• Health Policy and Management
• /
• v.33 no.4
• /
• pp.400-410
• /
• 2023

Background: As the government has recently been discussing the expansion of the disaster health expenses support project, we would like to confirm the characteristics of beneficiaries of the support project, particularly those of high-cost beneficiaries. Methods: Using the database of catastrophic health expenditure support project from 2019-2020, this study aims to confirm the characteristics of high-cost beneficiaries focusing on the overlap of the relieved out-of-pocket systems, known as the out-of-pocket ceiling system and the system for rare incurable diseases. Logistic regression analysis is used to examine this issue. Results: In order to analyze the factors influencing high-cost beneficiaries, five models were created and analyzed, including the status of duplicated beneficiaries for relieved out-of-pocket systems, sociodemographic and economic factors, and individual health status as sequential independent variables. All five models were statistically significant, of which economic factors had the greatest impact on the model's predictions. The main results indicated that those who benefited from multiple systems in duplicate were more likely to be high-cost beneficiaries, and there is a higher probability of incurring high health expenses among the underage. In addition, within the beneficiaries of catastrophic health expenditure support project, it was observed that higher health insurance premium percentiles are associated with a higher proportion of high-cost beneficiaries. Conclusion: This study examined the characteristics of high-cost beneficiaries by encompassing reimbursement and non-reimbursement. According to this study, it is expected to be used as basic data for setting priorities and improving the current criteria of catastrophic health expenditure support project, aiming to sequentially expand the program.

• Health Policy and Management
• /
• v.24 no.3
• /
• pp.283-290
• /
• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• Korean Journal of Health Education and Promotion
• /
• v.29 no.5
• /
• pp.37-48
• /
• 2012

Objectives: The economic evaluation of health promotion programs has increasingly become an imperative activity for securing public fund or budget. The purpose of this study is to conduct an economic evaluation for the healthy school canteen program using the contingent valuation method(CVM). Methods: To estimate the benefit from the healthy school canteen program, double-bounded dichotomous choice method as a sort of willingness to pay was employed. Four hundred parents who lived in Seoul and have students at middle or high schools, were administrated by semi-constructive questionnaire containing the necessary information for benefit estimation. Cost estimation of healthy school canteen program was made referring to three types of pilot programs. Finally, the benefit against the cost was worked out according to the three levels of estimated cost. Results: Cost estimate is 8,488 and 9,311 won depending on the two senarios about how to invest on the program, respectably. The results of benefit estimate shows that the average cost willingness to pay(WTP) for healthy school canteen program is 21,275 won(16,963-59,838 won, 95% CI) and total benefits turned out 14.7 billion won. According to the cost-benefit analysis, average benefit-cost ratio is from 2.3 to 3.6. Conclusions: Healthy school canteen program could be economically accepted, and government can take consideration of expanding beneficiaries of healthy school canteen program for health promotion.

• The Korean Journal of Applied Statistics
• /
• v.27 no.2
• /
• pp.211-226
• /
• 2014

This paper discusses life expectancy differentials of beneficiaries of national pension old-age benefit and benefit-cost analysis in Korea. These results are useful indicators for the assessment of retirement income security of beneficiaries and old-age benefits. This paper analyzes benefit-cost ratio, internal rate of return and generation transfer amount, using life tables by lifetime incomes. The result of the actuarial analysis for male life expectancy is approximately 21.69 to 24.63 years. The result of the actuarial analysis for female life expectancy is approximately 27.63 to 29.81 years. The result of the actuarial analysis of low income level is that the benefit-cost ratio is lower approximately 2.68 to 4.83%, the internal rate of return lower approximately 0.00 to 0.74%, the generation transfer amount lower approximately 3.00 to 5.74%, than total income level. The result of the actuarial analysis of high income level is that the benefit-cost ratio is higher approximately 2.07 to 4.98%, the internal rate of return higher approximately 0.03 to 1.73%, the generation transfer amount higher approximately 2.53 to 9.68%, than the total income level. The results by income varies due to the effect of income redistribution and life expectancy on the national pension.

• Journal of the Korean Home Economics Association
• /
• v.32 no.4
• /
• pp.85-95
• /
• 1994

Today the occurrence and world-wide transfusion of the AIDS has brought about new problems related to family relations. The AIDS is more threatening than any other disease because of the special processes of infection trough sex and intravenous injections high care cost and terminal death. The AIDS causes conflicts among family members economic destitution and family dissolution. In the U.S Marriage without noticing of the AIDS may lead to divorce like injuries abandonment and misfeasance during marriage. But the AIDS victims should not be rejected from the rights of parental decision divorce beneficiaries and visiting rights. More discussion is needed about such issues as the pregnancy rights rongful birth action and selective nontreatment by doctors. The AIDS may influence the every party involved and interdisplinary studies should be required to solve the problem including family science laws psychology sociology and medical research as well.

