• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• Health Policy and Management
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• v.21 no.2
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• pp.159-178
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• 2011

Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket share of patients of serious case and expanding the medical bill ceiling system to mention just a few. This study proposes to confirm effectiveness of the benefit extension policy by identifying changes in 'out-of-pocket expenditure as a share of the ability to pay' and 'incidence rate of catastrophic health care expenditure' of each individual household as manifested before and after the benefit extension policy was implemented. The 1st and 3rd year data from the Korea Welfare Panel Study (KoWePS), conducted by the Korea Institute for Health and Social Affairs (KIHASA), were used for the analysis, where low-income households and ordinary households are sampled separately. While the absolute amount of 'out-of-pocket expenditure' occurred to the average household increased for the period 2005-2007, the 'out-of-pocket expenditure as a share of the ability to pay' decreased. At the same time, the share decreased in the case of low-income households and households with patients of chronic or serious case as contrasted with ordinary households. 'Incidence rates of catastrophic health care expenditure' of ordinary households for 2007 stood at 14.6%, 5.9% and 2.8% at the threshold of 10%, 20% and 30%, respectively. The rates decreased overall between 2005 and 2007, while those of low-income households with patients of serious case statistically significantly increased. An analysis of this study indicates that it is related with the medical bill ceiling system regardless of incomes introduced in 2007.

• Journal of Korean Academy of Nursing
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• v.34 no.1
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• pp.191-201
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• 2004

Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

• Korean Journal of Artificial Intelligence
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• v.6 no.1
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• pp.16-20
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• 2018

The development of modern information technology has increased the amount of big data about patients' information and diseases. In this study, we developed a prediction model of diabetes using the health examination data provided by the public data portal in 2016. In addition, we graphically visualized diabetes incidence by sex, age, residence area, and income level. As a result, the incidence of diabetes was different in each residence area and income level, and the probability of accurately predicting male and female was about 65%. In addition, it can be confirmed that the influence of X on male and Y on female is highly to affect diabetes. This predictive model can be used to predict the high-risk patients and low-risk patients of diabetes and to alarm the serious patients, thereby dramatically improving the re-admission rate. Ultimately it will be possible to contribute to improve public health and reduce chronic disease management cost by continuous target selection and management.

• Korea Journal of Hospital Management
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• v.13 no.1
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• pp.24-41
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• 2008

This research is aimed at analyzing and understanding the perception and attitudes of inpatients in a general hospital in Seoul towards the activation of private health insurance. Survey was conducted against 231 inpatients, results of which were analyzed in the methods of frequency analysis, chi square test, and logistic regression. The results are summarized as follows; First, better-educated population who finished college education at least, higher-income population, and people who had more knowledge about private health insurance showed more perception about activation of private health insurance. Second, better-educated population who finished college education at least, higher-income population, those who are insured in existing private insurance, oncological patients, and people who had more knowledge about private health insurance showed more positive attitude towards private health insurance paying for actual damages, long-term care insurance, and income security insurance. Third, age and education were the factors affecting perception about activation of private health insurance. The older the age is, perception was 1.035 times positive towards activation of private health insurance, and those who finished college education or above showed 3.148 times positive perception towards the same. Forth, surgical patients showed 1.087 times more positive attitude towards private health insurance paying for actual damages than internal medicine patients, while oncological patients showed 2.314 times more positive attitude than internal medicine patients. Further, understanding on the activation of private health insurance was 6.014 times higher in the higher understanding group than in the lower understanding group. Intention to use long-term care insurance was 2.692 times stronger in the male group than in the female group, and 3.616 times stronger in the oncological patients group than in internal medicine patients group. Further, understanding on the activation of private health insurance was 3.881 times deeper in the higher understanding group than in the lower understanding group. Intention to use income security insurance was 3.185 times stronger in those who have academic background of under the high school than those over the college, and 4.175 times higher in the group those whose monthly average income is over 4 million won than those under 4 million won. Also, intention to use income security insurance was 4.323 times higher in the group those who are insured by existing private insurances than those who are not insured by those insurances and it was 5.234 times higher in the group of oncological patients than in the group of internal medicine patients. Further, intention to use income security insurance was 3.559 times higher in the group those who thought that out-of-pocket money of the National Health Insurance is too much to bear than those it is quite endurable. Understanding on the activation of private health insurance was 4.875 times deeper in the higher understanding group than in the lower understanding group. There were some suggestions could be made based on the results of this research. First, reinforced publicity and education is needed for the low-educated or low-income group, as there are gaps in the understanding on the activation of private health insurance depending on the degree of education and income. Second, government should prepare administrative complementary measures to solve the problem of adverse selection by the consumer which is foreseen when private health insurances are activated. Third, government should suggest the desirable course of development of private health insurance items to ensure efficient use of enormous fund of private insurance market for health security of the people. Further, institutional complementary measures are needed to convert existing cancer insurances or specific disease insurances to private health insurances paying for actual damages guaranteeing against every kind of disease. Forth, it judged that, not only private health insurances paying for actual damages, but also long-term care insurances and income security insurances are prospective as fields to create fresh demand for insurance industry.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2829-2832
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• 2012

