보건행정학회지 (Health Policy and Management)

  • 제28권4호
  • /
  • Pages.378-391
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  • 2018
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  • 1225-4266(pISSN)
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  • 2289-0149(eISSN)
한국보건행정학회 (Korean Academy of Health Policy and Management)
권호 표지
DOI QR코드

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인구고령화가 의료비 지출에 미치는 영향: Age-Period-Cohort 분석을 이용한 '건강한 고령화'의 관점

The Effect of Population Ageing on Healthcare Expenditure in Korea: From the Perspective of 'Healthy Ageing' Using Age-Period-Cohort Analysis

  • 조재영 (건강보험심사평가원 심사평가연구소) ;
  • 정형선 (연세대학교 보건과학대학 보건행정학과)
  • Cho, Jae Young (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service) ;
  • Jeong, Hyoung-Sun (Department of Health Administration, Yonsei University College of Health Sciences)
  • 투고 : 2018.07.31
  • 심사 : 2018.08.21
  • 발행 : 2018.12.31
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초록

Background: People who were born in different years, that is, different birth cohorts, grow in varying socio-historical and dynamic contexts, which result in differences in social dispositions and physical abilities. Methods: This study used age-period-cohort analysis method to establish explanatory models on healthcare expenditure in Korea reflecting birth cohort factor using intrinsic estimator. Based on these models, we tried to investigate the effects of ageing population on future healthcare expenditure through simulation by scenarios. Results: Coefficient of cohort effect was not as high as that of age effect, but greater than that of period effect. The cohort effect can be interpreted to show 'healthy ageing' phenomenon. Healthy ageing effect shows annual average decrease of -1.74% to 1.57% in healthcare expenditure. Controlling age, period, and birth cohort effects, pure demographic effect of population ageing due to increase in life expectancy shows annual average increase of 1.61%-1.80% in healthcare expenditure. Conclusion: First, since the influence of population factor itself on healthcare expenditure increase is not as big as expected. Second, 'healthy ageing effect' suggests that there is a need of paradigm shift to prevention centered-healthcare services. Third, forecasting of health expenditure needs to reflect social change factors by considering birth cohort effect.

키워드

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Figure 1. Separation of age, period, and cohort efects.

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Figure 2. Study model. APC, age-period-cohort.

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Figure 3. Forecasting frame. APC, age-period-cohort.

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Figure 4. Trends in annual increase rate (%) of per capita health ex-penditure by year and age group.

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Figure 5. Coefcient estimates of age (A), period (B), and cohort (C) efects on per capita healthcare expenditures using age-period-cohort-in-trinsic estimator model.

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Figure 6. Coefficient estimates of age (A), period (B), and cohort (C) effects on per capita healthcare expenditures by function and financing using age-period-cohort–intrinsic estimator model.

Table 1. Dependent/independent variables and data sources

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Table 2. Model ft statistics

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Table 3. Comparison of predicted values of per capita healthcare expenditure by model (unit: 1,000 won)

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Table 4. Forecasting results of future healthcare expenditure: 2018–2019 to 2030–2031 (unit: 100,000 people, 1 billion won, 1,000 won)

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