• 제목/요약/키워드: determinants of medical expenditure

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한방의료 이용현황 및 이용결정요인에 관한 연구 - 고령화 패널을 이용하여 - (Determinants of the Utilization of Oriental Medical Services by the Elderly)

  • 박지은;권순만
    • 대한한의학회지
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    • 제32권1호
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    • pp.97-108
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    • 2011
  • Objective: This study aimed to analyze the utilization of Oriental medical services and its determinants among the elderly. Method: Data from a Korean longitudinal study of aging was used. Regression analysis was used to find the determinants of the utilization of medical care. Results: People with low education and low income were more likely to use Oriental medical services. Determinants of using Oriental health service were sex, marriage, income, subjective health condition, activity restriction due to pain, and chronic disease. Among them, only subjective health condition and activity restriction due to pain were significant determinants of frequency of and expenditure on Oriental medical services. Especially, activity restriction due to pain was a significant factor in the use of Oriental medical services, but not in the use of Western medical services. Conclusion: Treatment related to pain was closely associated with Oriental medical services. These treatments need to be developed with scientific and clinical evidence.

국민의료비 결정요인 및 영향력 분석 (The Determinants of National Health Expenditure: A Decision Tree Analysis)

  • 이견직;정영호
    • 보건행정학회지
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    • 제12권3호
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    • pp.99-111
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    • 2002
  • This paper draws the determinants of National Health Expenditures(min) and collectivizes OECD countries which are positioned by same conditions using the decision tree analysis. Major findings are summarized as follows. We find that the power of influence of income level on NHE has been 58.35% in 1985, 65.37% in 1990, 66.90% in 1995, and 66.47% in 1997. The power of influence of public share in NHE has been on the increase during that period: 19.50% in 1985, 19.91% in 1990, 22.81% in 1995 and 26.88% in 1997. The two factors(income level, public share) tells for the most part of NHE: 77.85% in 1985, 85.28% in 1990, 89.71% in 1995, 93.35% in 1997. Our results support the hypothesis that NHE could be explained mostly by the income level and show that public share is negatively correlated with the growth of NHE.

입원환자 의료비 부담에 영향을 미치는 요인 (Factors Affecting the Burden of Medical Costs for Inpatients)

  • 권이승;안병기
    • 보건의료산업학회지
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    • 제6권4호
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    • pp.143-152
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    • 2012
  • This study analyzes Korea health panel data (2008) (beta version 1.2) of Korea Institute for Health and Social Affairs, and National Health Insurance Corporation to figure out determinants of healthcare expenditure. In result of Multiple Logistic Analysis, in-patents felt burden on the medical expenditure were 70.0%. As to the patients' payment of medical expenditure, patients over 65 years old had 4.765 times higher than those under 14 years, disabled patients 2.778 than non-disabled patients, chronic patients 1.632 times than non-chronic patients, patients belonging to 12 million won ~ 46 million won and under 12 million won in family income had 1.680 times and 2.168 times respectively than patients with over 46 million won, patients in professional recuperation facility 1.546 times than patients in hospital, patients in private medical institutions 1.700 times than patients in national and public medical institutions, patients using upper grade rooms 1.701 times than patients in non-upper grade rooms. As a health care safety net mechanism to protect people from medical expenditure burden, there is the patients' payment ceiling in the National Health Insurance System. Thus, in order to facilitate the patient's payment ceiling, it is required that the level of ceiling is to be specified according to the income level, and self-payment items is to be included.

의약분업 전후 의원의 건강보험 진료비 분포변화 및 결정요인분석 (Distributional changes in Physicians' Medical Care Expenses from the National Health Insurance and its Determinants After the Separation of Prescription and Dispensing)

  • 이애경;정현진
    • 보건행정학회지
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    • 제14권3호
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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.

한방외래의료 이용의 사회경제적 결정요인 연구: 의료패널자료를 이용한 고정효과모형과 합동 Ordinary Least Square 모형의 비교 (Socioeconomic Determinants of Korean Medicine Ambulatory Services: Comparing Panel Fixed Effect Model with Pooled Ordinary Least Square)

  • 박민정;권순만
    • 보건행정학회지
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    • 제24권1호
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    • pp.47-55
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    • 2014
  • Background: Korea is considered to have an integrative health system where both western medicine and Korean (traditional) medicine are officially recognized and provided. Although Korean medicine has been covered by National Health Insurance over 20 years, equity in the utilization of Korean medical care has rarely been examined. Methods: We examined medical care utilization and expenditure of outpatient Korean medicine using panel fixed effects model to remove selection bias. Then we compared it with pooled ordinary least square (OLS) model. This study used Korea Health Panel data, which provides accurate information on out-of-pocket health care payment, including non-covered medical services. Results: Principal findings indicate that the frequency of the utilization of Korean medicine is related with unobservable individual choices different from western medicine, so the panel fixed effect model is appropriate. But pooled OLS model is better fitted for the expenditure of Korean medicine, after controlling for western medical care expenditure. After adjusting for the selection bias, socioeconomic status (income, education) was significantly associated with the expenditure of Korean medicine, but not with the frequency of the utilization of Korean medicine. Conclusion: This study shows that expenditure of Korean medicine utilization is inequitable across socioeconomic groups, which implies that health insurance coverage of Korean medicine is not sufficient.

