• 대한예방의학회:학술대회논문집
• /
• 1999.10a
• /
• pp.31-32
• /
• 1999

• Journal of Korean Academy of Nursing
• /
• v.39 no.4
• /
• pp.574-583
• /
• 2009

Purpose: This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. Methods: A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. Results: The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. Conclusion: Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.

• Journal of Biomedical Engineering Research
• /
• v.30 no.3
• /
• pp.226-232
• /
• 2009

In this study, treadmill walking and overground walking were compared at the same condition based on kinematics and energy expenditures(EE). In addition, we compared the actual energy expenditure and calculated EE by treadmill. The kinematics of treadmill and overground walking were very similar. The values at each joint were significantly different(P<0.05), but magnitude of the difference was generally less than 4$^{\circ}$. In the EE using cardiopulmonary exercise, EE of treadmill walking was significantly greater when measured on the overground. It seemed to be the increased stress during the gait by the continuous movement of the belt. As the velocity increased, there was significant difference between actual EE and calculated EE by treadmill due to EE curve increasing exponentially. Therefore the further study would be required to find the correlation of the two methods and calibrate the values from them.

• Journal of Preventive Medicine and Public Health
• /
• v.22 no.4 s.28
• /
• pp.528-541
• /
• 1989

The purpose of this study was to identify and measure the economic costs and benefits due to smoking in Korea. Cigarette smoking is a major cause of morbidity and mortality. In addition to the health risks of smoking, there are important economic consequences. A complete assessment of the economics of smoking requires evaluation of various health, economic, and intangible parameters, including benefits as well as costs of both the production and consumption of tobacco. In this article we focus on costs resulting from the health effects of smoking (expenditures for medical care and the value of productive output lost to morbidity, and premature mortality among smokers), since economic benefits from tobacco industry is offset by expenditures for purchasing tobacco. Two distinct methodologies will be applied to measure the economic costs of smoking cigarette, the human capital and willingness-to-pay approaches. This article used the former method. In 1985, total economic losses due to smoking was estimated as 505.7 billion won, which was composed of morbidity losses 64.9 billion won mortality losses 429.1 billion won and indirect costs 11.7 billion won.

• Journal of Preventive Medicine and Public Health
• /
• v.32 no.4
• /
• pp.546-555
• /
• 1999

Objectives : To determine the prevalence, pattern. and out-of-pocket expenditure of complementary and alternative medicine (CAM) utilization in Korean adult population. Methods : We conducted a representative telephone survey of 2,042 persons aged 18 or older. Data about any health problem, details of their use of medical doctors(MDs) offices/hospitals/pharmacies services and CAM during the preceding 12 months were collected with structured questionnaire. Results : The utilization rate of CAM among Korean adults was 29% in one year. A total of 231 kinds of CAM was identified from this survey. Annual out-of-pocket expenditure associated with CAM use in 1998 amounted to ${\xi}{\S}1.88$ billion and was comparable to 40.8% of out-of-pocket expenditure paid for MDs offices/hospitals/pharmacies services. Among those(N=424) who paid for both MDs offices/hospitals/pharmacies services an d CAM, 35.8% paid more for CAM. CAM gave more satisfaction than western medicine to those who had experience of both types of therapy. About half of CAM users were willing to recommend CAM to others. Disclosure rate to physician among CAM users was not high(40.6%). Conclusion : CAM became a popular source of health care in Korea, Korean spent a substantial amount of out-of-pocket money on CAM without any public control. Because CAM use is likely to be increased rapidly through lay referral system, health policy makers and health professionals should pay more attention to CAM for making appropriate utilization of CAM.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.6
• /
• pp.106-112
• /
• 2016

The purpose of this study was to examine the differences in the direct medical expenditure of community residents according to their physical activity level. The quota sampling method was used to select samples from a youth community center, senior center, community cultural center, and community recreational sports center in G city in Gyeongbuk-do. Of the 773 questionnaires distributed, 716 were completed. The questionnaires consisted of the demographic characteristics, regular exercise and physical activity levels, health status and medical costs. While the beneficial effect of regular exercise and physical activity on dental costs was not (significant), its effect on the costs of visiting hospital services was (significant). The mean differences in the total monthly direct medical expenditures on outpatient services and medicine for those with very high, high, moderate, low, and very low levels of physical activity were 7,500, 26,299, 47,517, 9,314, and 9,9978 won, respectively. The result of this study supported the findings of previous studies that regular exercise and physical activity. are not associated with the reduction of medical expenditure.

• Journal of Nutrition and Health
• /
• v.38 no.9
• /
• pp.786-792
• /
• 2005

With dramatic transitions from a traditionally food-insecure to a food-sufficient society, over weight and/or obesity are an increasing health concern in Korea. In 2000, $35.9\%$ of Korean adults were over weight (BMI>25) with increasing trends. It is well known that obesity is highly correlated with chronic diseases, such as diabetes, hypertension, cardiovascular disease, cancer and high cholesterol. In 2003, the social cost of obesity is estimated at $529.5\~799.3$ billion won (direct cost) and at $1,200\~1,817$ billion won (including indirect cost). The share of the direct cost is estimated at $2.6\~3.9\%$ of total medical bill 20,742 billion won. These costs are underestimated and would surely be higher if the expenditures outside of the official medical insurance system of Korea were included. Based on the rapid increase of obesity rate among the Korean youth, it is crucial to develop and implement appropriate policies to curb the obesity epidemic.

• Korea Journal of Hospital Management
• /
• v.22 no.4
• /
• pp.61-73
• /
• 2017

In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.

• Environmental and Resource Economics Review
• /
• v.29 no.2
• /
• pp.113-144
• /
• 2020

Throughout various data sources, it is widely observed that air quality in South Korea has become improved. Koreans, however, insist that their health status and economic burden due to worsened air quality get degenerated. This study aims to explain the mismatch between perception and measured data, air pollution-led medical expenses, and consumption behaviors in the economics perspectives. First, we demonstrated data-driven evidence of mismatch in the perceived severity of air pollution and its enhancement in measured data. Second, using the health demand model, we theoretically derived and empirically showed a co-rising relation between air pollution severity and medical expenses. Last, we analyzed that the perception led to increased defensive expenditures in consumption. This result implies the possibility of overestimation in air pollution impacts on socioeconomic losses and its possible reverse interpretation from increased social benefit after improved air quality. Our results recommend policy consideration to strengthen air quality standards, to support socially vulnerable groups regarding defensive expenditures, and to improve the accessibility and credibility of air pollution information.

• Journal of Preventive Medicine and Public Health
• /
• v.46 no.3
• /
• pp.147-154
• /
• 2013

Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.