• 보건행정학회지
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• 제18권3호
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• pp.110-127
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• 2008

Expenditures on pharmaceuticals of different concepts were estimated and their functional, financing and providers' breakdowns were examined in line with the OECD's System of Health Accounts (SHA) manual. This study also shows the way such estimates are made. The results are then analyzed particularly from the international perspective. Data from both Household Survey by the National Statistical Office and the National Health and Nutritional Survey by the Ministry of Health and Welfare of Korea were used to estimate pharmaceutical expenditures that. are financed by out-of-pocket payments of the household, while national health insurance data etc. were used for estimation of pharmaceutical expenditures that are financed by public funding sources. The 'per capita expenditure on pharmaceutical/medical non-durables' in Korea stood at 380 US$ PPPs, less than the OECD average of 443 US$ PPPs in 2006, but its share of the per capita health expenditure of 25.9% noticeably outnumbered the OECD average of 17.1%, due partly to low per capita health expenditure as a denominator of the ratio. This indicates that Koreans tend to spend less on health care than an OECD average, while tending to spend more on pharmaceuticals than on other health care services, much like the pattern found in relatively low income countries. An international pharmaceuticals pricing mechanism is most likely responsible for such a tendency. In addition, it is to be noted that the percentage comes down to 21.0%, when expenditures on both medical non-durables and herbal medicine, which is locally quite popular among the elderly, have been excluded.

• 보건행정학회지
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• 제24권1호
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• pp.35-46
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• 2014

Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.

• 보건행정학회지
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• 제31권1호
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• pp.17-23
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• 2021

With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

• 보건행정학회지
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• 제2권2호
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• pp.221-237
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• 1992

The reasons for cost inflation in medical insurance expenditure are classified into demand pull inflation and cost push inflation. The former includes increase in the number of beneficiaries and utilization rate, while the latter includes increase in medical insurance fee and the charges per case. This study was conducted to analyze sources of increases of expenditure in medical insurance demonstration area by the period of 1982-1987 which was earlier than national health insurance and the period of national health insurance(1988-1990). The major findings were as follows: Medical expenditure in these areas increased by 9.4%(15.1%) annually between 1982 and 1990 on the basis of costant price(current price) and for this period, the yearly average increasing rate of expenses for outpatient care[10.5%(15.8%)] was higher than that of inpatient care [7.3%(12.6%)]. Medical expenditure increased by 6.3%(8.9%) annually between 1982 and 1987, the period of medical insurance demonstration, while it increased by 10.7%(18.9%) after implementing national health insurance(1988-1990). Medical expenditure increased by 35.9%(45.9%) between 1982 and 1987. Of this increase, 115.2%(92.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 61.0%(68.1%) was due to the increase in the charges per case, but the expenditure decreased by 76.2%(60.2%) due to the reduction in the number of beneficiaries. Beteen 1988 and 1990, the period of national health insurance, medical expenditure increased by 21.2%(41.4%). Of this increase, 87.5%(46.4%) was attributable to the increase in the frequencies of utilization per beneficiary and 52.4%(73.4%) was due to the increase in the charges per case, and of the increase in the charges per case, 69.6%(40.8%) was attributable to the increase in the days of visit per case. Medical expenses per person in these areas increased by 78.2%(89.0%) between 1982 and 1987. Of this increase, 76.6%(69.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 23.4%(30.9%) was due to the increase in the charges per case. For this period, demand-pull factor was the major cause of the increase in medical expenses and the expenses per treatment day was the major attributable factor in cost-push inflation. Betwee 1988 and 1990, medical expenditure per person increased by 31.2%(53.1%). Of this increase, 60.8%(37.2%) was attributable to the demand-pull factor and 39.2%(62.8%) was due to the increase in the charges per case which was one of cost-push factors. In current price, the attributalbe rate of the charges per case which was one of cost-push factors was higher than that of utilization rate in the period of national health insurance as compared to the period of medical insurance demonstration. In consideration of above findings, demand-pull factor led the increase in medical expenditure between 1982 and 1987, the period of medical insurance medel trial, but after implementing national health insurance, the attributable rate of cost-push factor was increasing gradually. Thus we may conclude that for medical cost containment, it is requested to examine the new reimbursement method to control cost-push factor and service-intensity factor.

