• Title/Summary/Keyword: the inequality of health

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Fairness of Health care financing: Progressivity and Retstributive Effect (가구 소득과 보건의료비 지출의 형평성 : 누진성과 소득재분배 효과)

  • 신호성;김명기;김진숙
    • Health Policy and Management
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    • v.14 no.2
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    • pp.17-33
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    • 2004
  • The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.

Changes in Distributive Equity of Health Insurance Contribution Burden (건강보험료 부담의 형평성 변화)

  • Kang, Hee-Chung;Park, Eun-Cheol;Lee, Kyu-Sik;Park, Tae-Kyu;Chung, Woo-Jin;Kim, Han-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.1
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    • pp.107-116
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    • 2005
  • Objectives : We analyzed the changes from 1996 to 2002 in distributive equity of the contribution burden in the Korean National Health Insurance. Methods : The study subjects were a total of 8,923 employee households and a total of 7,296 self-employed households over the period from 1996 to 2002. Those were the households meeting the two criteria as completing each annual survey and having no change in the job of head of the household during that period from the raw data of the Household Income and Expenditure Survey annually conducted by the Korean National Statistical Office. The unit of analysis was a household, and this was the standard for assessing the contribution that is now applied on a monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and Contribution Concentration Index were estimated as the index of inequality. Multiple regression analysis was conducted to compare the annual ability-to-pay elasticity of the contribution to the reference year of 1996 for three groups (all households, the employee households, and the self-employed households). Results : For the index of inequality, the distributive equity of contribution was improved in all three groups. In particular, the employee group experienced a substantial improvement. Using multiple regression analysis, the ability-to-pay elasticity of the contribution in the employee group significantly increased ($\beta$=0.232, p<0.0001) in the year 2002 as compared to the reference year of 1996. The elasticity in the self-employed group also significantly increased ($\beta$=0.186, p<0.05), although its change was smaller than that in the employee group. Conclusions : The employee group had a greater improvement for the distributive equity of the contribution burden than the self-employed group. Within the observation period, there were two important integration reforms: one was the integration of 227 self-employed societies in 1998 and the other was the integration of 139 employee societies in 2000. We expected that the equity of the contribution burden would be improved for the self-employed group since the integration reform of 1998. However, it was not improved for the self-employed group until the year 2000. This result suggests that capturing exactly the beneficiaries' ability-to-pay such as income is the precedent for distributive equity of the contribution burden, although a more sophisticated imposition standard of contribution is needed.

Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models

  • Mansori, Kamyar;Solaymani-Dodaran, Masoud;Mosavi-Jarrahi, Alireza;Motlagh, Ali Ganbary;Salehi, Masoud;Delavari, Alireza;Asadi-Lari, Mohsen
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.1
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    • pp.33-40
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    • 2018
  • Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The $Besag-York-Molli{\acute{e}}$ (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in at-risk areas.

The Effect of Incidence of Ankle Sprains on Both Leg Length Inequalities and Range of Motion of Ankle Joint in 20's Female University Students (20대 여대생의 양다리길이차이 및 발목관절가동범위가 발목 염좌 발생률에 미치는 영향)

  • Park, Jong-Hang;Jeong, Yeon-Woo;Kim, Tae-won
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.21 no.1
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    • pp.29-35
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    • 2015
  • Background: The purpose of this study was conducted to investigate the effect of incidence of ankle sprains on both leg length inequalities and range of motion of ankle joint in 20's female university students. Methods: 20's female university students were targeting 32 people attending K university in Gwangju. Both leg length inequality was measured using a tape measure, ranges of motion of ankles was measured using a goniometer. Results: The ankle sprain incidence was quite high, with 56.25% (n=18) for the right ankle, 34.38% (n=11) for the left ankle, and 9.38% (n=3) for both. As for the difference between the ankle sprain incidence and both leg length, the average value of the right leg was $83.08{\pm}3.69$, the average value of the left leg was $84.28{\pm}3.27$, making the right leg shorter than the left by 1.2cm with a higher incidence and showing a positive statistical correlation between the two (p<.05). Also showed that there was a negative statistical correlation between ankle sprain incidences and the inversion range of motion spread of the right ankle (p<.05). Conclusion: The incidence of ankle sprains was higher for the larger the difference between both leg length inequality. In addition, the smaller the inversion range of motion spread of the right ankle, the higher the incidence of ankle sprains. Therefore, The evidence suggests that the incidence of ankle sprains can be reduced by recommending stability and efficient exercises that take into consideration the both leg length as well as the ranges of motion of ankle joints.