Background: This study aimed to research the awareness of screening colonoscopy (SC) among patients with colorectal cancer (CRC) and their relatives. Methodology: A questionnaire form including information and behavior about colonoscopic screening for CRCs of patients and their first-degree relatives (FDRs) was prepared. Results: A total of 406 CRC patients were enrolled into the study, with 1534 FDRs (siblings n: 1381 and parents n: 153). Positive family history for CRC was found in 12% of the study population. Previous SC was performed in 11% of patients with CRC. Mean age of the patients whose FDRs underwent SC was lower than the patients whose FDRs did not (52 vs 57 years; p<0,001). The frequency of SC in FDRs was 64% in patients diagnosed CRC under 35 years of age. Persons having a positive family history of CRC had SC more often (51 vs 22%, p<0,001). FDRs of patients having a higher educational level and income had SC more frequently. Conclusions: When screening for CRC is planned, elderly subjects, those with family history for CRC, and those with low educational and lower income should be given esspecial attention in order that they be convinced to undergo screening for CRC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.6
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• pp.432-437
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• 2021

Objectives: The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods: This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results: A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion: Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

• Health Policy and Management
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• v.22 no.2
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• pp.275-296
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• 2012

Graduate School of Public Health, Seoul National University The national health insurance system in Korea is characterized as relatively high out-of-pocket payments, which are the principal source of catastrophic health expenditure (CHE). The objectives of this study are to estimate the incidence of household CHE and to clarify the characteristics that affect the occurrence and recurrence of household CHE using the Seoul Welfare Panel Survey database for 2008 and 2010. Thresholds to estimate CHE were 10% and 20% of the total household income (T/X), and 25% and 40% of the income excluding food share (T/Y). Determinants of the occurrence and recurrence of CHE at the threshold of T/X=10% were analysed using multiple logistic regression models. Out of the 3,665 households that responded in 2008 survey, households with CHE were 12.07% (T/X${\geq}$10%), 5.34% (T/X${\geq}$20%), 6.84% (T/Y${\geq}$25%), and 4.44% (T/Y${\geq}$40%). Risk factors associated with household CHE included living with a spouse, non-Medicaid beneficiary, householder unemployment, low household income, the number of disabled members, poor subjective health, and the number of chronic diseases. A total of 41.78% of households with CHE in 2008 repeatedly experienced CHE in 2010. Risk factors of CHE recurrence included decreased household income and an increase in chronic diseases over the two time periods, the number of members with disability or chronic diseases, and the presence of cancer patients in 2008. Households with lower socioeconomic and health status had a higher financial burden on health care than do their counterpart households. There is a need to enhance society-wide financial protection from health spending among vulnerable citizens in Seoul, particularly, households with low income, disabled members or cancer patients.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.853-867
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• 1996

This study was designed and undertaken to identify the degree of burden and depression in family caregivers of patients with stroke and to determine whether burden was directly related to depression. The data were collected from October 23th to November 20th, 1995. The subjects in this study were 80 caregivers, that is, one family member and 80 patients with stroke who were hospitalized in one oriental medicine hospital located in Taejon City. The questionnaires consisted of questions regarding burden(13 item, 6 point scale) and depression(20 item, 4 point scale). Data were analyzed using percentages, means, t-test, ANOVA and Peason-correlation coefficients, done with the SAS program. The results of this study are as follows : 1. The score for family caregiver's burden was higher than the mid level for the 13 items. 2. The score for of family caregiver's depression was relatively low. 3. The relationship between burden and depression showed a significant inverse correlation. 4. In the relationships between total burden and general characteristics of the family caregivers : there were no significant differences. But, in the relationship between objective burden and general characteristics of the family caregivers ; age and education had statistically significant differences. That is, the 40's group felt more objective burden than any other age group and the high education group more than the illiterate group. 5. In the relationship between depression and general characteristics of the family caregivers ; sex, education and monthly income had statistically significant differences. That is, female caregivers felt more depression than males, and the lower the level of education and the lower the monthly income, the higher the degree of depression. 6. In the relationships between burden and general charateristics of the stroke patients, only subjective burden according to the patients' sex was significantly different. That is, caregivers felt more subjective burden when caring for male patients than for female patients. 7. In the relationships between depression and general charateristics of the stroke patients, only the patients' economic status showed a statistically significant difference. That is, caregivers felt more depression in case of patients' low economic status.

• The Journal of the Korean dental association
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• v.49 no.6
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• pp.334-339
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• 2011

The purpose of this study was to investigate the oral health condition and dental treatment need of low socioeconomic elderly people. A total of 116 elderly people who visited Boramae Hospital were evaluated with oral examination and panoramic radiogaph. The results showed that the most expecting treatment of low income aged people was removable partial denture. It was very clear in the age group of 70-84. In the age group under 70, most of the patients wanted prosthodontic tratement using fixed partial denture or crown. As the result of this study, elderly people with low socioeconomic status under age 85 needed removable partial denture or fixed prosthesis than complete denture. It is necessary to develop a more expanding and customized Senile prosthetic restoration program.