This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.
Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.
Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.
Bresson, Georges;Etienne, Jean-Michel;Mohnen, Pierre
STI Policy Review
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v.6
no.1
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pp.1-23
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2015
Based on the work of Anand et al. (2013) we measure inclusive income growth, which combines growth in gross domestic product (GDP) per capita and growth in the equity of the income distribution. Extending the work of Causa et al. (2014), we estimate a dynamic simultaneous structural equations model of GDP per capita and inclusive income on panel data for 63 countries over the 1990-2013 period. We estimate both equations in error correction form by difference GMM (generalized method of moments). Among the explanatory variables of the level and the distribution of GDP per capita we include R&D (research and development) expenditure per capita. In OECD countries we obtain a large positive effect of R&D on GDP. R&D is found to have a positive effect on the social mobility index but its impact on the income equity index at first decreases, then switches around to become slightly positive in the long run. In non- OECD countries, R&D is found to decrease inclusive income, mostly through a negative growth effect but also because of a slightly increasing income inequity effect.
A program of ecosystem conservation fund was proposed by the Ministry of Environment in Korea and has been supposed to come into force in early 2001. However, currently the program is withheld because there are strong objections to it for several reasons. The prime purpose of this paper is to analyze the reasons and problems involved in the program, to suggest some guidances to revise the program, and to design a new program by using a multiattribute index based on environmental significance. We found that there are two major problems of the program: first, inequity in choosing those whom the fund are levied on; second, irrationality of the way the fund are imposed. The paper also provides a simulation study to analyze the effects of four scenarios concerning feasible alternatives. We argue that natural resource damages caused by development works cannot be fairly prevented by the existing environmental impact assessment system only and should be used in harmony with the new system.
The aim of the study was to analyze the distribution of dental filling materials for carious permanent teeth of school children in a city. The study was designed as time-serial study, using the data of the dental survey for children aged 8-, 10- and 12-year children living in Gimhae city. The samples were selected by stratified clusters sampling. The number of surveyed samples in depth-analysis for types of dental filling materials were 567 in 2009 and 331 in 2013, respectively. They had dental restorations on one or more teeth. The changing pattern of used dental filling materials was analyzed between 2009 and 2013. Statistical analysis was conducted according to variables related to dental filling material type; DMFT and DMFS index, number of fissure sealed teeth and surface and surveyed year. Amalgam filling rate decreased from 27.9% in 2009 to 18.8% in 2013, while filling rate of tooth-colored materials increased from 56.1% in 2009 and 68.9% in 2013. Amalgam filling rate was a negative correlation with filling rate of tooth-colored materials or gold and number of fissure sealed teeth and a positive correlation with DMFT index. Filling rate of tooth-colored materials was a negative correlation with filling rate of amalgam or gold and DMFT index and a positive correlation with number of fissure sealed teeth. The light-curing composite resin should be included in the reimbursement range of National Health Insurance to solve an inequity of dental health care services.
Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.
Journal of the Korean Institute of Landscape Architecture
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v.47
no.2
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pp.100-116
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2019
Urban green spaces, as a means to mitigate social problems and environmental risks, are getting more attention in evaluating urban environment. The inequity of green space distribution is becoming a major issue in urban planning and management. This study investigated the characteristics of green space in 3 districts (Jung-gu, Dongdaemun-gu, Seongdong-gu), that are composed of 46 administrative divisions in central Seoul, to analyze the environmental equity of urban green spaces. The correlations between the amount of green space, including the coverage of street trees, and the socioeconomic status of each administrative division were analyzed. To deduce the effects of plant coverage on the urban temperature regime, the relationship between the normalized difference of vegetation index (NDVI) and land surface temperature (LST) was analyzed. The research revealed that the mean NDVI of an administrative division was negatively correlated with the percentage of basic living recipients and disabled people. The LST of a division with low NDVI was higher due to the lack of green coverage. Such environmental inequities were closely related to residential building type, which was strongly affected by the economic status of residents. The LST of an apartment area was $2.0^{\circ}C$ lower than that of single-family houses and multi-housing areas. This is expected as the average NDVI of the apartment area was more than twice as high as the other environments considered in this study. The inequity can be exacerbated without urban planning which is deliberately designed to reduce it.
Officially assessed land price has been the index of South Korea since 1989 throughout different sectors of tax and welfare. Officially assessed land price is used as a tax valuation for the tax on property holdings, and the equity of such is the most important factor in the fair taxation for the people of South Korea. On this wise, this research analyzed and verified the horizontal and vertical inequity of officially assessed land price in Seoul by using the real transaction data between 2016 and 2018. In fact, Seoul's assessment ratio for the entire three-year period was 60.64% and it showed to increase each year. Horizontal equity was found to be most favorable in 2017, and the horizontal equity of each borough of Seoul appeared to improve each year. Vertical inequity was found to have reverse inequality in most boroughs of Seoul, however, some parts of Gangnam districts such as Gangnam-gu, Seocho-gu, and Gangdong-gu presented progressive inequality. Such example showed the need for improvement in terms of balance by each borough. The use of quantile regression demonstrated reverse inequality in most quantile, but, the differences in the value of the coefficient by each quantile showed the need for improvement of officially assessed land price with the equity of each quantile. Through the equity verification of officially assessed land price, it was analyzed that the lack of equity was found by year, by borough, and by use district. In order to redeem the lack of equity, the government must systematically supplement the real-estate disclosure system by initiating ratio studies to verify horizontal and vertical equity.
Journal of the Economic Geographical Society of Korea
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v.22
no.4
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pp.513-525
/
2019
In Seoul, the subway system has been in use since 1974 and is the most frequently used travel mode accounting for approximately 40% of passenger journeys in 2015. As such the subway system is widely adopted by people and therefore, can have great impacts on their everyday life. However, it is easily noted that transit resources are not distributed spatially uniform, in other words, not all parts of the city gain the same benefits from their networks. This study aims to examine the inequity of spatial distribution of subway networks based on accessibility. Accessibility of subway networks are calculated based on the time-distance between stations and then equity is measured using the Gini index. Resulted map of subway accessibility shows that the benefits are not evenly distributed in Seoul with a pattern of highly accessible core - less accessible periphery areas. Also the subway accessibility network has fairer distribution against the employees' distribution rather than the distribution of general population or possibly transit dependent groups.
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