• Health Policy and Management
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• v.23 no.2
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• pp.112-123
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• 2013

Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.

• Journal of Korean Library and Information Science Society
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• v.37 no.1
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• pp.3-28
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• 2006

The purpose of this study is to describe the problems. which academic libraries in the V.S., U.K., Australia, and Canada have faced since the 1990s. These problems are mostly caused by environmental changes in higher education. In this study, only discussed are the problems that academic libraries in various countries have commonly experienced. but not unique ones libraries in each country has due to its own national, societal, cultural, academic or informational situations. Major problems include continuing decrease in library expenditures, changing role of libraries themselves. changing nature of library collections, development of information technology and technological Infrastructure on campus, steep increase in prices of scholarly journals, and relative decrease in purchasing powers of libraries. These Problems are all closely inter-related, and seem to require more comprehensive and systematic strategic solutions carried out by the national or government intervention, rather than individual libraries.

• Journal of Korean Library and Information Science Society
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• v.37 no.1
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• pp.55-82
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• 2006

The purpose of this study is to analyze the development strategy of academic libraries in the U.S., U.K., Australia, and Canada which have been established in response to the problems faced since the 1990s. Major problems, which academic libraries in various countries have commonly experienced include continuing decrease in library expenditures, changing role of libraries themselves, changing nature of library collections, development of information technology and technological intrastructure on campus, steep increase in prices of scholarly journals, and relative decrease in purchasing powers of libraries. In this study, discussed are the strategic planning and solutions carried out at the national or government level, rather than by individual libraries. Their efforts commonly focus on such measures as resource sharing, shared catalog and storage facilities, cooperative purchasing and negotiation for scholarly journals, etc.

• Korean Journal of Social Welfare
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• v.37
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• pp.307-326
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• 1999

The primary purpose of this study is to analyze changes, if any, in the financial status and the intensity of health care service utilization of the regional health insurance societies following the 1995 merger of some rural and urban regional health insurance societies. Ultimately, this study is aiming at providing an empirical basis for predicting the impact of the 1998 merger of the Regional Health Insurance Program and the Health Insurance Program for Government Employees and Teachers and, further, predicting the impact of the merger of the entire health insurance programs scheduled for the year 2000. The study results did not suggest that the 1995 merger had brought about notable changes in the rate of increase in the total expenditures or the insurance payment of the merged regional insurance societies in comparison to non-merged ones. Neither did it show that the merger had resulted in significant changes in the intensity of the use of health services. The study, however, found that the 1995 merger had reduced the rate of increase in the management and operational cost of the merged insurance societies. Based on these findings, some policy implications are discussed, and suggestions are made for the total merger plan scheduled for the year 2000.

• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.241-246
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• 2018

Background: The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. Methods: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Results: Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Conclusion: Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations.

• STI Policy Review
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• v.4 no.1
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• pp.27-53
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• 2013

Technology research and development (R&D) expenditures have increased as most countries recognize that technological innovation is a significant factor for continued economic growth. R&D subsidies by governmental entities were permitted in accordance with the Subsidy and Countervailing Measure (SCM) Agreement under the World Trade Organization (WTO) system. However, according to Article 31 of the SCM Agreement the provision for R&D subsidies have been terminated as of January 2000 and legal disputes over R&D subsidies are likely to increase. The aircraft industry has been the only industry where R&D subsidies have become an issue under the WTO. This paper examines international trade disputes within the aircraft industry in regards to measures by Canada and bilateral disputes between the U.S. and the European Communities (EC). In these cases, various R&D subsidies on civil aircraft are found to be inconsistent with WTO rules. This study summarizes the WTO decisions on various R&D subsidies disputed in the aircraft cases and examines the type of R&D subsidies found to be inconsistent (or consistent) with the WTO to provide guidelines for current and future R&D subsidy policies in high-tech industries. The Canada-Aircraft case indicates that R&D subsidies directly targeted towards near market R&D projects with a high export potential will likely be in violation of current WTO rules. Furthermore, findings from the EC-Aircraft and the U.S.-Aircraft cases suggest that the forms (or the methods) of R&D subsidy distribution were not a sufficient condition for the WTO ruling; instead, what ultimately mattered was whether and specifically to whom the benefits of the R&D subsidies are conferred by the government entities.

• Journal of Environmental Policy
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• v.8 no.3
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• pp.81-113
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• 2009

This study conducted a regulatory impact analysis regarding the introduction of the Korean version of REACH(Registration, Evaluation and Authorization of Chemicals). The direct cost of the Korean REACH is estimated at a total of 101 billion Korean won over the 11 year period. The cost includes pre-registration, testing, registration, Chemical Safety Assessment(CSA) and Chemical Safety Report(CSR), evaluation, and the authorization costs of 15,223 chemical substances produced and imported more than 1 ton per year in Korea in 2006. With regard to the benefit, the only public health benefit is included in the estimation. Based on the available foreign and domestic data, this study estimated that the economic values of public health benefits are in the range of 33.2~138.6 billion Korean won if only the savings of the National Health Expenditures are considered and it reaches 203.9~1,640.3 billion Korean won if the willingness to pay(WTP) for disease prevention is included. This study proved that the Korean REACH passed the cost/benefit criteria. The benefit-cost ratio of the Korean REACH, however, is estimated to be lower than its EU counterpart. Thus it is suggested that a rigorous study to reduce the costs to industry be required before the Korean government introduces the Korean REACH.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.61-73
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• 2017

In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.

• 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.

• 한국사회정책
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• v.25 no.2
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• pp.243-280
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• 2018

This paper examines the discussion on the income-led growth known as the core economic strategy of Moon's administration in terms of Korean welfare regime. Although the income-led growth strategies have presented various issues, the income-led growth strategy seems to be a timely alternative discourse that emphasizes the demand side, considering supply-oriented growth strategies have caused long-term recession and deepening of inequality. It is important that the income-led growth strategy places social expenditures as an important growth engine for virtuous cycle of production and consumption. However, this paper has confirmed that simply raising wages and increasing social expenditure do not increase the aggregate demand and production. Moreover, empirical studies have shown that the inclusion of external sectors and liabilities into the analysis weakens the wage-led growth of the Korean economy. For this reason, this study concluded that the government's sophisticated policy intervention is necessary for the increase of real wages and social spending to be economic growth.