• 보건행정학회지
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• 제25권2호
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• pp.80-89
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• 2015

Background: This study aims to identify the monthly average medical expenses of public pension recipients, and analyze the determinants of total health and medical expenses and Western and Oriental medicine expenses, medical service expenses, and medical supplies expenses. Methods: This study used the fifth year data of 2013 out of the raw data of the Korean Retirement and Income Study collected by the National Pension Research Institute. This study conducted t-test, analysis of variance, and linear regression to verify publicly the relevance between pension recipients' general characteristics and health and medical expenses status using IBM SPSS ver. 21.0 for data analysis. Results: It was analyzed that there is a difference in the spending of expenditure and health care costs according to public pension recipients. Medical expenses of the national pensioners was higher compared to the special corporate pensioners. The national pensioner is related expenditure size, education level, family members living together, residential areas, status of spouse, number of chronic illness, and status of limitation in daily life with psychological health status. Conclusion: Therefore, fairness does not occur fire to the medical use between the special corporate pensioners and national pensioners, aggressive of government such as health policy and financial support for the retiree pension policy that reflects the reality intervention would be required.

• 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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• 제17권3호
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• pp.26-49
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• 2007

The purpose of this study is to analyze the equity of health care utilization by income groups in terms of both quantity and quality of care, which is measured by expenditure, type of care, and type of health care institutions. Equity in health care utilization is measured by HIwv index, based on the survey of 1,480 Gwangju-Jeonnam residents. Health care utilization in terms of the probability and quantity of outpatient and inpatient care show equitable or pro-poor inequitable distribution, whereas the distribution of health care expenditure, which can account for the quality of care, is pro-rich inequitable, implying that the better off tend to use more expensive medical care. In terms of the types of care, simple visits for basic care show equitable distribution, whereas the distribution of the utilization of traditional tonic medicine, comprehensive health examination, CT, MRI, and ultrasound is pro-rich inequitable. Utilization of general hospitals and traditional health institutions show pro-rich inequitable distribution, hospitals and dental care institutions equitable, and physician clinics and public health centers pro-poor inequitable.

• 보건행정학회지
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• 제28권3호
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• pp.257-262
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• 2018

This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

• 농촌의학ㆍ지역보건
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• 제2권1호
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• pp.30-35
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• 1977

Health care conditions in Korea are gradually improving along with the economic and social development. However, the volume of disease is still great, especially in rural areas. This study attempts, therefore, to initiate a comprehensive proposal of rural health care delivery system. The proposal is constructed three parts, problem of health care system, medical cost, medical education system. The proposal consist of the following components: I. The health care system 1. health sub-center is required to be locate in "Myun" the basis administrative unit of local government for delivering primary health care. But, in the viewpoint of medical economics, the primary health care is operated cautiously. 2. Health center is desirable to provide health services in coordinating the health sub-center and other private health institution. 3. The secondary health care is performed in regional combination hospitals, and the attitude that doctors accomodate this system is required. II. The medical cost, Insurance In the expenditure of medical care, the method of a third person's payment is required absolutely. III. The medical education system. 1. The medical education system (process) is changed from the medical education to regional doctor education. 2 In the nurse education system. nursing technical high school is resurrected.

• 디지털융복합연구
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• 제17권4호
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• pp.203-210
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• 2019

본 연구는 직업분류에 따른 의료비 지출 영향요인을 분석하였다. 한국의료패널(Korea Health Panel)의 2012년도 데이터를 이용하여 만20세 이상의 성인을 대상으로 결측값을 제외한 총 4,538명을 최종 분석대상으로 하였다. 자료분석은 의료비 지출 영향요인을 분석하기 위하여 로지스틱 회귀분석을 하였다. 연구분석 결과 Model 1은 단순노무 종사자에 비해 농림어업 숙련 종사자, Model 2의 경우 직종의 경우 판매 종사자에 비해 단순노무 종사자에서 의료비 지출 증가에 영향을 주는 것으로 분석되었다. 성별은 남자에 비해 여자, 혼인은 무에 비해 유, 소득계층은 1분위에 비해 4분위, 5분위, 만성질환은 무에 비해 유에서 의료비 지출이 높은 것으로 분석되었다. 따라서, 건강검진 또는 예방활동 활성화를 위한 보건의료정책 및 보건학적 접근에 있어서 직종, 만성질환 등을 반영한 보다 체계화된 접근이 필요하다.