• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.43-57
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• 2022

Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region. Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate. Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect. Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

• Journal of Korean society of Dental Hygiene
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• v.20 no.2
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• pp.129-137
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• 2020

Objectives: Using the annual data from the 2016 Korean Health Panel, this study aims to identify the factors that affect the dental utilization and expenditure of patients with chronic diseases, and to provide basic data to explain the inequality gap in dental utilization. Methods: The dental utilization and expenditure of 3,557 patients with chronic diseases were analyzedfor frequency using the SPSS Windows version 23.0 (SPSS Inc. IL, USA). Analysis of the factors that affect dental utilization and expenditure were performed using a multiple regression analysis. The level of statistical significance was 0.05. Results: The frequency of dental utilization in patients with chronic diseases was high for subjects who were younger than 65 years and those whose education level was below high school. The frequency of dental utilization was relatively lower for subjects who did not have disabilities and those with healthier subjective health status. The dental expenditure of patients with chronic diseases was higher in subjects who were younger than 65 years and those with greater household income. Conclusions: The above findings suggest that a plan is needed to control dental utilization by efficiently managing chronic diseases, and that a policy-based plan is needed to devise ways to supplement the uninsured medical expenses of dental care.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.44-55
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• 2019

Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.

• Health Policy and Management
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• v.30 no.1
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• pp.126-130
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• 2020

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2018 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. The households experienced the catastrophic health expenditure 2.08% in 2018 using the NaSTaB data. Trend analysis was significant with the decreasing trend (Annual Percentage Change [APC], -4.88; p<0.0001) in the proportion of households with the catastrophic health expenditure. On the other hand, the results of the HIES showed 2.92%, and KHP showed 2.48% of households experienced the catastrophic health expenditure in 2016. The trend was significantly increased in HIES (APC, 1.43; p<0.0001) and KHP (APC, 6.68; p<0.0001). Therefore, this suggests that further interventions to alleviate the burden of catastrophic health expenditure to the low-income group are needed.

• Health Policy and Management
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• v.31 no.1
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• pp.140-144
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• 2021

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2019 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of households with catastrophic healthcare expenditure. The households experienced a catastrophic health expenditure of 2.44% in 2019 using the NaSTaB data. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -4.49; p<0.0001) in the proportion of households with catastrophic health expenditure. Also, the results of the 2017 KHP and the 2016 HIES showed 2.20% and 2.92%. The trend was significantly increased in the KHP (APC, 1.79; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, this study suggests that further public healthcare interventions to alleviate the burden of catastrophic health expenditure, especially for low-income households, are needed.

• Health Policy and Management
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• v.32 no.1
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• pp.107-112
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• 2022

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 2020 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. In the NaSTaB 2020 data, households who experienced catastrophic health expenditure was 1.73%. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -5.55; p<0.0001) in the proportion of households with the catastrophic health expenditure. Also, in the 2018 KHP and the 2016 HIES, households who experienced catastrophic health expenditure was 2.21% and 2.92% respectively. In contrast, the trend was significantly increased in the KHP (APC, 0.55; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, the findings suggest the need to strengthen public health care financial support and monitor catastrophic healthcare expenditures, especially for low-income group.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4067-4076
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• 2015

This study aims to examine the trend in household catastrophic medical expenditure according to the healthcare coverage types and its associated factors based on the raw data of the Korean Health Panel over the years 2008 to 2011. Correspondence analysis was used to investigate the trend in the incidence rates of annual catastrophic medical expenditure and generalized estimating equation to examine the factors influencing the incidence of catastrophic medical expenditure. The annual mean incidence rates of household catastrophic medical expenditure were 25.1%, 15.4%, 10.1%, 5.4% and 3.2% in the threshold levels of 10%, 15%, 20%, 30%, and 40% respectively. The incidence rate of household catastrophic medical expenditure was higher when the total annual household income was lower, the education level of the householder was lower, the healthcare coverage type was National Health Insurance, the householder had disability, the age of the householder was older, the number of household members was smaller, the subjective health status of household members was lower, and the prevalence rate of the chronic disease of the household was higher(p<0.05). Therefore, a policy for vulnerable households with older or patient members of chronic diseases should be established.

