• 보건행정학회지
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• 제5권2호
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• pp.155-172
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• 1995

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.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.237-248
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• 2013

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.

• 보건행정학회지
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• 제29권3호
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• pp.288-302
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• 2019

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.

• STI Policy Review
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• 제6권1호
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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.

• 자원ㆍ환경경제연구
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• 제9권3호
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• pp.563-587
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• 2000

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.

• 대한치과의사협회지
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• 제55권5호
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• pp.339-350
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• 2017

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.

• 보건행정학회지
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• 제13권3호
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• pp.104-128
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• 2003

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.

• 한국조경학회지
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• 제47권2호
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• pp.100-116
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• 2019

도시지역의 사회문제 및 환경위험을 완화시킬 수 있는 수단이자 사회적 측면에서의 지속가능한 발전을 위해 질 좋은 도시녹지의 양적인 확대 및 관리에 대한 중요성이 부각되고 있다. 이에 본 연구에서는 서울시 중구, 동대문구, 성동구 등 3개 자치구의 46개 행정동을 대상으로 각종 사회경제적 데이터와 녹지데이터, 위성영상 등을 활용해 녹지의 분포 현황과 이의 분배적 형평성을 파악하고자 했다. 연구의 분석과정은 1) 행정동별 녹지분포 현황과 사회경제적 현황, 녹지의 효과를 체감하기 쉬운 가로수 면적 등을 파악하고, 위성영상을 이용한 정규식생지수와 지표면온도를 확인했다. 2) 이를 바탕으로 각 변수들의 상관관계 및 회귀분석을 실시하였다. 연구지역 녹지의 분배적 형평성 분석결과, 행정동별 환경특성 중 녹지율과 면적에서 큰 편차를 보였으며, 정규식생지수, 지표면온도 모두 동별 차이가 큰 것으로 나타났다. 또한, 환경변수와 사회경제적 변수와의 상관관계 분석결과, 기초생활수급자비율과 장애인비율이 높은 동의 정규식생지수가 낮고 지표면온도는 높은 것으로 나타나 환경형평성이 낮은 것으로 평가되었다. 환경불평등은 주거지역의 환경요인뿐 아니라, 주거형태와도 밀접하게 관련되어 있는 것으로 판단된다. 아파트 단지의 지표면온도는 단독 및 다가구 주택 밀집지역에 비해 $2.0^{\circ}C$ 가량 낮았으며, 정규식생지수 평균은 아파트 단지가 단독 및 다가구 주택 밀집지역에 비해 2배 이상 높은 것으로 나타났다. 녹지분포의 행정동별, 주거유형별 환경불평등성이 확인된 만큼 소외지역에 녹지의 양적 확충이 필요하며, 녹지 환경에서의 사회적 배제 극복을 위한 정책 등을 통해 배제된 지역 주민들의 삶의 질 개선 노력이 필요하다.

• 지적과 국토정보
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• 제50권2호
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• pp.133-153
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• 2020

우리나라의 공시지가 제도는 1989년 도입되어 각종 조세와 복지 등 여러 분야에 걸쳐 활용되어 왔다. 공시지가는 부동산의 보유세를 대표하는 재산세에 대한 과세평가액으로 활용되고 있으며, 국민 공평과세에 있어서 공시지가의 형평성은 가장 중요한 요소라고 할 수 있다. 이에 본 연구는 서울특별시의 토지의 실거래가격을 활용하여 2016~2018년 공시지가의 형평성을 분석하고 검증하였다. 그 결과 서울특별시의 현실화율은 해마다 점진적으로 상승하는 것으로 나타났으며, 3년 전체 현실화율은 60.64%로 나타났다. 수평적 형평성은 2017년이 가장 양호한 것으로 나타났으며, 해마다 자치구별 수평적 형평성이 개선되는 것으로 나타났다. 수직적 형평성은 대부분 지역에서 역진적 불형평성이 존재하는 것으로 나타났지만 강남구, 서초구, 강동구 등 강남권역에서 누진적 불형평성으로 나타나 자치구별 균형성 측면에서의 개선이 필요한 것으로 확인되었다. 분위 회귀분석 결과는 대부분 분위에서 역진적 불형평성이 나타났지만, 분위별 계수 값에 차이가 존재하여 공시지가 분위별 형평성 개선이 필요한 것으로 확인되었다. 공시지가 형평성 검증 결과 연도별, 자치구별, 용도지역별 형평성이 결여된 것으로 분석되었으며, 이를 보완하기 위해 정부는 비율 연구를 도입하여 수평적·수직적 형평성을 검증하고 부동산 공시 제도를 체계적으로 보완·점검해야 한다.

• 한국경제지리학회지
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• 제22권4호
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• pp.513-525
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• 2019

서울시 지하철은 1974년 개통되어 네트워크를 지속적으로 확대해왔다. 지하철은 최근 전체 여객 통행의 40% 정도를 담당하며 가장 자주 사용되는 교통수단으로 자리매김하였다. 따라서 지하철 접근성이 시민들의 일상생활에 미치는 영향이 매우 크다고 볼 수 있다. 하지만 지하철을 비롯한 대중교통 자원은 공간적으로 균등하게 분배되지 않아 이로 인한 혜택이 불균등하게 배분되는 경우가 일반적이다. 본 연구에서는 서울시 지하철 접근성의 공간적 분포와 형평성을 살피고자 한다. 지하철 접근성은 역 간 이동시간을 계산하여 산출하였고 형평성은 지니계수를 적용하여 수치화하였다. 그 결과 지하철 접근성은 중심부-주변부 패턴을 보이며 중심업무지구는 높게 서울시 외곽은 낮게 나타났다. 또한 지하철 네트워크는 인구 및 대중교통 의존 계층의 공간 분포보다 고용자 분포를 고려해 보았을 때 보다 공평하게 배분되어 있음을 확인하였다.