• Journal of Korean Academy of Nursing Administration
• /
• v.11 no.4
• /
• pp.401-414
• /
• 2005

Purpose: This study was to evaluate the utilization of health care service and to provide supportive data for health care policy making in one urban area in Korea. Method: This study tested the significance of public health service using the database of an university hospital and public health center from Feb. 2000 to Dec. 2004. Data were analyzed by multidimensional analysis and data mining technique and produced the information on the classification of utilization characteristics by main disease and the total cost of use and disease association with the users of the public health center. Results: The Results were as follows: 1) Top 10 diseases in the area accounted for 22.4% of total frequency for the most recent 5 years in university hospital, while 59.0% in public health center. 2) There were significant correlations between university hospital and public health center user's insurance type and place of residence: It showed higher use of public health center for free service beneficiaries residing in Seoul than residents in nearby or local area. The medical insurance types for hospital users were more various than those for public health center users. 3) The use of hospital for patients of hypertension, diabetes mellitus and hyperlipidemia was tended to concentrate in mostly autumn and winter since August 2000, while the cost of using public health center for those patients has been steadily reduced since July 2000. 4) As a result of cluster analysis, there were classified into three homogeneous groups according to the total cost of using public health service, age, and the frequency of use. 5) The association analysis on patients with chronic disease in public health center produced a detailed information on accompanying diseases related to the incidence rate of disease of high frequency due to aging, information on drug abuse and immune disease. Conclusion: The health care policy for local community should be evaluated continuously. And the policy to build an integrated data warehousing by public health indicator system and to enhance the faithfulness of data is required.

• Journal of Digital Convergence
• /
• v.15 no.7
• /
• pp.259-269
• /
• 2017

This study analyzed medical aid case management effects based on the number of access by visits, phone calls, letters, internal investigation, resource links, and requests, in medical aid case management business that is carried out to improve the quality of life of medical care beneficiaries and reduce financial cost. Secondary analysis study using data of 564 high-risk group in the medical aid case management and their healthcare utilization data. Letters had positive correlations with the scores of all case management domains. The higher visits was, the lower the score of self-health care ability was, and the higher the number of phone calls was, the higher the score for reasonable medical use was. While there was no significant difference in medical cost according to aid management by interventions, the higher visits and resource links were, the lower the subjects' total number of payment days was. There is a difference in the various areas of the quality of health -related life and medical use depending on case management by intervention method and its number. It is necessary to carry out the efficient number of access to case management by intervention method.

• Journal of Preventive Medicine and Public Health
• /
• v.35 no.2
• /
• pp.99-106
• /
• 2002

Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

• Journal of Distribution Science
• /
• v.13 no.5
• /
• pp.83-90
• /
• 2015

Purpose - This research aims to understand the different behaviors of consumers according to cognitive age. Specifically, this research is focused on pro-social behavior. Pro-social behavior is defined as behavior benefiting others, rather than behavior benefiting one's self. It often entails individual risk or cost, such as when giving resources to others, waiting in line, asking for or paying a fair price, or risking one's life in battle. Therefore, we sought to understand consumer psychology and cognitive age as a reflection of inner psychology. People frequently perceive themselves as younger or older than their chronological ages. This self-perceived or cognitive age is a subjective age perception independent of actual chronological age. The discrepancy degree between chronological and cognitive age represents how much individuals perceive themselves as younger than they are. This study examines the gap in donation intention based on cognitive age. In order to investigate cognitive age, composed of four sub-categories (feel-age, look-age, do-age, and interest-age), this study explores the differential donation intention based on cognitive age, which determines the relationship between the young age and old age. Research design, data, and methodology - Data research was conducted by gathering 216 survey samples, excluding those with unreliable answers. Data coding and cleaning were used and SPSS 19.0 software for the data analysis. The respondents were categorized into two types, younger cognitive ages and older cognitive ages. Additionally, we analyzed the moderating variables. In particular, we used cognitive age degree and congruency level (cognitive age low vs. cognitive age high) × (congruency close vs. congruency distant) between - subjects design. First, regression was done to verify the difference between chronological age and cognitive age. Second, a t-test was done to verify the difference of cognitive age level in donations. Third, ANOVA (analysis of variance) was done to verify the difference between cognitive age and congruency in donations. Last, ANOVA was done to verify the difference between cognitive age and moral judgments in donations. Result - The results show most respondents perceive themselves as younger than their chronological ages. In particular, older respondents feel they are younger than their actual age. Moreover, the result of the comparison between low degree and high degree groups of cognitive age, show high donations at the higher degree of cognitive age groups. In addition, the closer the distance to the beneficiaries, the higher the donation in high degree cognitive age groups. The higher moral judgment groups also show relatively high contributions in lower degree cognitive age groups. Conclusions - Donations belong to the category of pro-social behavior reflecting an individual's psychological state. Therefore, it is important in understanding cognitive age. This study implies that it is necessary to take into account both cognitive age and chronological age when segmenting donors. Moreover, this study confirmed that there are different factors affecting the motives behind donations. Thus, it may be utilized to create differential donation strategies.