• Health Policy and Management
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• v.32 no.2
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• pp.228-236
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• 2022

The aim of this study was updating suicide-related indicators, including the number of suicidal deaths, suicide rate, and the prevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-date information. This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983-2020), Korean Wealth Panel Study (KOWEPS, 2012-2020), and Korea Health Panel Survey (KHP, 2010-2013, 2016-2018), Korean National Health and Nutrition Examination (KNHANES, 2007-2013, 2015-2020), and Korean Community Health Survey (KCHS, 2008-2009, 2013, 2017). The suicide rate per 100,000 population decrease from 26.9 in 2019 to 25.7 in 2020. Based on recently available data, the rates of suicidal ideation were 1.48% (KOWEPS, 2020), 2.61% (KHP, 2018), 4.62% (KNHANES, 2019), and 6.96% (KCHS, 2017). Those of suicide attempt as were 0.07% (KOWEPS, 2020), 0.44% (KNHANES, 2020), and 0.32% (KCHS, 2017). Annual percentage change (APC) of suicide rate was -1.87% (Statistics Korea, 2011-2020). APC of suicidal ideation was -10.7% (KOWEPS, 2012-2020), -11.5% (KHP, 2010-2013, 2016-2018), -14.7% (KNHANES, 2007-2013, 2015, 2017, 2019), and -2.5% (KCHS, 2008-2009, 2013, 2017). APC of suicide attempt was -11.3% (KOWEPS, 2012-2019), -5.2% (KNHANES, 2007-2013, 2015-2020), and -4.4% (KCHS, 2008-2009, 2013, 2017). Although the suicide rate in Korea has decreased compared to 10 years ago, it is still at a high level. Thus, continuous observation and appropriate suicide prevention policies are needed.

• Health Policy and Management
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• v.33 no.3
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• pp.363-369
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• 2023

The term "catastrophic health expenditure" means assessing the extent to which medical costs cause financial hardship for households. The aim of this research is to analyze the percentage of households that faced severe financial strain due to medical expenses from 2006 to 2021. This was achieved by utilizing data obtained from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). A trend analysis was conducted to examine the percentage of households that experienced catastrophic healthcare expenses. The households that experienced the catastrophic health expenditure was 2.49% in 2021 using the NaSTaB data. The trend analysis yielded a statistically significant result, indicating a decreasing trend (annual percent change [APC], -4.79; p<0.0001) in the proportion of households facing catastrophic health expenditures. Also, the results of the 2019 KHP and the 2021 HIES showed 1.09% and 2.44% for the households that experienced catastrophic health expenditure. The trend was increased according to the KHP (APC, 0.55; p=0.0004) and the HIES (APC, 7.04; p<0.0001). As a result, this study proposes that sustained attention and further interventions are necessary to ease the economic pressure caused by catastrophic health expenses, particularly for low-income households.

• Health Policy and Management
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• v.34 no.1
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• pp.87-93
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• 2024

Background: In recent years, studies have shown conflicting results regarding the benefits of dietary supplements in reducing healthcare expenditures. This study aimed to address this inconsistency by examining the association between supplement consumption and health expenditures using nationally representative data from the Korea Health Panel Survey (2019-2020). Methods: A 1:1 matched case-control dataset was established using propensity score matching technique based on supplement consumption. Then, total annual healthcare expenditures were compared between the two groups. In addition, a multivariate regression analysis (Proc Surveyreg) was performed to determine the association between the supplement consumption and medical costs. Results: The supplement user group spent about 1.72 million Korean won, while the non-user group spent about 1.43 million Korean won on medical services (p=0.0186). The results of multivariate regression showed that the costs were approximately 26.15% higher in the user group than in the non-user group (p=0.0004). Conclusion: Contrary to the previous studies that have shown the benefits of supplement use in reducing healthcare costs, this study showed that those who consistently consumed supplements spent more on medical services. This can be interpreted in the same context as previous studies suggesting that dietary supplement intake is a healthy behavior for managing one's health. However, we caution against drawing firm conclusions due to data limitations. Further analysis using patient-level epidemiologic data is needed.