• KDI Journal of Economic Policy
• /
• v.30 no.2
• /
• pp.99-128
• /
• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• The Journal of Korean Medicine
• /
• v.32 no.6
• /
• pp.67-73
• /
• 2011

Objectives: To examine the overview of fatigue-related health conditions in the Korean general population. Methods: Data were collected from 2,203 adults (1,126 men and 1,077 women) via a self-reporting questionnaire and their sleeping, exercise, stress, physical problems, use of functional food, and fatigue status were analyzed. Results: The average sleeping hours was about $6.6{\pm}2.0$ hrs per day, and 24.3% of subjects didn't exercise (over 30 min) in a week. Around 16.5% of subjects were under severe stress, and 46.1% (36.9% male vs. 55.6% female) had had trouble with at least one form of physical distress including dyspepsia, headache or muscular pain. 45.4% (37.2% male vs. 53.9% female) of subjects used functional supplements. 46.3% (42.8% male vs. 50.0% female) of subjects complained of chronic fatigue, and they were significantly different compared with no-fatigue subjects regarding severe stress status (8.6% vs. 24.0%), frequency of physical distress (33.2% vs. 69.9%), and use of functional supplements (41.6% vs. 49.8%). Conclusion: This result first reports the features of fatigue-related health conditions including prevalence of chronic fatigue in the Korean population. This data could be helpful to develop fatigue-focused traditional Korean medicine in the future.

• CELLMED
• /
• v.3 no.4
• /
• pp.29.1-29.11
• /
• 2013

Certain dietary contents, biological supplements might influence the occurrence or treatment of epilepsy. Some studies have found that the supplementation with individual nutrients reduced seizure frequency or improved other aspects of health in patients with epilepsy. Potentially beneficial dietary interventions include treating blood glucose dysregulations. Identifying and avoiding allergenic foods, and avoiding suspected triggering agents such as alcohol, aspartame, and monosodium glutamate. The Atkins diet (very low in carbohydrates) is a less restrictive type diet that may be effective in some cases. Nutrients that may reduce seizure frequency include vitamin B6, magnesium, vitamin E, manganese, taurine, dimethylglycine, and omega-3 fatty acids. Administration of thiamine may improve cognitive function in patients with epilepsy. Supplementation with folic acid, vitamin B6, biotin, vitamin D, and L-carnitine may be needed to prevent or treat deficiencies resulting from the use of anticonvulsant drugs. Vitamin K1 has been recommended near the end of pregnancy for women taking anticonvulsants. Melatonin may reduce seizure frequency in some cases, and progesterone may be useful for women with cyclic exacerbations of seizures. In most cases, nutritional therapy is not a substitute for anticonvulsant medications. However, in selected cases, depending on the effectiveness of the interventions, dosage reductions or discontinuation of medications may be possible. However, nutrient supplementation may be necessary to prevent or reverse the effects of certain deficiencies that frequently result from the use of antiepileptic drugs.

• Korean Journal of Human Ecology
• /
• v.16 no.6
• /
• pp.1231-1241
• /
• 2007

This study was conducted to investigate the nutrient supplement use and its related influencing factors by high school students in Chonbuk area. Self administered questionnaires were collected from 489 (urban: 268, rural: 221). Statistical data analysis was completed using a SPSS v. 10.0 program. The results are summarized as follows. According to the general characteristic of subjects, the job and education level of parents and family monthly income respectively affected the nutrient supplement use of subjects (p<0.001). According to the living area, taking a nutrient supplement of parents and nutritional information respectively affected the nutrient supplement use of subjects (p<0.001). About 42.2% of subjects, who taking a nutrient supplement, responded to take a traditional medicine type, and 24.4% of them a multivitamin. Their mothers were important recommended person. The main reason for taking was 'to recommended from parent' (38.5%) and 'recovery from tiredness' (29.6%). The main reason for not-taking was that they were health, therefore nutrient supplements were not necessary. In the future about 43.7% of urban and 33.9% of rural area responded to take a nutrient supplements (p<0.05). These findings show that the behaviors of nutritional supplement usage by subjects are not reasonable, and their supplement usage tends to be affected by general characteristics. Therefore, nutritional understanding and education that are intended to from reasonable behaviors toward nutritional supplement usage of adolescents should be provided with considering the relationship between general characteristic of subjects and supplement usage.

