• Title/Summary/Keyword: out-of-pocket

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The Benefits of the National Health Insurance and Oriental Medical Services (건강보험의 보장성과 한방의료 급여확대방안)

  • Kim, Yoon-Hee;Kim, Jin-Hyun
    • 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.

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Determinants of Out-of Pocket Health Insurance Expenditure by the Employed in the US. (미국 근로자 가계의 의료보험지출과 영향요인)

  • 김혜연;홍성희
    • Journal of the Korean Home Economics Association
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    • v.39 no.3
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    • pp.93-105
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    • 2001
  • The purpose of this study was to examine the factors associated with health insurance expenditures of the employed in the US. The data were from the 1994 Consumer Expenditure Surrey and the sample selected was admits aged 18 to 64 who were either a single head of household or part of a married couple. Results of Tobit regression indicated that age, education, and occupation of household head, region of residence, number of earners, homeownership(as a proxy for wealth), total expenditure(as a proxy for income), health care expenditures(as a proxy for health status) are significantly related to out-of-pocket health insurance expenditures by the employed.

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A Study on the Factors Influencing Medication Compliance At Community Pharmacies - Based on The 3rd (2005) Korea National Health and Nutrition Examination Survey Data - (외래약국 복약이행도에 영향을 미치는 요인 연구 - 제3기(2005년) 국민건강영양조사자료를 근거로 -)

  • Kwon, Jin-Won;Park, Eun-Ja;Sohn, Hyun-Soon
    • YAKHAK HOEJI
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    • v.55 no.6
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    • pp.500-509
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    • 2011
  • This study was to identify factors influencing drug compliance based on the subjects' interview regarding community pharmacy utilization for 2 weeks, in 2005 KNHANES. Good compliance was regarded as important factors in improving the effectiveness and minimizing adverse drug reaction, resulting in reducing the medical costs. 83% of total 11,208 pharmacy visits in 7,066 subjects showed good compliance. Good satisfaction for pharmacist's medication counseling (OR=2.23, 95% CI 1.92-2.58), higher out-of-pocket money (OR=1.32, 95% CI 1.14-1.54), and users of prescription drugs than non-prescription (OR=2.21, 95% CI 1.91-2.57) drugs were significant factors for better compliance. Disease of nervous system and mental and behavioral disorders showed lower drug compliance.

Estimating the Cost of Air Pollution on Morbidity: Focusing on Hospital Visit for Acute Respiratory Diseases (대기오염으로 인한 건강효과의 경제적 비용 -급성 호흡기 질환 외래환자를 중심으로-)

  • Shin, Young Chul
    • Environmental and Resource Economics Review
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    • v.11 no.4
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    • pp.659-687
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    • 2002
  • This study used a discrete choice model to investigate an association between air pollution and hospital visits for acute respiratory symptoms with the national health interview survey conducted in 1998 in South Korea. The results showed that $NO_2$ and TSP were significantly related to hospital visits in a single-pollutant model, but when they were simultaneously considered, only $NO_2$ remained significant. It was estimated as $NO_2$ level increased by 10%(0.0027ppm) from 0.027ppm (the mean $NO_2$ level), hospital visits increase by 0.176%. This study also measured respondent's out-of-pocket expense and the time cost for commuting and waiting for the visit. We found that on the average, out-of-pocket expense is 5,600 won per hospital visit, but the total cost per hospital visit is measured at 33,440 won with time cost of commuting and waiting at 27,840 won. Time cost was over 63.6~83.3% of the total cost per hospital visit.

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The Clinical and Microbiological Study of the Effect of Minocycline Strip Locally Administrated on Adult Periodontitis (성인성 치주질환에서 미노클린 국소송달제 효과에 대한 연구)

