• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.611-621
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• 2020

Objectives: This study aimed to verify the impact of dental health care insurance coverage policy by analyzing the changes in dental care utilization and expenditures over 5 years from 2012 to 2016, when the dental health insurance coverage expansion policy was implemented. From the national cohort data collected by the Korea Health Panel Survey, a retrospective study was conducted for all household members using dental services. Methods: This study statistically verified the difference in the dependent variables by frequency analysis, chi-square test, t-test, and one-way analysis of variance (SPSS version 22, IBM Co. USA, p<0.05). Results: The annual utilization rate steadily increased from 23.4% to 26.1% between 2012 and 2016. Although there were differences in utilization rates by gender, age, and income level, patients kept using the dental services in 2016 regardless of the type of health insurance. The average annual copayment for patient expenditures (out-of-pocket amount) increased from ￦463,844 to ￦537,401 in 2012 and 2016, respectively. Of the dental care expenditures over 5 years, the ratio of uninsured expenses by the elderly decreased from 38.5% to 25.9%, and the national health insurance service coverage increased from 40.3% to 49.1%. Conclusions: Although this policy did not reduce overall patient expenditures, it has been found that there was a positive effect on the elderly and low-income groups; it increased the utilization and access to dental services.

• Research in Community and Public Health Nursing
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• v.28 no.1
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• pp.13-22
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• 2017

Purpose: The aim of this study is to examine the reciprocal causal relationship between social activities and health with reference to the cognitive function level among community-dwelling older adults. Methods: We conducted a longitudinal data analysis using the $4^{th}$ (Time 1) and $5^{th}$ (Time 2) waves from the Korean Longitudinal Study of Ageing adopting cross-lagged panel analysis (CLPA). Results: A total of 3,473 community-dwelling older adults were included in the analysis: 2,053 in the normal cognitive function group, 912 in the mild cognitive impairment group, and 508 in the moderate to severe cognitive impairment group. The CLPA revealed that higher levels of social activities at Time 1 significantly influenced better subjective health perception at Time 2 in all three groups. In addition, better subjective health perception at Time 1 significantly influenced higher levels of social activities at time 2 only in the normal cognitive function group. Conclusion: This study demonstrates that participating in social activities has positive effects on health regardless of the cognitive function level in community-dwelling older adults. This finding suggests that there is a need to develop strategies that can be used to encourage older adults with cognitive decline to maintain participation in social activities.

• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.495-503
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• 2023

Objectives: While older adults using community care services are known to be vulnerable for depression, community care utilization (CCU) may help to improve the mental health of these elderly. To date, however, it is much less clear how CCU affects depressive symptoms in the elderly population. This study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea. Methods: Using the 2006-2019 Korean Welfare Panel Survey, this study is focused on elderly born in 1940 or earlier and selected 3281 persons for baseline interviews in 2006. This consisted of 35 800 person-year observations during a period of 14 years. Panel data analysis were employed to construct years of CCU. Results: After controlling for covariates, linear term of years using community care was negatively associated with depressive symptoms, but a quadratic term was positively significant. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased. The level of depressive symptoms at the 14th year of using community care remains significantly lower than the level at the outset of its utilization. Conclusions: This finding implies that CCU could be beneficial for improving mental health among older adults.

• Health Policy and Management
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• v.25 no.2
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• pp.97-106
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• 2015

Background & Methods: The purpose of this research is to estimate the efficiency of the pharmaceutical firms and the determinants of their efficiency. Stochastic frontier analysis(SFA) and panel study are applied to the data of 60 domestic pharmaceutical firms from 2006 to 2012. Results & Conclusion: First, the result of the stochastic frontier analysis shows that overall efficiency of the pharmaceutical firms is increasing as time goes by. However, if firms are classified by the scale, the larger firms show more efficiency and if classified by the degree of innovativeness, the innovative firms show more efficiency compared to the non-innovative firms. This evidences show that the scale and R&D investment have significant relationships with the efficiency of the pharmaceutical firms. Therefore, it is necessary to increase the national level of investment for the fundamental researches to vitalize R&D of the new drugs. Second, the result of estimation of the determinants of efficiency shows that the firms with larger sales promotion expenses and entertainment expenses have less efficiency compared to the other firms. This can be explained by the structural characteristics of the small generic pharmaceutical firms. Therefore, the government had better make the pharmaceutical firms to reduce sales promotion and entertainment expenses and increase R&D expenses by introducing systems such as global budgeting system on medicine or reference pricing system.

