• Health Policy and Management
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• v.14 no.3
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• pp.20-44
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• 2004

The National Health Insurance Expenditure has been increased rapidly since the introduction of the separation of prescription and dispensing in 2000, and this trend of rapid growth in overall spendings rate has been observed predominantly among medical practitioners. This study was conducted to investigate the growth rate and distributional changes in private medical practitioners' expenses from 1999 to 2002 and its determinants using the National Health Insurance claims data. The total increasing rate of all medical practitioners' expenditure paid by the National Health Insurance between 1999 and 2002 was $41.71\%$, which exceeding that of general hospitals by $20\%$p. But the income distribution among each practitioner was improved as the changes in Gini coefficient(from 0.40 to 0.38) and decile distribution ratio(from 0.25 to 0.29) during the same period showed. However, this improvement in distributional patterns is not enough since even in 2002 it turned out that the highest $10\%$ income group earned 33times more than the lowest $10\%$ income group did. Also, higher Gini coefficient was observed in larger cities and some department like plastic surgery, obstetrics and gynecology. The major causes of this differentials in medical practitioners' expenses were factors related to medical demand like proportion of old population, residential economic status in a given area. In addition, providers' economic incentives also played an important role in determining their income distribution. The large income differentials among physicians may imply a skewed distribution of patients and thus long waiting time, inefficient utilization of resources and potential inadequate quality of care. In this sense, unreasonable distributional gaps should be reduced, so effective measures as well as ongoing monitoring would be necessary to correct current distributional problems.

• Health Policy and Management
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• v.24 no.1
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

• Korean Journal of Social Welfare
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• v.48
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.770-785
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• 1998

This study describes the relation of physician's income and price of medical service and social welfare through microeconomic view, reviews the literature of influencing factor on physician's income, and it describes general distribution of physician's income, and analyzes influencing factor of physician's income. A total of 844 persons responded to the mail survey, through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study, and the unit of analysis is a physician. To examine the change of average income per month, multiple regression was used to test the change according to physician's characteristics, demographic characteristics, scale of clinic, average intensity of ordinary work, and specialty. The major findings of this study are as follows; 1. As for self-employed physicians, the difference of average income per month among specialties was mcreased \4,850,000, but the difference was \6,020,000 under the control of control variables. 2. The number of average out-patients per month and number of nurses and nursing aides significantly positively associated, and average income per month was significantly higher for physicians who had sick-beds than physicians who had no sick-beds. In conclusion, the number of out-patient and number of nurses and nursing aides is the major influencing factor, and the difference of average income per month among specialties existed in self-employed physicians. So this study suggests basic hypothesis that the price of medical service and supply of physician by specialties are not pertinent. Being a cross-sectional study, this study can not suggest causal explanations. In the future, further study is needed for causal explanations.

• The Journal of the Korea Contents Association
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• v.15 no.12
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• pp.560-571
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• 2015

This study aims to examine primary determinant for medical expenditure depending on different age and income brackets. The age and income brackets are simultaneously taken into account for a forming of structural models, and GARCH methodology is utilized in analyzing the model. Empirical evidence reveals that no matter how general medical care system is appropriately operated, medical expenditure is vulnerable in taking care of potential socially-disadvantaged class and the group of catastrophic medical expenditure as long as the age and income brackets concern, simultaneously. It signifies that more elaborately designed medical-related policy seems to be established to improve its effectiveness. On the contrary, ageing society is comparatively well-treated by public health law and act on long-term care insurance for the aged.

• Journal of Digital Convergence
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• v.16 no.10
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• pp.49-57
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• 2018

This study aims to identify the inequalities and characteristics of health care expenditure of the elderly and non-elderly households by income level. As a result, health care expenditure of elderly households was statistically significantly higher than that of non-elderly households. As a result of calculating the concentration index of health care expenditure by income level, inequality was higher in order of non-elderly households, elderly households, and total households. In order to confirm the effect of health expenditure on household income inequality, we calculated the concentration index of income excluding total health care expenditure from total income. As a result, inequality was higher in order of elderly households, whole households, and non-elderly households. There was not much difference in inequality of health care expenditure among elderly households and non-elderly households. And, the health care expenditure of elderly households was much higher than that of non-elderly households. Also, inequality of health care expenditure by income group was serious. There should be no cases where the medical care support policy for elderly households can not use necessary medical services.