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The SOC, Capacity-fade, Resistance-fade Estimation Technique using Sliding Mode Observer for Hybrid Electric Vehicle Lithium Battery (하이브리드 자동차용 리튬배터리의 충전량, 용량감퇴, 저항감퇴 예측을 위한 슬라이딩 모드 관측기 설계)

  • Kim, Il-Song;Lhee, Chin-Gook
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.5
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    • pp.839-844
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    • 2008
  • A novel state of health estimation method for hybrid electric vehicle lithium battery using sliding mode observer has been presented. A simple R-C circuit method has been used for the lithium battery modeling for the reduced calculation time and system resources due to the simple matrix operations. The modeling errors of simple model are compensated by the sliding mode observer. The design methodology for state of health estimation using dual sliding mode observer has been presented in step by step. The structure of the proposed system is simple and easy to implement, but it shows robust control property against modeling errors and temperature variations. The convergence of proposed observer system has been proved by the Lyapunov inequality equation and the performance of system has been verified by the sequence of urban dynamometer driving schedule test. The test results show the proposed observer system has superior tracking performance with reduced calculation time under the real driving environments.

The Influence of Sacroiliac Joint Mobilization on Lower Extremity Muscle Strength (천장관절 가동술이 하지 근력에 미치는 영향)

  • Gong, Won-Tae;Ma, Sang-Yeol;Kim, Byoung-Gon
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.2
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    • pp.101-112
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    • 2007
  • Purpose : The purpose of this study was to evaluate influence of sacroiliac joint mobilization on lower extremity muscle strength. Methods : The subjects were consisted of thirty patients who had Leg length inequality(LLI) of more than 10mm(16 females. 14 males) from 21 to 41 years of age(mean aged 24.87). All subjects randomly assigned to sacroiliac joint mobilization group(n=15), control group(n=15). sacroiliac joint mobilization group received sacroiliac joint mobilization about 10 minutes for 3 times per week during 4 weeks period. Control group not received intervention during 4 weeks period. The tape measure method(TMM) was used to measure functional Leg length inequality. Biodex System 3 Pro was used to measure strength of Knee extension & flexion. All measurements of each subjects were measured at pre-test, 2weeks post-test and 4weeks post-test. Results : 1. The LLI of sacroiliac joint mobilization group was significantly reduced according to within treatment period(p<.05), most significantly reduced between pre-test and post-test(p<.05). sacroiliac joint mobilization group significantly more reduced than control group(p<.05). 2. The knee extension strength of sacroiliac joint mobilization group was significantly increased according to within treatment period(p<.05), most significantly increased between pre-test and post-test(p<.05). sacroiliac joint mobilization group significantly more increased than control group(p<.05). 3. The knee flexion strength of sacroiliac joint mobilization group was significantly increased according to within treatment period(p<.05), most significantly increased between pre-test and post-test(p<.05). sacroiliac joint mobilization group significantly more increased than control group(p<.05). Conclusion : sacroiliac joint mobilization can reduce LLI and increased lower extremity muscle strength.

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Analysis of health inequality by the type of employment on health among employees - Pathway of the effect via the exposure of hazardous factors - (임금근로자의 고용형태에 따른 건강수준의 차이 분석 - 유해위험요인 노출을 경유한 영향 경로 -)

  • Rhee, Kyung Yong
    • Journal of the Korea Safety Management & Science
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    • v.16 no.2
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    • pp.81-90
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    • 2014
  • Flexible production system has been expanded to all sectors of economy with the change of labor market and diversification of employment. The unstable employment with irregular work has replaced stable employment with regular work. This study has investigate the impact pathway of the type of employment on health status especially ill-health symptoms experiences. Among the first Korean Working Conditions Survey data, the employee's response data was used to analyze the path way with multiple regression analysis. The result has shown the direct effect of the type of employment on ill-health symptoms experience. Indirect effect of the type of employment was found the pathway via the exposure to noise, high temperature, low temperature, dust, skin contact to chemicals, painful posture, heavy material handling, standing position, repetitive movement of hands. However the exposure to the other hazardous factors such as organic solvent, wholebody vibration, radiation, lifting people, infectious materials were not influenced by the type of employment.