  • Choi, Seong-Ho;Hyun, Suk-Ju;Koo, Hyun-Seo;Suh, Jong-Jin;Cho, Kyoo-Sung;Chai, Jung-Kui;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.28 no.2
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    • pp.193-203
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    • 1998
  • 20 Subjects with clinical diagnosis of adult periodontitis with sites having average pocket depth of 4mm were selected for the study. After scaling and root planing of those sites, 30% minocycline-HCI contained in biodegradable device were inserted in one group, scaling and root planing was carried out in another group and the last group was without any periodontal treatment. the difference between the group was detemined by pocket dept, bleeding on prbing, attachment level, distribution of subgingval plaque bacteria. Conclusion was made for the comparisons between baseline and 4 week and the groups. 1. In analysis of pocket depth, there was significant sifference in scaling and root planing group only. 2. Both the scaling and root planing group and minocycline group showed significant decrease in bleeding on probing. 3. There was significant increase in the attachment level in scaling and root planing group, but no difference was foundbetween the groups. 4. There was significant decrease in the total number of subgingival bacteria in all groups and the number of motile bacteria decreased significantly in the minocycline group. These result indicate that insertion of Minocycline-HCI at the base of periodntal pocket was useful as an additional aid of mechanical trarment at the point of periodontal pocket, bleeding on probing, attachment level, microbial distribution.

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Effects of metronidazole gel as an adjunct to scaling and root planing on the treatment of adult periodontitis (치근면 활택술후 metronidazole gel의 치료효과에 관한 연구)

  • Lim, Sang-Cheol
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.57-70
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    • 1998
  • The purpose of this study was to evaluate the clinical and microbiological effects of metronidazole 25% dental gel that was applied to periodontal pockets who have moderate to advanced chronic adult periodontitis were selected for this study. The quadrants that had 2 or 3teeth with 5-8mm probing pocket depth were selected and divided into test side and control side according to the split-mouth design. The metronidazole 25% dental gel applied on test side and 0.12% chlorhexidine solution applicated on positive control side, normal saline irrigation into periodontal pocket was applicated to negative control side respectively. Above procedures followed scaling and root planing at baseline(0week). The subgingival sterile saline irrigation and chlorhexidine irrigation were done for about 30 seconds respectively. The metronidazole 25% dental gel was applied to periodontal pocket at 0,1 week in the test side. The clinical and microbiological analysis carried out at baseline(0week) and 4,8 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth were significantly reduced in the test group. The relative proportions of spirochetes and motile rods were significantly reduced to negative control group and the proportion of cocci was correspondingly increased in the test group. 2. The sulcular bleeding index, probing pocket depth were significantly reduced in metronidazole group. and, there was a significant differences between 2 groups. Also, the relative proportions of spirochetes and motile rods were reduced in both group. And, there was a significant differences between 2 groups. In conclusion, application of metronidazole 25% dental gel as an adjunct to mechanical debridement of root surfaces may improved the clinical and microbiological status of periodontal disease sites.

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Household Out-of-Pocket Payments and Trend in Korea (가계직접부담 비용의 현황과 추이)

  • Park, Yoonsik;Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.3
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    • pp.374-378
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    • 2019
  • After the announcement of Moon Jae-in Government's plan (Moon's Care) for Benefit Expansion in National Health Insurance in August 2017, it is necessary to monitor the effects of the policy, especially household out-of-pocket payments (OOP). This paper aims to observe the current status and trend of OOP in Korea. Current health expenditure (CHE) was 144.4 trillion won in 2018, which accounts for 8.1% of gross domestic product (GDP) increased 9.7% from the previous year. Although GDP's share of CHE has been close to the average of the Organization for Economic Cooperation and Development (OECD) countries, the public fund's share was 59.8% of the total in 2018, which was lower than the OECD average of 73.5%. OOP's share was 32.9% in 2018, which decreased from 37.4% in 2008. The share of OOP of non-covered services was 20.0% in 2018, which decreased from 22.9% in 2008. The share of cost-sharing with third-party payers was 12.9% in 2018, which decreased from 14.5% in 2008. The OOP of non-covered services was significantly decreased in hospital and inpatient curative care, but the OOP of non-covered services was significantly increased in the medical clinic. The effect of Moon's Care was not showed in OOP through the results of 2017 and 2018, but further monitoring is needed because the Moon's Care is progressing and the observational period is short.