• Journal of agricultural medicine and community health
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• v.15 no.1
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• pp.28-40
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• 1990

Rapid industrialization has induced the migration of rural people to urban areas. Such migration has created enlarged the existing low income group. Residents of low income area have increased health risk owing to their poor living environment, low income. overwork and inappropriate health care. The general objective of this study was to group the pattern of medical care utilization of low income group. The specific objectives were to identify disease prevalence and medical care utilization of low income group. To meet the objectives of this study, household interview method was applied. A total of 1845 households in 5 areas such as Bongchon 5th Dong, Bongchon 2nd Dong, Sanggae 5th Dong, Sanggae 4th Dong, and Shinrim 7th Dong were visited and interviewed by field team during the period from April 19 to May 3. 1989. The major findings obtained from the information collected were as follows : The Number of room per household used was one to two rooms. The employment state of the head of household disclosed that 88.6% had a job and the remaining 11.4% were unemployed. The average monthly income was 502,770won. however, 30% of the total income was less than 300,000 won in Bongchon 5th dong area. and 34.5% in Shinrim 7th Dong area. 41.3% of households had debts, which was consisted of household expense(33.4%), income formulation(22.7%) and medical care cost(15.9%) etc. Prevalence rate of diseases during the preceding 30days before the date of the household interview was 387.7 per 1000 persons. The prevalence rate of female was higher than that of male. 8.9% of the sick persons wasn't receiving any medical treatment, and the main reasons of which were lack of economic availability(43.3%) and feeling of non treatment needed(33.7%). According to the study results it was found that the prevalence rate of chroic diseases and the disabled in low income resident areas was higher than that in the other areas. Therefore, the health status of this group should be improved through PHC approaches. In addition. in order to prevent the diseases and promote the health of those people, the health center as well as health subcenter should be strengthened.

• Journal of agricultural medicine and community health
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• v.18 no.2
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• pp.121-129
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• 1993

This study was conducted to investigate the incidence and related factors of farming tool-machinery injuries developed in the Chonnam rural area in 1992. A total of 9,068 persons (4,571men and 4,497women)were selected in a stratified cluster sampling manner, and interviewed individually to complete a structured questionnaire covering farmer characteristics, duration of farm working, annual income, kind of farming tools and machinery, type of injuries and medical care. The results were as follows : 1. The incidence rate of farming tool-machinery injuries was 63 per 1,000 persons over all, 73 in males and 54 in females. The age standardized incidence rate was 69 per 1,000 persons over all, 83 in males and 65 in females. 2. The associated factors with farming tool-machinery injuries in univariate analysis were sex, age, duration of farming and monthly income. The occurrence of injuries was higher in men than in woman, and the higher in high-income group than in the low-income group. 3. More men than woman were involved in trunk injuries and treated at the large scale medical care units such as hospitals, and they paid much higher medical fees. 4. The complaint rates for each item of farmers' syndrome in the injured group were higher than those of the non injured group in 'shoulder stiffness', 'sleeplessness', 'dizziness', and 'gastric fullness'. 5. When multiple logistic regression was applied to farming tool-machinery injuries, the significant variables were farmer's syndrome, age, and duration of farming in both males and females.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4221-4227
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• 2012

Cancer of the uterine cervix is a worldwide menace taking innumerable womens' lives. The literature is vast and a large number of studies have been conducted in this field. Analyses have shown significant differences exist in terms of screening and HPV testing facilities among high income and low to middle income countries. In addition, acute lack of awareness and knowledge among the concerned population is particularly noted in rural areas of the low income countries. A detailed review of Indian case studies revealed that early age of marriage and childbirth, multiparity, poor personal hygiene and low socio-economic status among others are the principal risk factors for this disease. This review concludes that a two pronged strategy involving strong government and NGO action is necessary to minimize the occurrence of cervical cancer especially in low and medium income countries.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6303-6309
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• 2015

Differences in socioeconomic status (SES) such as income levels may partly explain why breast cancer screening (BCS) disparities exist in countries where health care services are free or heavily subsidized. However, factors that contribute to such differences in SES among women living in well resourced Middle East countries are not fully understood. This quantitative study investigated factors that influence SES and BCS of Arab women. Understanding of such factors can be useful for the development of effective intervention strategies that aim to increase BCS uptake among Arab women. Using data from a cross-sectional survey among 1,063 Arabic-speaking women in Qatar, age 35+, additional data analysis was performed to determine the relationship between socioeconomic indicators such as income and other factors in relation to BCS activities. This study found that income is determined and influenced by education level, occupation, nationality, years of residence in the country, level of social activity, self-perceived health status, and living area. Financial stress, unemployment, and unfavorable social conditions may impede women's participation in BCS activities in well resourced Middle East countries.