공적연금유형에 따른 은퇴자들의 보건의료비지출 결정요인 (Influence Factors on Health and Medical of Retirees Expense to Public Pension Recipients)

  • 최령;황병덕
    • 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.

개인의 성별이 재난적 의료비 지출 여부에 미치는 영향: 세부집단분석을 통한 젠더적 접근 (The Effect of Gender on Catastrophic Health Expenditure in South Korea: Gender-Based Approach by Subgroup Analysis)

  • 김연수;김혜윤
    • 보건행정학회지
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    • 제28권4호
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    • pp.369-377
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    • 2018
  • Background: Catastrophic health expenditure (CHE) occurs when medical expenditure of a household passes over a certain ratio of household income. This research studied the effect of gender on CHE based on Korea Health Panel data. Methods: This study implemented binary logistic regression model to figure out whether gender affects CHE and how different gender groups show pattern of CHE process. With gender, age, marital status, income level, economic activity, membership of private insurance, existence of chronic disease, and self-rated health were included in the model. Results: Results showed that females faced CHE 1.5 times more than males (odds ratio, 1.241). Also, main determinants of CHE in female groups were marital status, while age and economic activity status were significant in male groups. Subgroup analysis displayed that married female under 35 years old are located in intersectionality of CHE including pregnancy and delivery, multiple health risk behaviors, mental stress, and relatively vulnerable social status due to lower income. Meanwhile, both gender above 50 years old faced remarkably high chance of CHE, which seems to be caused by complex health risk behaviors and chronic diseases. Conclusion: Such results implied not only that gender is an important determinant of CHE, but also other determinants of CHE differ according to gender, which suggests a necessity of gender-based CHE support and rescue policy.

노년기 상용치료원 보유의 효과 분석: 의료비와 주관적 건강상태에 대한 효과를 중심으로 (An Analysis on the Effect of Having a Usual Source of Care for the Elderly: Focusing on the Healthcare Expenditure and the Subjective Health Status)

  • 전예지;사공진
    • 보건행정학회지
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    • 제31권4호
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    • pp.531-543
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    • 2021
  • Background: Population aging is a serious problem in Korea. And we have experienced a rapid increase in the health expenditures of the elderly. The purpose of this paper is to analyze the effect of having a usual source of care (USC) for the elderly. Methods: This study used the Korea Health Panel Survey data of 2012, 2013, 2016, 2017, and 2018. The sample was the person who answered the USC questions among the elderly. The panel logit model was used to analyze the determinants of having USC and the panel simultaneous equation model was used to analyze the effect of having USC among the elderly on the medical expenses, medical utilization, and subjective health status. Results: The estimation result shows that age, income, marriage, and so forth turn out to be the factors of having USC. Having the clinic level USC is estimated to reduce the health care utilization and the health expenditure and to improve the subjective health status. Conclusion: It is expected that the result of our analysis will provide evidence for encouraging having USC.

농촌주민(農村住民)의 의료비지출(醫療費支出)에 관(關)한 연구(硏究) (Medical Care Expenditure and Its Determinants in Rural Areas)

  • 문해선
    • Journal of Preventive Medicine and Public Health
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    • 제9권1호
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    • pp.31-37
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    • 1976
  • This study was conducted for the purpose of obtaining basic information on the patterns of medical care expenditures, and identifying some determinants of medical care expenditures in the rural Korea. Nine guns were chosen from the eight provinces, excluding Cheju island. One gun in each province and two villages were selected from the each myon or ub within the selected guns. The total number of households was 1,789 and the sample size was 9,826 non-institutionalized people. Followings are the major findings of the study : 1) Medical care expenditures increase proportionally with age in terms of cost per patient, per episode of illness, per treated case, and per person. Averagely, it cost 2,756 won per patient, 2,614 won per spell of illness, 4,361 won per treated case, and 413 won per person. 2) Medical care expenditures increase proportionally with educational level of patients. College graduates spent the most, 4,726 won per patient, 5,987 won per treated case, and 670 won per person. 3) The male spent a little more than the female in terms of per patient, per episode, and per person. For example, a male spent 23 won more than a female. 4) Those who were suffering from illnesses longer than 1 year spent three times more than that had illnesses of less than 1 year duration. 5) The simple correlation coefficient between activity restriction and medical care expenditures was the highest among others, 0.491. The next was 0.294 between duration of illness and medical care expenditures. 6) Attempts are made to identify the explanatory variables in medical care expenditures. Thirty one per cent of the variances in tile expenditures can be accounted for by the selected 15 predictors. Those predictors belonged to clinical renditions, such as activity restriction, duration of illness, and nature of conditions, are proved to be the most potent independent variabes. Level of education and monthly family income are also significant in terms of beta coefficient. Further studies are called for to unreveal the determinants of medical expenditures.

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Macroeconomic Environments and Demand for Retail Space in Shopping Centres in Malaysia

  • ZAKARIA, Zukarnain;ISMAIL, Mohd Roslan;ARUMUGAM, Vijayesvaran
    • The Journal of Asian Finance, Economics and Business
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    • 제8권10호
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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.