• Health Policy and Management
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• v.13 no.4
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• pp.48-65
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• 2003

Detailed analyses of total health expenditure and its sub­categories are essential for the evidence­based health policy(EBHP). These analyses, again, should be based on timely and reliable data that are comparable across countries. The System of Health Accounts (SHA), published by the OECD in 2000, provides an integrated system of comprehensive and internationally comparable accounts. The author has implemented the SHA manual into Korean situation, and examined overall expenditure estimate and its basic functional breakdown following the manual. This study explains how pharmaceutical expenditure is estimated. The results are, then, analyzed particularly from the international perspective. Both administrative data in Statistical Yearbooks (National Health Insurance, Medical Aid, Industrial Accident Compensation Insurance) and survey data on Health and Nutrition are used for the estimation. Per capita pharmaceutical expenditure in Korea (183 US$ PPPs) was far less than the OECD average (308 US$ PPPs) in 2001, but pharmaceutical expenditure share in total health expenditure (20.3％) was higher than the average (16.7％). This can be explained by the fact that there is a statistically significant correlation between pharmaceutical expenditure share and per capita GDP of each country. Korean people follow the tendency of relatively low­income countries to spend less than OECD average for health care, but follow again their tendency to spend more on drugs than on other health care services. In consideration of results and analysis as above, per capita pharmaceutical expenditure in Korea is expected to grow in the future, but the growth rate of the pharmaceutical expenditure is expected to be less than that of overall health expenditure.

• Health Policy and Management
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• v.21 no.4
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• pp.585-598
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• 2011

This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

• Health Policy and Management
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• v.29 no.4
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• pp.412-421
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• 2019

Background: The purpose of this study was to identify the status of Successful Aging among the elderly aged 65 and over in rural areas and to compare factors related with Successful Aging between "kyung-ro-dang" users and non-users. Methods: A total of 181 elderly aged 65 or older were selected from four districts (Heung-upri, Mejiri, Sajerri, and Daeanri) of Wonju city. A survey method using face to face interviews was applied to collect information. Successful aging was measured on a 5-point Likert-type scale using the successful aging scale developed for the Korean elderly, which indicates the higher the score, the higher the level of successful aging. Descriptive statistics, bivariate, and multivariate analyses were computed; the level of significance was set at 5%. Hierarchical polynomial regression was applied to find out the factors associated with successful aging. Results: Of the total, 112 elders used kyung-ro-dang and 69 elders who did not use kyung-ro-dang. The level of successful aging of the elderly was higher among kyung-ro-dang users than non-users. The factors related to successful aging among kyung-ro-dang users were walking and social participation. Users who walk more than 4 times per week and social participation activities have a higher level of satisfaction. In the case of non-users, a higher level of monthly income, having a spouse, social support, and social participation associated with a higher level of successful aging. Conclusion: Monthly income, social participation, and social factors were found to be related to successful aging along with physical and mental health conditions among the elderly in rural areas. Therefore, it can be concluded that income, social as well as mental and physical factors, are more critical for successful aging in the rural community care in Korea.

• Health Policy and Management
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• v.23 no.3
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• pp.233-243
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• 2013

Background: This study was conducted to evaluate the individual and community level factors which were influencing the severe injury patients' death and transfer at discharge. Methods: Analysis data is based on Korean National Hospital Discharge In-depth Survey Data released by the Korea Center for Disease Control and Prevention from 2006 to 2008. Study subjects was 11,026 inpatients with of severe injury. For multi-level analysis, socio-demographic characteristics, injury related characteristics, hospitalization related characteristics were used as individual level factors, and socio-environmental characteristics and health care resource characteristics were used as community level factors. Results: As to community level factors affecting mortality of severe injury, the possibility of death was also high in cases of less numbers of surgeons per a population of 100,000 and more number of operation beds. As to community level factors affecting transfer of severe injury, vulnerable areas with higher social deprivation index and low population density had higher possibility of transfer. Conclusion: Both individual level factors and community level factors affected clinical outcomes of treatment for severe injury. In particular, since there happened higher death and transfer of severe injury in socioeconomic and medical vulnerable areas, special efforts for establishing preventive policy and care system for injury in national and area level should be directed toward such areas.

• Health Policy and Management
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• v.25 no.3
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• pp.221-228
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• 2015

Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.