• Journal of Ginseng Culture
• /
• v.1
• /
• pp.93-109
• /
• 2019

This study aims to look at the process of ginseng being removed from the Western pharmacopoeia in the 19th century, experiencing a crisis as an export product in the America in the 20th century, and eventually settling in the U.S. society and the military as a dietary supplement in the 21th century. In this process, the legislation of provided a bridgehead for ginseng and other botanical dietary supplements to enter the U.S. market. As a result, ginseng could be re-listed in the U.S. pharmacopoeia as a dietary supplement. However, this did not mean a complete soft landing of ginseng and other botanical dietary supplements in the America. The U.S. medical community, which has been afraid of the indiscriminate spread of botanical dietary supplements, has constantly raised "the risk-discourse" and expressed concerns over the use and abuse of botanical dietary supplements that have not been scientifically verified. This involved not only the fundamental problems caused by the lax verification process of , but also a new atmosphere in the U.S. where the public sought information about botanical dietary supplements rather than seeking professional clinicians related to their health. Against this situation, "the advocate-discourse" suggested by dietary supplement manufacturers and the people in charge of botanical products seemed rather relaxed. As consumers are taking this side, the advocates had only to stress that botanical dietary supplements have been used worldwide for a long time without any problems and were made from 'natural' materials. The fact that ginseng and other botanical dietary supplements were able to advance to the U.S. Military's dietary supplement manual, which is strict in controlling food, seems to have jumped on the bandwagon of this atmosphere in the U.S. Society. In the early U.S. dietary supplement manual reviewed in this paper, ginseng was the most detailed among many botanical dietary supplements. Although there are some 'safety concerns' that still exist in the civilian society, but there are also certainly good scientific explanations for the efficacy and references to the popularity and influence of ginseng in the American society. Given this, the U.S. society and military's interest in ginseng as a dietary supplement seem quite high.

• Journal of the Korean Society of Food Culture
• /
• v.29 no.4
• /
• pp.364-371
• /
• 2014

The purpose of this study was to estimate usage of vitamin and mineral supplements as over-the-counter (VM-OTC) drugs as well as examine factors associated with VM-OTC usage in Korean adolescents. A total of 1,407 adolescents attending middle or high school in all parts of country were included in the analysis. Prevalence of VM-OTC usage was 56.1%, and it was higher as monthly income, father's education level, and socioeconomic status of family increased (p<0.001). VM-OTC intake was higher in middle school students than in high school students as well as in rural areas or small & mediumsized city residents than big city residents (p<0.01). Subjects mainly received information on VM-OTC mainly from 'family and relatives' (46.6%), whereas only 20.3% received information from experts. Subjects took VM-OTC 'when they are healthy' (49.1%), 'when they feel sick' (17.7%), 'when they are on a diet' (17.3%), and 'when they are stressful' (15.9%). The effectiveness of taking VM-OTC were mainly 'fatigue recovery' (35.0%), 'health improvement' (30.6%), and 'nutritional status improvement' (13.2%). The most frequently used VM-OTC was vitamin C (49.1%), multi-vitamins (18.6%), multi vitamins & minerals (13.2%), and calcium (9.2%). Among VM-OTC users, only 21.9% replied that they usually check the nutrition facts when they buy products, 62.4% follow the recommended dosage, and 9.7% fully understand the nutrition labels of the products. According to logistic regression analysis, the most influential factor affecting VM-OTC use was parents' and siblings' VM-OTC consumption (p<0.001). In addition, school type (middle or high school) (p<0.01), residence (p<0.05), self-concerns about health (p<0.05), father's education level (p<0.05), and socioeconomic status of family (p<0.05) all influenced VM-OTC use. These results show that VM-OTC use is widespread among adolescents, few users actually check and fully understand the nutrition labels when they purchase VM-OTC, and they are highly dependent on unprofessional advice and information. Therefore, it is necessary to educate adolescents to help them select proper VM-OTC and read nutrition labels.

• Asian-Australasian Journal of Animal Sciences
• /
• v.19 no.9
• /
• pp.1271-1282
• /
• 2006

The objective of this study was to investigate the effects of either maize or sulla silage supplementation to grazing dairy cows in summer. Forage mixtures used in the four week trial were based on previous experimental results but inclusion of rumen fistulated cows in five treatments enabled rumen sampling and use of in sacco incubations to determine the diet effects on digestion kinetics. Sulla and maize silages were used to supplement pasture and to meet minimum requirements for dietary protein concentration. Five groups of ten cows were grazed on a restricted daily allowance of 18 kg dry matter (DM) pasture/cow to simulate a summer pasture deficit, and four of these five groups received an additional 6 kg DM $cow^{-1}d^{-1}$ of silage (sulla, maize, or sulla and maize silages). A sixth group was given a relatively unrestricted (38 kg DM $cow^{-1}d^{-1}$) pasture allowance. The silage mixtures and pasture were incubated in sacco during the final week of the trial. The pasture was of high nutritive value and not typical of usual summer conditions, which favoured a response to quantity rather than quality of silage supplements. There was no difference in cow performance with the four silage supplements and the low milk solids (MS) production (about 1.0 kg $MS\;d^{-1}$) relative to full pasture (1.3 kg $MS\;d^{-1}$) showed the principal limitation to performance was dry matter intake. Milk composition was not affected by silage type and the low level of pasture substitution (0.29) suggested metabolizable energy (ME) was the principal limitation to performance. Samples of rumen liquor and in sacco data demonstrated significant effects of supplement; DM degradation rates (k) was highest ($0.084h^{-1}$) when cows were fed 6 kg sulla silage whereas diets with a high proportion of maize silage were slowly degraded (p<0.01).

