• Health Policy and Management
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• v.24 no.1
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• pp.13-23
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• 2014

Background: A need arises to efficiently control health expenditure for medical aid due to a sharp increase in medical aid expenditure. This study experimently analyzes the impact of physician behavior on medical use for medical aid beneficiaries using supplier induced demand (SID) theory. Methods: This study looks into analyze SID effect using expenditure factor analysis of medical aid for the years between 2003 and 2010 in comparison with health insurance. Moreover, this study analyzes the existence and scale of SID using econometrics modeling with panel data on 16 cities and provinces's health expenditure data for medical aid from 2003 1/4 to 2010 4/4. Results: This study finds that the growth rate of visit days per capita and treatment amount per visit days for medical aid is higher than health insurance. Furthermore, the result of econometrics modeling analysis shows the existence of SID in general hospital, hospital, clinic, oriental clinic. Conclusion: In order to efficiently control expenditure for medical aid, it is required to reinforce macro polices such as the introduction of 'target management' and micro policies such as the strengthen of management on medical institutes in the perspective of suppliers as well as regulations of demanders.

• Health Policy and Management
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• v.27 no.1
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• pp.75-79
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• 2017

Suicide is becoming a public health issue in many countries, and even more so in Korea. Korea has the highest suicide rate in the Organization for Economic Cooperation and Development countries. To address these issues, we investigated the recent trends in suicidal ideation and suicide attempts among the adult population. We used data from four sources: Korean National Health and Nutrition Examination Survey (KNHANES, '2007-2012, '2013, '2015), Korean Community Health Survey (KCHS, '2008-2009, '2013), Korean Wealth Panel Study (KOWEPS, '2012-2015), and Korea Health Panel Survey (KHP, '2010-2013). Weighted frequencies and trend tests were used. The rate of suicidal ideation as recent year was 5.10% (KNHANES, '2015), 8.95% (KCHS, '2013), 2.34% (KOWEPS, '2015), or 5.39% (KHP, '2013). Regarding the suicide attempts, the rate of suicide attempts as recent year was 0.61% (KNHANES, '2015), 0.41% (KCHS, '2013), or 0.04% (KOWEPS, '2015). Average percent change of suicidal ideation during survey year was -2.80% (KNHANES, '2007-2012), 5.78% (KNHANES, '2013-2015), 0.62% (KCHS, '2008-2013), -5.63% (KOWEPS, '2012-2015), and -10.94% (KHP, '2010-2013). Average percent change of suicide attempts during survey year was -3.84% (KNHANES, '2007-2012), 4.55% (KNHANES, '2013-2015), -2.54% (KCHS, '2008-2013), and -18.96% (KOWEPS, '2012-2015). Those who had lower income level were more likely to have self-reported suicidal ideation and suicide attempts. Our results suggest that further efforts are needed for more effective intervention to identify and manage low income strata with suicide problem.

• Korea Journal of Hospital Management
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• v.26 no.1
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• pp.71-82
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• 2021

Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

• Journal of Preventive Medicine and Public Health
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• v.56 no.1
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• pp.67-76
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• 2023

Objectives: Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities. Methods: We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types. Results: As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p<0.001). In particular, PTI effectively reduced the likelihood of CHE for low-income households (OR, 0.85; 95% CI, 0.81 to 0.89; p<0.001) and those who received medical benefits (OR, 0.78; 95% CI, 0.68 to 0.89; p<0.001). Conclusions: This study highlights the positive effect of PTI on decreasing CHE. Household income and the health insurance type were significant effect modifiers, but economic barriers seemed to persist among low-income households with non-Medical Aid beneficiaries. Federal policies or programs should consider increasing the total amount of PTI targeting low-income households with disabilities that are not covered by the Medical Aid program.

• Journal of the Korean Home Economics Association
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• v.44 no.10
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• pp.133-144
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• 2006

The purpose of this study was to examine the effects of human capital and social capital, including employment status, education, income, social supports, and social participations, on the health status of the elderly aged over 50, after controlling for various demographic variables. Data were from the 6th wave of the Korean Labor and Income Panel Study(n=3,459). The major findings of this study were as follows: First, human capital and social capital were both resources that can contribute to improving the health status of the elderly aged over 50. Second, the effects of human capital and social capital on the health status of the elderly differed in the three subsamples defined by employment status. Based on the empirical results, policy implications were provided.