Utilization and Out-of-pocket Expenditure of Complementary and Alternative Medicine in Low-income Patients with Osteoarthritis in a City (일개 시지역 저소득 골관절염 환자의 보완대체요법 이용실태 및 비용 -의료급여 및 건강보험하위 20% 대상자를 중심으로-)

  • Kam, Sin;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.33 no.2
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    • pp.181-192
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    • 2008
  • Objective: The use of complementary and alternative medicine (CAM) is common especially among patients with osteoarthritis The aim of this study was to investigate the utilization rate and expenditures of patients who use CAM. Method: Two hundred seventy four patients with osteoarthritis were interviewed by a telephone survey. A structured questionnaire about sociodemographic features and type, cost, satisfaction and reason of CAM utilization was used Results: Among 274 patients with osteoarthritis, 251 patients(91.6%) had used at least one type of CAM during six months. There was a significant difference in sex (female), age (70 years), medical security (insurance), educational level between the user and non-user of CAM. Hyperthermia was the most use. The average cost for CAM utilization was 120 thousands won/person during six months and there was no difference in sociodemographic features among the out-of-pocket cost of users. The scores of satisfaction for CAM use were ranged between 60-70. Conclusions: CAM became a popular source of health care because of elderly and lay referral system. And Korean spent a substantial amount of out-of-pocket money on CAM without benefit. Health care system and professionals should pay more attention to CAM, make a evidence for CAM.

The Effect of Co-insurance Reduction Policy on the Average Length of Stay and the Cost of Hospital Admission of Patients under Age of 15 (15세 이하 입원 진료비 본인부담 경감 정책이 평균재원일수 및 입원 진료비 변화에 미친 영향 분석)

  • Kim, Hyunhwa;Kim, Heenyun;Jeong, Hyojeong;Seo, Youngjoon
    • Korea Journal of Hospital Management
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    • v.26 no.3
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    • pp.1-12
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    • 2021
  • Purpose: This study aims to examine the effect of the copayment reduction policy on the health care utilization of patients under age 15 after the policy started in 2017. (이하는 아래 methodoloty로 이동) Methodology: Data on the ALOS, the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age from 2015 to 2019 were obtained from the National Health Insurance database. Policy effects were measured by analyzing three dependent variables before and after policy: the average length of stay (ALOS), the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age. The collected data were analyzed using the SAS package, and the analysis methods used in this study were the mean difference test and linear regression analysis. Findings: The study results reveal that, after the copayment reduction policy in the year 2017, the ALOS and the out-of-pocket expenditure were significantly decreased, but the average admission cost was significantly increased. Practical Implications: These results imply that the policy of copayment reduction for the patients under the age of 15 has contributed to mitigating the patients' financial burden with little concern about growing medical utilization.

Analysis of Influencing Factors of High-Cost Beneficiaries of Catastrophic Health Expenditure Support Project (재난적의료비 지원사업의 고액수급자 영향요인 분석)

  • Nayoung Kim;Haejong Lee;Seungji Lim
    • Health Policy and Management
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    • v.33 no.4
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    • pp.400-410
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    • 2023
  • Background: As the government has recently been discussing the expansion of the disaster health expenses support project, we would like to confirm the characteristics of beneficiaries of the support project, particularly those of high-cost beneficiaries. Methods: Using the database of catastrophic health expenditure support project from 2019-2020, this study aims to confirm the characteristics of high-cost beneficiaries focusing on the overlap of the relieved out-of-pocket systems, known as the out-of-pocket ceiling system and the system for rare incurable diseases. Logistic regression analysis is used to examine this issue. Results: In order to analyze the factors influencing high-cost beneficiaries, five models were created and analyzed, including the status of duplicated beneficiaries for relieved out-of-pocket systems, sociodemographic and economic factors, and individual health status as sequential independent variables. All five models were statistically significant, of which economic factors had the greatest impact on the model's predictions. The main results indicated that those who benefited from multiple systems in duplicate were more likely to be high-cost beneficiaries, and there is a higher probability of incurring high health expenses among the underage. In addition, within the beneficiaries of catastrophic health expenditure support project, it was observed that higher health insurance premium percentiles are associated with a higher proportion of high-cost beneficiaries. Conclusion: This study examined the characteristics of high-cost beneficiaries by encompassing reimbursement and non-reimbursement. According to this study, it is expected to be used as basic data for setting priorities and improving the current criteria of catastrophic health expenditure support project, aiming to sequentially expand the program.