• Health Policy and Management
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• v.20 no.3
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• pp.36-57
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• 2010

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea's health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high, compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage, income inequality after deduction of health care expenditure should be continuously monitored.

• Journal of Digital Convergence
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• v.16 no.10
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• pp.49-57
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• 2018

This study aims to identify the inequalities and characteristics of health care expenditure of the elderly and non-elderly households by income level. As a result, health care expenditure of elderly households was statistically significantly higher than that of non-elderly households. As a result of calculating the concentration index of health care expenditure by income level, inequality was higher in order of non-elderly households, elderly households, and total households. In order to confirm the effect of health expenditure on household income inequality, we calculated the concentration index of income excluding total health care expenditure from total income. As a result, inequality was higher in order of elderly households, whole households, and non-elderly households. There was not much difference in inequality of health care expenditure among elderly households and non-elderly households. And, the health care expenditure of elderly households was much higher than that of non-elderly households. Also, inequality of health care expenditure by income group was serious. There should be no cases where the medical care support policy for elderly households can not use necessary medical services.

• The Journal of the Korea Contents Association
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• v.16 no.8
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• pp.366-375
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• 2016

This study evaluates the degree of the inequality of medical care expenditure and private health insurance benefits and the relation with household income inequality in korea health care system. This study used the 2014 korea Health Panel survey, and study method is Gini coefficient. The main results are as follow. First, average household income in 1st income quartile is 6,290,000won and 10st income quartile is 101,930,000won. And Gini coefficient of Korea household income is 0.3756. In other words, family income inequality is quite serious. Second, the Gini coefficient of the public institution supported medical care expenditure, such as health insurance and public assistance, is 0.0761, and the Gini coefficient of the expenditure of transportation fee and medical materials etc that don't supported is 0878. The inequality in medical care expenditure in public health care system and without public support aren't serious all. Third, Gini coefficient in excluding household medical care expenditure from household income slightly increased. That is, the medical care expenditure of our country household is the factor of aggravating the inequality of household income. Fourth, Gini coefficient of private health insurance benefits is 0.0927. Therefore, the ineqality in private insurance benefits is low. In addition, the Gini coefficient of the sum of private insurance benefits and household income is 0.3672. it decrease from Gini coefficient(0.3756) of household's. Private health insurance perform the functions somewhat weaken household income inequality. However, it is very little improvement.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.1
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• pp.20-31
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• 2015

Purpose: The purpose of this study was to explore ways to define the concept of health inequality. Methods: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. Results: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. Conclusion: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.2 no.1
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• pp.17-30
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• 2006

Federal disability law has evolved from several laws geared to protect people with disabilities since the late 1960s and early 1970s. When U.S. Congress passed the Americans with Disabilities Act (ADA) in 1990, no federal statute prohibited the majority of employers, program administrators, owners and managers of places of public accommodation and others from discriminating against people with disabilities. Toward the ends to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with the disabilities, the ADA pursues three major strategies: Title I addresses inequality in employment, Title II, inequality in public services, and Title III, inequality in services and accommodations offered by private entities. The purposes of the study were to analyze the impact of the ADA on health care for persons with disabilities and to review the ongoing health policy reforms at the federal and state governments. Essential remedies that the ADA contemplates are based on two principles, simple discrimination and reasonable accommodation, which significantly improved access to quality care, especially long-term care, by persons with disabilities. However, the ongoing Medicaid policy reforms to control rising health care costs in the U.S. could threaten the access to care by persons with disabilities in optional groups and to optional care services by persons with disabilities in mandatory groups.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.379-388
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• 2022

Objectives: Throughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households. Methods: This study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP. Results: Average Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively. Conclusions: In this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.4
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• pp.239-244
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• 2014

This research was carried out for the purpose of providing basic data to establish a policy for improving health and medical service inequality in the disabled's households, by analyzing it according to composed groups through the application of data about the panel survey of the employment for the disabled, from 2010 to 2012. The results of analysis showed that as for Gini's coefficient, disabled women, the disabled without participation in economic activities, the disabled in their 40s, physically handicapped people and severely disabled people had more and more inequality in expenditure of health care expenses, and inequality in North Gyeongsang Province continued to be on the rise. As for the entropy coefficient, disabled women, the disabled without participation in economic activities, the mentally disabled and severely disabled people had more and more inequality in consumption of health care, and the inequality got severe in Ulsan and North Gyeongsang Province. And as for the decomposition of factors by composed group, inequality in health care expenses were higher inside a group than between groups. Based on these results, research limitations and implications were suggested.

• Health Policy and Management
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• v.27 no.4
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• pp.304-314
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• 2017

Background: This study aimed to analyze effects of postpartum care services to women after birth, identify the factors affecting their use, and examine the extent of income-related inequality in the postpartum care services utilization and expenditures using Korean Health Panel data between 2010 and 2013. Methods: The panel data of the year 2010-2013 of the 247 women after birth were used. First, EuroQoL-5D was used to evaluate the effects of postpartum care service to women's quality of life. Second, multinominal logistic regression analysis was used to identify determinants of the use of the postpartum care services. Finally, concentration index and HIwv (horizontal equity) index were used to find that the concentration index for the inequality in the use of postpartum care services showed negative sign, which implied pro-rich. Results: The estimation results showed that utilization of the postpartum services has a positive effect on women after birth. Also age, area of residence, and number of household members turn out to be the factors of using postpartum services. And there are inequality in the use of postpartum care services whose HIwv index showed positive sign, which implied pro-rich. Conclusion: Therefore, the government's policy of the postpartum care service is necessary to be expanded and diversified considering the personal characteristics and equity of the women after birth.

• The Journal of the Korea Contents Association
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• v.19 no.5
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• pp.331-341
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• 2019

The purpose of this analysis is to examine the effects of health expenditure on income inequality on household income after the financial crisis by using the household income survey form 1996 to 2016. The main results are as follows. First, after the financial crisis, the gross income inequality of households has been changing steadily, though there has been a slight change in each year. Second, high-income earners spend more on health care expenditure by income level. Therefore, unequal levels are maintained. Third, the Gini coefficient of income excluding health care expenditure was calculated. The results of the analysis are larger than the Gini coefficient of total income. Income inequality is intensified by the expenditure of health care expenditure of households. The inequality of household income due to health care expenditure has been increasing steadily since the financial crisis. Efforts such as strengthening the protection of health insurance have been continuously carried out for the purpose of reducing the burden of the national medical expenses. However, it does not contribute to resolving income inequality. In the future, it will be necessary to provide a more selective medical support system to reduce the medical expenditure of the low income class.

• Health Policy and Management
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• v.24 no.1
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.