• Health Policy and Management
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• v.28 no.1
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• pp.91-94
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• 2018

Unmet healthcare needs do not end with the phenomenon itself, but lead to possibilities of increased severity of illness. Missed opportunities for treatment at the right timing increase possibilities of complications, and affect prognosis of disease. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, '2007-2016); the Community Health Survey (CHS '2008-2016); the Korea Health Panel Survey (KHP '2011-2014); and the Korean Welfare Panel Study (KOWEPS '2006-2016). The proportion of individual reporting unmet healthcare needs as of 2016 was 8.8% (KNHNES), 11.5% (CHS), and 12.8% (KHP, as of 2014). Annual percentage change which characterizes trend for the follow-up period was -9.9%, -3.1%, and -1.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost was 1.8% (KNHNES), 1.5% (CHS), and 3.0% (KHP). The proportion of households reporting unmet healthcare needs due to cost was 1.0% (KOWEPS). Annual percentage change was -10.0%, -15.2%, -5.4%, and -17.5%, respectively. Low income populations had more unmet healthcare needs than high income populations. Therefore, in order to improve unmet healthcare needs, it is necessary to focus on low income populations.

• The Korean Journal of Health Service Management
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• v.11 no.1
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• pp.131-142
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• 2017

Objectives : This study aimed to examine to relevance of socioeconomic class recognition and subjective health status of injured workers. Methods : We used data collected over 3years by the Panel Study of Worker's Compensation Insurance(PSWCI; 2015). Data was analyzed using the chi-square test and logistic regression using SPSS ver. 22.0 to verify the relevance between the socioeconomic class recognition and general characteristics of injured workers. Results : First, the income groups of first class, second class and third class were analyzed as being of lower socioeconomic class status, and the income group four class and five class was analyzed as being the middle-ower the socioeconomic class status. Second, the better the subjective health status, higher the perception of socioeconomic class status, as analyzed by Model 1 using only the parameters of socioeconomic status recognition and Model 2 and Model 3 using income class and general characteristics. Conclusions : Health and industrial accident policies are needed to improve awareness of socioeconomic class status of injured workers.

• Journal of Korea Society of Digital Industry and Information Management
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• v.19 no.4
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• pp.73-86
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• 2023

The purpose of this study is to prepare basic data that can be applied to the development of personalized programs in which chronic patients can actively participate in health care on their own, by analyzing the relationship between health literacy, level of metal health, and level of life health of patients with chronic diseases. For the study, the Korean Medical Panel's annual data(Version 2.1) was used, and 4,095 people aged 19 or older with chronic diseases and without disabilities were extracted, and frequency analysis, t-test, ANOVA, and chi-squared goodness of fit test, etc. were performed with IBM SPSS Statistics 26.0. As a result, it was found that the higher health literacy, the higher level of mental health and level of life health. In addition, the distribution between health literacy, level of mental health, and level of life health was found to be different from each other. Respondents with higher ability to health literacy tend to evaluate level of metal health and life health lower, and the rate of change in this trend was relatively higher than the rate of change in the tendency to evaluate level of mental health and life health higher in respondents with lower ability to health literacy.

• Human Ecology Research
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• v.54 no.5
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• pp.515-527
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• 2016

This study investigated social determinants and their interaction effects on the health of school-aged children in diverse environmental factors pertaining to the individual, family, and peers from an ecological systematic perspective. Data were drawn from the first wave of the Korean Children and Youth Panel Survey (KCYPS) developed by the National Youth Policy Institute and conducted in 2010. Data were analyzed by descriptive statistics, Cronbach ${\alpha}$, correlation, and hierarchical regression analysis using SPSS ver. 18. The results from this study showed that sex and age were related to the health of school-aged children, as social determinants. Self-rated levels of the health of boys and younger children were more positive than girls and older children; in addition, levels of self-resilience, satisfaction of peer relation, and parenting rearing attitude were found to have a positive impact on self-rated levels of the health of school-aged children as protective factors. Especially, according to the result of interaction analysis between factors, self-resilience, and parenting rearing attitude were moderators of the effects on between sex and household income and self-rated level of the health of school-aged children respectively. The findings from this study suggested the need to expand the social intervention range to improve school-aged children's health.

• Health Policy and Management
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• v.24 no.1
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• pp.24-34
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• 2014

Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.