Family Role Status and Physical/Mental Health of Men and Women : Who is More Vulnerable? (남녀의 가족 역할 점유와 건강 문제)

  • Cha, Seung-Eun;Han, Kyung-Hae
    • Korea journal of population studies
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    • v.29 no.2
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    • pp.167-194
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    • 2006
  • The purpose of this research is to examine the impact of marriage and parenthood on the physical and mental health, in consideration of gender differences. We have retested various theories including Gove's inequality theory to explain how marriage and parenthood affect the contemporary Korean men and women. This study tries to answer these questions by analyzing the data from ${\ulcorner}$Successful Midlife Development: Survey on Mental health and Work/Family Life Course in Korea and the United States (Han et at., 2001)${\lrcorner}. The data were collected from the survey of 1696 adults (women: 49.5% (n=839)) at the age of 27 to 60. In this survey, physical and mental health were evaluated in three dimensions, respectively: depression, perceived physical health and illness symptoms. The results were that occupying both marital and parental status showed better health profile than possessing other role combinations(single parent/married but no child/never-married). Gender differences and other findings have been discussed further.

Regional Factors Affecting the Avoidable Mortality: 2010~2019 (회피가능한 사망에 미치는 지역 영향요인 분석: 2010~2019)

  • Lee, Hyun-Ji;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.27 no.1
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    • pp.43-57
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    • 2022
  • Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region. Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate. Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect. Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

Factors related to the difference in the incidence of caries between children in fluoridated and non-fluoridated areas (수돗물불소농도조정사업 지역과 비사업지역 아동 간의 치아우식 발생 격차 관련요인)

  • Han, Sang-Jun;Kwon, Yong-Bong;Kim, Se-Yeon;Kim, Ji-Soo;Lee, Jung-Ha;Kim, Jin-Bom
    • Journal of Korean Academy of Oral Health
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    • v.42 no.4
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    • pp.136-144
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    • 2018
  • Objectives: The aim of this study is to analyze the differences in factors related to the incidence of dental caries between children in fluoridated and non-fluoridated areas and compared the DMFT and DMFS scores to confirm the effect of water fluoridation program (WFP) in Geoje and Changwon. Methods: The oral health examination and questionnaire survey were conducted in fluoridated and non-fluoridated areas. The number of surveyed children aged 8, 10, and 12 years in the fluoridated and non-fluoridated area of two cities was 1,524 and 1,383, respectively. Self-recorded questionnaires included self-perception of their own dental health, daily toothbrushing frequency, intake frequency of cariogenic sweet snacks and beverages, experience of gingival bleeding, experience of unmet dental treatment, and use of oral hygiene device except for toothbrush and toothpaste. The prevalence of caries and fissure-sealant status were surveyed. The logistic regression analysis was used to analyze the difference in children's self-rated oral health status between the fluoridated and non-fluoridated area. The mean number of sealed teeth and surfaces, marginal means of the DMFT and DMFS scores adjusted for the difference in the samples' sex distribution, and region were compared between the fluoridated and non-fluoridated areas. Results: In the fluoridated area, the experience rate of unmet dental treatments was higher among children aged 10 years, intake frequency of cariogenic sweet snacks and beverages were higher among the whole sample, and experience rate of professional fluoride application were lower than in the non-fluoridated area. The DMFT score for permanent dentition adjusted for differences in sex, region, and mean number of fissure-sealed teeth in the fluoridated area was significantly lower among whole samples and 8-, 10-, and 12-year-olds alone than in the non-fluoridated area. Conclusions: WFP can alleviate oral health inequality because it is effective in reducing the incidence of caries among children is disadvantaged demographic, socioeconomic, and cultural contexts.