• Agribusiness and Information Management
• /
• v.8 no.1
• /
• pp.17-26
• /
• 2016

India is largest producer of banana in the world producing 29.72 million tonnes from an area of 0.803 million ha with a productivity of 35.7 MT ha-1 and accounted for 15.48 and 27.01 per cent of the world's area and production respectively (www.nhb.gov.in). In India, Tamil Nadu leads other states both in terms of area and production followed by Maharashtra, Gujarat and Andhra Pradesh. In Rayalaseema region of Andhra Pradesh, Kurnool district had special reputation in the cultivation of banana in an area of 5765 hectares with an annual production of 2.01 lakh tonnes in the year 2012-13 and hence, it was purposively chosen for the study. On $23^{rd}$ November 2003, the Government of Andhra Pradesh has commenced a comprehensive project called 'Andhra Pradesh Micro Irrigation Project (APMIP)', first of its kind in the world so as to promote water use efficiency. APMIP is offering 100 per cent of subsidy in case of SC, ST and 90 per cent in case of other categories of farmers up to 5.0 acres of land. In case of acreage between 5-10 acres, 70 per cent subsidy and acreage above 10, 50 per cent of subsidy is given to the farmer beneficiaries. The sampling frame consists of Kurnool district, two mandals, four villages and 180 sample farmers comprising of 60 farmers each from Marginal (<1ha), Small (1-2ha) and Other (>2ha) categories. A well structured pre-tested schedule was employed to collect the requisite information pertaining to the performance of drip irrigation among the sample farmers and Data Envelopment Analysis (DEA) model was employed to analyze the performance of drip irrigation in banana farms. The performance of drip irrigation was assessed based on the parameters like: Land Development Works (LDW), Fertigation costs (FC), Volume of water supplied (VWS), Annual maintenance costs of drip irrigation (AMC), Economic Status of the farmer (ES), Crop Productivity (CP) etc. The first four parameters are considered as inputs and last two as outputs for DEA modelling purposes. The findings revealed that, the number of farms operating at CRS are more in number in other farms (46.66%) followed by marginal (45%) and small farms (28.33%). Similarly, regarding the number of farmers operating at VRS, the other farms are again more in number with 61.66 per cent followed by marginal (53.33%) and small farms (35%). With reference to scale efficiency, marginal farms dominate the scenario with 57 per cent followed by others (55%) and small farms (50%). At pooled level, 26.11 per cent of the farms are being operated at CRS with an average technical efficiency score of 0.6138 i.e., 47 out of 180 farms. Nearly 40 per cent of the farmers at pooled level are being operated at VRS with an average technical efficiency score of 0.7241. As regards to scale efficiency, nearly 52 per cent of the farmers (94 out of 180 farmers) at pooled level, either performed at the optimum scale or were close to the optimum scale (farms having scale efficiency values equal to or more than 0.90). Majority of the farms (39.44%) are operating at IRS and only 29 per cent of the farmers are operating at DRS. This signifies that, more resources should be provided to these farms operating at IRS and the same should be decreased towards the farms operating at DRS. Nearly 32 per cent of the farms are operating at CRS indicating efficient utilization of resources. Log linear regression model was used to analyze the major determinants of input use efficiency in banana farms. The input variables considered under DEA model were again considered as influential factors for the CRS obtained for the three categories of farmers. Volume of water supplied ($X_1$) and fertigation cost ($X_2$) are the major determinants of banana farms across all the farmer categories and even at pooled level. In view of their positive influence on the CRS, it is essential to strengthen modern irrigation infrastructure like drip irrigation and offer more fertilizer subsidies to the farmer to enhance the crop production on cost-effective basis in Kurnool district of Andhra Pradesh, India. This study further suggests that, the present era of Information Technology will help the irrigation management in the context of generating new techniques, extension, adoption and information. It will also guide the farmers in irrigation scheduling and quantifying the irrigation water requirements in accordance with the water availability in a particular season. So, it is high time for the Government of India to pay adequate attention towards the applications of 'Information and Communication Technology (ICT) and its applications in irrigation water management' for facilitating the deployment of Decision Supports Systems (DSSs) at various levels of planning and management of water resources in the country.