and activation of adaptive thermogenesis in brown adipose tissue (BAT). Fat specific Tph1 knock-out (Tph1 FKO) mice exhibit similar phenotypes as mice with pharmacological inhibition of 5-HT synthesis, suggesting the localized effects of 5-HT in adipose tissues. In addition, Htr3a KO mice exhibit increased energy expenditure in BAT and Htr2a KO mice exhibit the decreased lipid accumulation in WAT. These data suggest the clinical significance of the peripheral serotonergic system as a new therapeutic target for anti-obesity treatment.