• Research in Community and Public Health Nursing
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• v.26 no.1
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• pp.11-17
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• 2015

Purpose: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. Methods: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. Results: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). Conclusion: Copayment does not seem to be a great influencing factor on beneficiaries' accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

• Journal of Society of Preventive Korean Medicine
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• v.11 no.1
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• pp.139-151
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• 2007

This paper evaluated the benefits of the National Health Insurance(NHI) and suggested the necessity of extending some oriental medical services into the benefits schedule in the NHI. Comparing the rate of public financing in national health expenditure in OECD countries and measuring out-of-pocket payments in total medical cost showed the level of insurance payments to total medical cost is approximately $50%{\sim}60%$ in Korea, which is quite insufficient to pay household medical expenses, although the NHI covers the whole population. A few of consumers' priority surveys for medical needs suggested herb medicine, muscle treatment, and manufactured herb medicine be included in the list of the NHI benefits, based on efficiency and equity criteria. It was estimated that the NHI can afford to cover these three items of oriental medical services.

• Health Policy and Management
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• v.24 no.1
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• pp.24-34
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• 2014

Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

• The Journal of Asian Finance, Economics and Business
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• v.8 no.10
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• pp.297-303
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• 2021

The performance of the retail industry in a country, which simultaneously reflects the demand for retail space, is significantly influenced by the macroeconomic environment of said country. However, in the case of Malaysia, studies regarding this issue are limited. Therefore, this paper aims to identify the macroeconomic determinants of the demand for retail space in shopping centers in Malaysia through the study of six variables: per capita income, private expenditure, inflation rate, interest rate, total population, and the number of tourists arrival. The nexus between these variables and the demand for retail space in shopping centers were examined by cointegration and causality tests, and regression analysis using quarterly data for the period 1993Q1 to 2016Q4. The results from bivariate cointegration tests indicate that inflation rate, interest rates, population size, and the number of tourists arrival have significant long-run relationships with the demand for retail space of Malaysian shopping centers. Meanwhile, the Granger causality tests show that only population size can cause the demand for shopping centers' retail space. Finally, the results from the regression analysis revealed that income per capita, private expenditure, interest rates, and population are the variables that significantly influence the demand for the retail space of the Malaysian shopping centers.

• Health Policy and Management
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• v.26 no.3
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• pp.172-184
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• 2016

Background: The objective of this study was to examine the effect of occurrence and reoccurrence of catastrophic health expenditure (CHE) on transition to poverty and persistence of poverty in South Korea. Methods: The data of the year 2008-2011 from the Korea Health Panel were used. CHE was defined as the share of total health expenditure in a household out of a household's total income at various threshold levels (more than 5%, 10%, 15%, and 20%). The effect of catastrophic expenditure on transition to poverty and persistence of poverty was analyzed through multivariate logistic regression. Results: The shares of households facing CHE at various threshold levels have increased gradually with 37.7%, 21%, 13.1%, and 9.5% in 2011. Households facing CHE were more likely to experience transition to poverty at thresholds level of more than 5% and 20% in 2010 set. Households facing CHE seemed to experience persistence of poverty, but it was not statistically significant. About 40% of households facing CHE in 2009 encountered another shock of CHE in 2010. Households without CHE seemed to experience more transition to poverty and persistence of poverty, but it was not statistically significant. For household with multiple CHE, those with medical aid were more likely to experience transition to poverty with statistical significance, but the statistical significance disappeared in case of persistence of poverty. Conclusion: The Korean health system needs to be improved to serve as a social security net for addressing transition to poverty and persistence of poverty due to facing CHE.

• Journal of Family Resource Management and Policy Review
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• v.1 no.2
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• pp.109-118
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• 1997

The consumption of various medical cares is affected not only by income and price but also by the number of household members. This study aims at examining how the number of household members affects the consumption pattern of medical care in Japan. The major findings of this study are summarized as follows; The elasticities of household members on the medical care consumption are estimated to be -2.4 in the 20-years groups in case of total medical care expenditure, 4.1 in the 50-years groups of medical care items, -3.1 in the 40-years groups of medical supplies and equipments, and -5.6 in the 60-years groups and -2.7 in the 50-years groups of medical services.

