• Title/Summary/Keyword: Healthcare financing

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The Priority Analysis on the Financing of Healthcare Institutions in Korea (의료기관 자본조달 우선순위 분석)

  • Lee, Woo-Chun;Ahn, Young-Chang
    • Korea Journal of Hospital Management
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    • v.13 no.3
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    • pp.1-16
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    • 2008
  • According to Myers (1984) and Myers and Majluf(1984), there exists a financial hierarchy from internal to external financing, from long-tenn debt to equity, due to information costs. The purpose of this study is to assess the profit-making corporation of healthcare institutions. Data was collected from 130 hospital presidents and financial managers. We analysed the frequency and one way ANOVA by SPSS Windows 14.0K. The major findings of the study were as follows: We found that the priorities which a healthcare institutions financing were internal financial, other allowance, a credit loan, a security loan, and a lease through this study. The priorities which a healthcare institutions raised the capital differed as to the number of beds and revenues. The priorities were no difference from ownership, location and an annual business.

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Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

  • Mahumud, Rashidul Alam;Sarker, Abdur Razzaque;Sultana, Marufa;Islam, Ziaul;Khan, Jahangir;Morton, Alec
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.2
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    • pp.91-99
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    • 2017
  • Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis

  • Zandian, Hamed;Takian, Amirhossein;Rashidian, Arash;Bayati, Mohsen;Moghadam, Telma Zahirian;Rezaei, Satar;Olyaeemanesh, Alireza
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.2
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    • pp.83-91
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    • 2018
  • Objectives: One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households' income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

Financing of Healthcare Facilities in Pension System Assets of Ecologically Problematic Regions in Kazakhstan

  • YESSENTAY, Aigerim;KIREYEVA, Anel A.;KHALITOVA, Madina;ABILKAYIR, Nazerke A.
    • The Journal of Asian Finance, Economics and Business
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    • v.7 no.7
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    • pp.531-541
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    • 2020
  • The purpose of the study is a theoretical and practical justification for building a mechanism for financing health facilities based on public-private partnerships from a pension fund in regions with environmental problems. The theoretical background is built on works of local and foreign authors on state and non-state pension provisions issues, pension funds' assets management. This study provides an analysis of the health status of the population of the Kyzylorda region; it analyzes also the worldwide and Kazakhstan practice of investing pension funds and implementing projects. There has been legislative and methodological framework for financing health projects based on public-private partnerships in Kazakhstan. The scientific methods considered in this study made it possible to develop a mechanism for financial support for the modernization of a healthcare facility using the budget of pension funds. The authors point out possible risks in the implementation of projects in the field of healthcare and make recommendations on the construction a mechanism for financing healthcare facilities in the regions of Kazakhstan with environmental problems. In addition, they underline the key insights of the analysis, which are requisites for identifying the profitability of project for business and social effects for the public. Factors influencing efficacy, effect and implementation risks identified.

Design and Management of Health Care Financing and Delivery System -What can We Learn from the Canadian Experience\ulcorner- (국민건강보장을 위한 효율적인 보건의료체계 -캐나다 의료보장재원의 배분과 활용을 중심으로-)

  • 김병익
    • Health Policy and Management
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    • v.2 no.2
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    • pp.1-32
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    • 1992
  • The Canadian experience-universal government health insurance administeredby the ten provinces and two territories with some fiscal and policy variations-suggests the possibility of more effectve and efficient health care delivery system. The central purpose of the Canadian health in surance was to reduce and hopefully eliminate financial barriers to medical care. In this it succeeded. But it also produced varous kinds of unexpected side-effects on cost and quality. The Federal and Provincial Governments of Canada continue to exert theri efforts to ameliorate these problems. The lesson from Canada is that the health care revenue should be raised at the national level and managed at the regional level, and the regional healthcare financing organization has to take over the functions of the public health center. These alternatives is expected to make the Korean health care delivery system more efective and efficient, and to achieve health for all. This paper also discussed the policy agenda for implementing such alternatives in Korea.

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2015 National Health Accounts and Current Health Expenditures in Korea (2015년 국민보건계정과 경상의료비)

  • Jeong, Hyoung-Sun;Shin, Jeong-Woo
    • Health Policy and Management
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    • v.27 no.3
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    • pp.199-210
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    • 2017
  • Background: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public-private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. Methods: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. Results: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. 'Transfers from government domestic revenue' share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to 'compulsory contributory health financing schemes,' 'Transfers from government domestic revenue' share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. Conclusion: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.

Catastrophic Health Expenditure Status and Trend of Korea in 2015 (2015 재난적 의료비 경험률과 추이)

  • Kim, Woorim;Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.1
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    • pp.84-87
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    • 2017
  • Catastrophic healthcare expenditure refers to out-of-pocket spending for healthcare exceeding a certain proportion of a household's income and can lead to subsequent impoverishment. The aim of this study was to investigate the proportion of South Korean households that experienced catastrophic healthcare expenditure between 2006 and 2015 using available data from the Korea Health Panel, National Survey of Tax and Benefit, and Household Income and Expenditure Survey. Frequencies and trend tests were conducted to analyze the proportion of households with catastrophic healthcare expenditure. Subgroup analysis was performed based on income level. The results of the Household Income and Expenditure Survey revealed that around 2.88% of households experienced catastrophic healthcare expenditure in 2015 and that this proportion was highest in the low income group. Results also showed a statistically significant increasing trend in the number of households with catastrophic healthcare expenditure (annual percentage change= 0.92%, p-value < 0.0001). Therefore, the findings infer a need to strengthen public health care financing and to particularly monitor catastrophic healthcare expenditure in the low income group.

Exploring Regional Disparities in Unmet Healthcare Needs and Their Causes in South Korea: A Policy-Oriented Study (한국 미충족 의료 니즈 수준 및 발생 사유의 거주지역 간 격차 분석과 정책적 시사점)

  • Woojin Chung
    • Health Policy and Management
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    • v.33 no.3
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    • pp.273-294
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    • 2023
  • Background: Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: "burden of medical expenses," "time constraints," and "lack of care." The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%-13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are "lack of care," "time constraints," and "burden of medical expenses." Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to "lack of care" is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%-14.1%) than in Busan (1.3%; 95% CI, 1.3%-1.4%). The probability due to "burden of medical expenses" is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%-4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%-0.4%). Conclusion: Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents-similar to the approaches of the United Kingdom and France.

Evaluation on Fitness between Human Resource Management System and Strategy on Subsidiary Hospitals of Medical Center (일개 의료원 산하 병원간 전략과 HR시스템의 정합성 평가)

  • Kim, Young-Hoon;Kim, Han-Sung;Woo, Jung-Sik;Kim, Hyo-Jung
    • Korea Journal of Hospital Management
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    • v.17 no.1
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    • pp.59-78
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    • 2012
  • The purpose of this study is to evaluate on the fitting with human resource practice and strategic on 6 public hospital in the point of resource based view. At the result of this study, public strategy is not much fitted into HRM(human resource management) system, but it shows positive result of the fitting with efficiency strategy and HRM system. These results were associated with the integration of G Medical Center. Generally 6 public hospitals of the HRM system and the strategy had not been linked. They also did not achieve a great outcome. We suggest that the manager in charge of each hospital make strategies of the hospital, and then evaluates about fitting with HRM system. We hope, hereafter, it applied the analysis methods that evaluates it with financing result and individual non-financial result all together.

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