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.
Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.
Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.
Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.
Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.
Journal of Korean Home Economics Education Association
/
v.12
no.2
/
pp.107-122
/
2000
The purposes of this study were to investigate the decision making process & preference for imported products and to suggest the systematic education programs for adolescent consumers. The data for this research were attained from 426 middle & high school students in Pohang. The data were analyzed by frequency distribution. mean standard deviation analysis of variance t-test, χ(sup)2-test and Pearson’s correlation with SAS program. The results of this study were as follows: 1. preference for imported products was significantly different according to sex, amount of pocket money, region. T.V advertising, friends and the attitude of their mothers. 2. Decision making process was composed of 4 dimensions in this study; information sources criteria for products problem experience of consumption and type of problem solving. In case of information sources there was a signifiant difference according to sex. grade level of parents’education. Criteria for products were significantly different according to sex grade. level of father’s education type of father’s job amount of pocket money and how they gained their pocket money. Consumption problem experience & type of problem solving were significantly different according to sex and grade. 3. Preference for imported products was significantly different according to criteria for products and consumption problem experience out of adecision making process.
The Journal of Korean Society for School & Community Health Education
/
v.15
no.2
/
pp.51-61
/
2014
Objectives: This study examined the factors affecting the quality of life relating to oral health using OHIP-14 of college students. Also, this was to help college students to enhance their oral health. Methods: A Total of 334 self-administered questionnaires were collected from university student in Cheon-an. The statistical methods used for data analysis were the descriptive statistics, Independent samples t-test, One-way ANOVA, correlation analysis, multiple linear regression analysis. Results: First, A month pocket money and coffee consumption were significantly related to functional and physical Oral health foctor. Second, A month pocket money and coffee consumption were significantly related to Mental and social Oral health foctor. Finally, multiple linear regression analysis showed that a month pocket money, coffee consumption have a negative effect on the quality of life relating to oral health, Whereas an experience of oral health education a positive effect on this. Conclusion: Oral health related quality of life should be improved by investigating the factors affecting oral health and thus developing the program enhancing the oral health to prevent oral disease. In addition, in order to health promotion physical, mental, social, including the oral health, program development and research incessant must be carried out.
This paper outlines the findings of a consumer survey conducted in 1996 and 2001 by the University of Bonn, Germany, across 15 European countries. The survey involved a sample of 3,300 respondents in 1996 and around 11,000 respondents in 2001, throughout all 15 EU countries. Children and adolescents between the ages of 10 and 17 were surveyed on their consumption habits and their attitudes towards the environment. The paper outlines the key findings on "the process of socialization with money". Children come to appreciate the importance of money even before their first day at school. Even young children know you sometimes need cash to fulfil dreams. But the chance to experiment with money for real only comes when children first receive pocket money, usually from their parents. Later, in adolescence, consumer pressure starts to make an impact and it becomes more difficult to make ends meet. Spare time or holiday jobs help top up pocket money and enable adolescents to keep out of debt. This paper reports on a long term comparative study throughout the European Union among children and adolescents, analysed by country, age group and gender. The paper discusses the places young consumers can turn to in trying to fulfil their growing consumer needs. It also examines how much money is at their disposal. It then concludes by considering the influence of "financial socialization" on how young people deal with money.
The purpose of this study is to propose changes that can be made to improve nurse uniforms in terms of outfit and functionality based on actual wearing conditions and nurse's preference. The proposed nurse uniform was composed of a blouse and pants. The design was as follows: the blouse had short set-in sleeve with China collar, a princess line, and it came down to middle hip. Armhole action pleats and back inverted pleats were embedded for convenient arm movements. The pants waist had a rubber band at the back waist, and the crotch length and the knee width were increased for activity. To make the pocket more accommodative, separate pocket slots treated with silicone were added to prevent belongings from coming out of the pocket. The pink tone of the uniforms, as well as the stripes on the blouses and spandex incorporated pants were based on nurses' preference. the nurse uniforms were produced after measuring the size of women in the age of 25 to 29, and the uniform patterns were corrected after two wearing experiments. Wearing test was examined in terms of appearance and functionality. For appearance, experts gave the uniforms a mean rating of 4.30, and nurses gave a mean rating of 4.00. Functionality was evaluated in terms of ease of activity and storage aspects. The total mean of ease of activity in nursing service was 4.30, whereas the evaluation of storage in terms of pocket position and convenience was 3.80.
This study clarifies that Scytian waistband had flowed into the Jeoseon Dynasty, and it was settled down to saezodae(which is male belt) and norigae(which is female accessory) and pocket in the Joseon Dynasty. Historical records and relic materials are examined and analyzed by quality assessment. 5 experts performs sensory evaluation for 17 pictures of Scytian waistband, and 42 of norigae, 24 of pocket, 6 of small knife, 11 of belt in the Joseon Dynasty, and finally similarity in form and purpose of use between both of them are come out. Research results are summarized as follows: First, Scytian waistband made with leather and metal was carried in the girdle. Men in the Joseon Dynasty carried various forms of belts as position and jobs such as saezodae, kwangdahae, dongdahae, doa. Trinkets of hopae, jangdo, pocket, etc. are put on belt or separately attached. Belt was not put on the women dress, but more various trinkets were used than those on men dress. Norigae, pocket, and jangdo were used practically and decoratively. Second, The types of Scytian waistband were excavated from the tumulus in the age of three states in Korea, and their form and function are same. Belt of the Joseon Dynasty carried below their chest and up navel, of which the wearing position went upper than before. As women jeogori was shorter, their belt is not necessary and various trinkets were put in their skirt. Finally, this study conclude that Korean traditional belt and trinkets come down from Scythian waistband.
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