• Journal of the East Asian Society of Dietary Life
• /
• v.22 no.3
• /
• pp.341-349
• /
• 2012

This study was aimed to investigate whether or not black soybean supplements affect levels of lipid profiles and female hormone (estradiol; E2, estrogen; Es) in 57 middle-aged women (in their 40s and 50s). All subjects were randomly assigned to the control or black soybean supplement group (BSS group). The BSS group was allocated to use dietary black soybean supplements (100 g/day) for 8 weeks. The BSS subjects were divided into two subgroups; 14 women were in the premenopausal group and 15 were in the postmenopausal group. We measured lipid profiles, female hormones and nutrient intakes at 0 weesk and 8 weeks. After 8 weeks, high-density lipoprotein (HDL) cholesterol was significantly decreased (P<0.01) and the athrogenic index (AI) was significantly increased (P<0.01) in control group. In BSS group, triglyceride (TG) (P<0.05), low-density lipoprotein (LDL) cholesterol (P<0.01) and LDL-HDL ratio (LHR) (P<0.01) were significantly decreased. However, E2 and Es were significantly increased (P<0.01). Compared to the control group, the BSS group revealed statistically significant improvements in the levels of TG, HDL-cholesterol, AI, LHR, E2 and Es (P<0.05). In the premenopausal group, HDL-cholesterol (P<0.05), E2 (P<0.01) and Es (P<0.05) were significantly increased and AI (P<0.01) and LHR (P<0.01) were significantly decreased after 8 weeks. In the postmenopausal group, E2 (P<0.05), and Es (P<0.05) were significantly decreased. However, total cholesterol (TC) was increased (P<0.01). Compared to the postmenopausal group, the premenopausal group was significantly improved on HDL-cholesterol, LDL-cholesterol and LHR (P<0.05). In conclusion, black soybean supplements may have beneficial effects on improving lipid profiles and female hormones.

• Advances in Traditional Medicine
• /
• v.6 no.4
• /
• pp.274-285
• /
• 2006

Allium sativum (Family Amaryllidaceae or Liliaceae) is used worldwide for various clinical uses like hypertension, cholesterol lowering effect, antiplatelets and fibrinolytic activity etc. Due to these common house hold uses of Allium sativum, as a herbal supplements, and failure of patients to inform their physician of the over-the-counter supplements they consume leads to drugnutrient interactions with components in herbal supplements. Today these types of interactions between a herbal supplement and clinically prescribed drugs are an increasing concern. In vitro studies indicated that garlic constituents modulated various CYP (cytochrome P450) enzymes. CYP 3A4 is abundantly present in human liver and small intestine and contributes to the metabolism of more than 50% of commonly used drugs including nifedipine, cyclosporine, erythromycin, midazolam, alprazolam, and triazolam. Extracts from fresh and aged garlic inhibited CYP 3A4 in human liver microsomes. The in vivo effects of garlic constituents are found to be species depended and the dosing regimen of garlic constituents appeared to influence the modulation of various CYP isoforms. Studies have indicated that the inhibition of various CYPs by organosulfur compounds from garlic was related to their structure also. Studies using in vitro, in vivo, animal and human models have indicated that various garlic constituents can be the substrates, inhibitors and or inducers of various CYP enzymes. The modulation of CYP enzyme activity and expression are dependent on the type and chemical structure of garlic constituents, dose regime, animal species and tissue, and source of garlic thus this review throws light on the possible herb drug interaction with the use of garlic.

• The Journal of Internal Korean Medicine
• /
• v.29 no.1
• /
• pp.160-176
• /
• 2008

Objective : We designed this study to analyse the Natural Standard methodology and apply the results to new study and evaluation methods. Methods : We investigated the main stream of complementary and alternative medicine (CAM), the methodology of Natural Standard, guideline in CAM, and concrete 35 cancer-related herbs and dietary supplements in 98 ones. Results : There are 35 graded herbs and supplements associated with cancer in natural standard contents: 9 foods, 17 herbs, 7 amino acids, enzymes and vitamins, and 2 herbal mixture formulas. Most of them get a grade of C: unclear or conflicting scientific evidence. Conclusion : Natural Standard aims to provide high-quality, reliable information about CAM therapies to clinicians, patients, and healthcare institutions. The more demands for and use of CAM grows, the more the needs for related studies increases. According to this international and multidisciplinary collaborative effort, we have to develop how to study and evaluate the results. We need guidelines in association with the evidence and recommendations of CAM.