• Journal of Biomedical Engineering Research
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• v.27 no.6
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• pp.301-309
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• 2006

The main purpose of this study is to derive a regression equation that predicts the individual differences in activity energy expenditure (AEE) using accelerometer during different types of activity. Two subject groups were recruited separately in time: One is a homogeneous group of 94 healthy young adults with age ranged from $20\sim35$ yrs. The other subject group has a broad spectrum of physical characteristics in terms of age and fat ratio. 226 adolescents and adults of age ranged from $12\sim57$ yrs and fat ratio from $4.1\sim39.7%$ were in the second group. The wireless 3-axis accelerometers were developed and carefully fixed at the waist belt level. Simultaneously the total calorie expenditure was measured by gas analyzer. Each subject performed walking and running at speeds of 1.5, 3.0, 4.5, 6.0, 6.5, 7.5, and 8.5 km/hr. A generalized sensor-independent regression equation for AEE was derived. The regression equation was developed fur walking and running. The regression coefficients were predicted as functions of physical factors-age, gender, height, and weight with multivariable regression analysis. The generalized calorie estimation equation predicts AEE with correlation coefficient of 0.96 and the average accuracy of the accumulated calorie was $89.6{\pm}7.9%$.

• Journal of the Korean Home Economics Association
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• v.40 no.4
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• pp.139-152
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• 2002

This study was performed to estimate living cost for the elderly couple living in a city in Korea. Living cost means expenditure per month for elderly couple. It was assumed that the elderly couple will need different living cost according to their circumstances. The circumstances are health status, retirement status, and the level of living they want. The subjects were the elderly couple households over the age 65 of household head. Total number of subject was 1,649 households. Used data was Annual Report surveyed by National Statistical Office on the Family Income and Expenditure. Analysis of data was done through frequency, percentage, means, median using SAS Program. The results of this study were as follows: Their standard living cost was 844,980 won by pure relative standard line and 842,300 won by quasi relative standard lines. And minimum living cost was 713,400 won by the former, by the latter was 557,600 won (3/2 of median). And abundant Living cost was 1,068,020 won by the former, by the latter 1,263,450 won. The living cost of elderly households was about 81-83%, comparing with non-elderly households. Among the item of expenditure, the proportion of housing and medical care cost was larger than any other items.

• 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.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.337-342
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• 2023

Purpose: This study aimed to compare the resting energy expenditure (REE) measured using indirect calorimetry with that estimated using predictive equations in severe trauma patients to determine the appropriate caloric requirements. Methods: Patients admitted to the surgical intensive care unit between January 2020 and March 2023 were included in this study. Indirect calorimetry was used to measure the patients' REE values. These values were subsequently compared with those estimated using predictive equations: the weight-based equation (rule of thumb, 25 kcal/kg/day), Harris-Benedict, Ireton-Jones, and the Penn State 2003 equations. Results: A total of 27 severe trauma patients were included in this study, and 47 indirect calorimetric measurements were conducted. The weight-based equation (mean difference [MD], -28.96±303.58 kcal) and the Penn State 2003 equation (MD, - 3.56±270.39 kcal) showed the closest results to REE measured by indirect calorimetry. However, the REE values estimated using the Harris-Benedict equation (MD, 156.64±276.54 kcal) and Ireton-Jones equation (MD, 250.87±332.54 kcal) displayed significant differences from those measured using indirect calorimetry. The concordance rate, which the predictive REE differs from the measured REE value within 10%, was up to 36.2%. Conclusions: The REE values estimated using predictive equations exhibited substantial differences from those measured via indirect calorimetry. Therefore, it is necessary to measure the REE value through indirect calorimetry in severe trauma patients.