• Health Policy and Management
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• v.29 no.2
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• pp.160-171
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• 2019

Background: This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender. Methods: Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used. Results: There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women. Conclusion: This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.23 no.11
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• pp.1420-1427
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• 2019

Super aged society, Japan actively uses Information Communication Technology(ICT) as one of solving methods for various social problem. Especially, for Korea where soon will become super aged society, it would be meaningful to examine the current policy trends and utilization of senior support using ICT in Japan. This study explores the policy trends and utilization of senior support using ICT in Japan through literature review, and then proposes some suggestions as follows. Opportunities for practical use of ICT should be widened in the field of senior support, and efforts are needed to build an information linkage network between institutions for senior support because linkage between care sector and medical sector is important for the elderly support. Besides, simplification of paperwork and easing of burden of care providers or workers in the field should be sought by development and dissemination of various robots. Moreover, the spread of technology for emotional support and stability should be actively pursued by using ICT.

• Journal of Family Relations
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• v.21 no.3
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• pp.3-23
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• 2016

Objectives: The purpose of this study is to examine the effects of symptoms of dementia elderly on the primary caregiver's depression. In addition, moderating effect of family support was examined. Based on the results, the necessity for intervention in the level of social welfare as a way to mitigate primary caregiver's depression was suggested. Method: In order to accomplish these purposes, a total of 197 who are spouse and adult-children of dementia elderly using day care facilities or services in Seoul, Gyeonggi, Busan province, South Korea were utilized. Data were analyzed by frequency analysis and descriptive statistics, regression model analysis with SPSS 18.0. Results: In case of analysis results, the mean value was reported 0.9 out of four point about primary caregiver's depression and the mean value of family support was reported 3.34 out of five point. And besides, the analysis result of dementia elderly's symptoms showed that prevalence of depression/dysphoria were 62.2%, prevalence of aberrant motor were 61.3%, prevalence of apathy/indifference were 56.6%. Crucial findings are as follows: the symptoms of dementia elderly was significantly associated with the primary caregiver's depression. At the same time, family support significantly influenced lower level of the primary caregiver's depression. While, in the relationship between the symptoms of dementia elderly and the primary caregiver's depression, family support has a moderation effect by important protection factor. Conclusions: From these findings, the necessities to provide the care service for dementia elderly to help improve symptoms of dementia as well as the policy and service to manage the mental health of the family as primary caregiver were suggested. Also, the necessities to provide the family therapy program to improve the relationship with family members were suggested.

• Journal of Digital Convergence
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• v.20 no.2
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• pp.261-268
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• 2022

Recently, the number of elderly living alone suffering from loneliness and depression is also increasing significantly due to the rapid aging of the population and nuclear families. In this paper, we propose a smart aging system that increases life satisfaction by providing the elderly with the optimal service tailored to the elderly with the help of IT according to their residential environment and health status. It is possible to provide an advanced customized support system for the elderly by fully utilizing IoT, AI, and Metaverse techniques not only for the elderly who want to live an active life in society but also for the elderly who need care in a nursing hospital. The proposed system provides human satisfaction by providing social connection in real space and virtual space in accordance with the residential environment and health status to the elderly suffering from loneliness in hospital (hospital care) facilities and at home. This paper proposes a new path for future-oriented welfare policy for the elderly by providing a user-customized smart aging system by combining AI and Metaverse technology with a rapidly changing social environment.

• Health Policy and Management
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• v.34 no.1
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• pp.94-102
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• 2024

Background: There is controversy surrounding the claim that current nursing workforce policies exacerbate the geographic imbalance of nurses in Korea, but very few studies have confirmed this assertion. Therefore, this study aimed to identify factors influencing the distribution of nurses at the regional level, including variables related to nursing workforce policies. Methods: This study analyzed the distribution of 225,462 practicing nurses across 250 regions in Korea as of 2020. National statistics were collected for these 250 regions, and regression analysis was conducted. Results: Factors influencing the distribution of practicing nurses included the number of annual inpatient days, integrated nursing care service beds, public healthcare institutions, tertiary hospitals, and general hospitals. Additionally, the number of nursing graduates and healthcare institutions with nurse staffing grade 1 and 2 had an impact on nurse distribution in non-capital regions. Conclusion: To prevent exacerbating the geographic imbalance of nurses, careful decisions should be made regarding the expansion of integrated nursing care service beds. Furthermore, it is necessary to increase the number of nursing students in non-capital regions and prioritize the improvement of wages and working conditions for nurses in those areas.