• Journal of muscle and joint health
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• v.27 no.3
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• pp.325-332
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• 2020

Purpose: This study attempted to classify the potential layer for pain in the middle-aged and elderly based on the seventh Aging Research Panel Survey (2018) data and to identify the degree of depression by potential layer. Methods: This study used data from the 2018 Aging Research Panel Survey, whose participants included 6,890 middle-aged and elderly people. The data were analyzed using SPSS/WIN 22.0 and M-plus 8.0 for latent profile analysis. Results: In the study, Type 1 was a "general pain group", Type 2 was the "high back pain group", Type 3 was the "lower body pain group", Type 4 was the "shoulder pain group", and Type 5 was the "pain-free group", which included those who answered that there was no pain. Second, it was found that the variables such as gender, age, education, or not alone were statistically significant (p<.001). Third, the difference in income, subjective health conditions, depression according to the pain site type group were confirmed. Depression was significantly higher in the back pain group, lower body pain group, and shoulder pain group compared to the pain-free group. Conclusion: Developing integrative interventions is necessary to reduce depression using the pain coping skills in middle-aged and Elderly.

• Health Policy and Management
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• v.29 no.1
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• pp.77-81
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• 2019

Suicide is a major public health issue that causes over 800,000 deaths each year globally. Korea ranks high in suicide rates, in which around 24.3 per 100,000 individuals are reported to have died by intentional self-harm in 2017 according to Statistics Korea. The aim of this study was to examine the current status and trend of suicide ideation and attempt using data from the following five sources: Korean National Health and Nutrition Examination (KNHANES, '07-13, '15-17), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-17), Korea Health Panel Survey (KHP, '10-13), and Statistics Korea (1983-2017). Suicide ideation and attempts were also further examined based on equalized household income levels. Data published by Statistics Korea were used to show the updated suicide rate and number of deaths by intentional self-harm. The rate of suicide ideation at the recent year was 4.73% (KNHANES, '17), 6.96% (KCHS, '17), 1.63% (KOWEPS, '17), and 5.39% (KHP, '13). That of suicide attempts as recent year was 0.71% (KNHANES, '17), 0.32% (KCHS, '17), and 0.09% (KOWEPS, '17). Annual percentage change of suicidal ideation was -15.4% (KNHANES, '07-17), -2.5% (KCHS, '08-17), -8.6% (KOWEPS, '12-17), and -10.9% (KHP, '10-13). Annual percentage change of suicide attempts was -4.0% (KNHANES, '07-17), -4.4% (KCHS, '08-17), and -14.9% (KOWEPS, '12-17). Individuals with lower income levels were more likely to experience suicide ideation and attempts. Considering that Korea still shows a high suicide rate despite the continuously decreasing trend of suicide ideation and attempt, continuous observation and appropriate policy implementation regarding suicide related problems are necessary.

• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.21-29
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• 2019

Objectives: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. Methods: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. Results: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. Conclusions: The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

• The Korean Journal of Applied Statistics
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• v.29 no.7
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• pp.1329-1346
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• 2016

Korea Health Panel (KHP) data and Korea National Health and Nutrition Examination Survey (KNHANES) data are collected by self-assess and self-report for individual's health status and medical use. Previous studies have claimed that the reliability for prevalence rates and health life expectancies obtained from these data should be validated. National Health Insurance Services in Korea recently released a sample cohort DB that contain all data related to the use of medical facilities for all entire Korea citizens. It has been shown that disease-specific prevalence rates calculated from these data are representative and reliable for the entire population. In this paper, we evaluate the reliability of prevalence rates derived from self-reported data such as KHP and KNHANES by comparing to the prevalence rates from the sample cohort DB. We found that both KHP and KNHANES underestimate prevalence rates and in turn overestimate health life expectancies. Moreover, the general trends of health life expectancies might be distorted (except for the sample cohort DB) because of sampling and non-sampling errors.

• Health Policy and Management
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• v.24 no.1
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• pp.56-70
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• 2014

Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.

• Health Policy and Management
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• v.27 no.1
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• pp.80-83
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• 2017

The proportion of people who reported unmet healthcare needs is an important indicator to measure the access problem in healthcare service. 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, '2007-2015); the Community Health Survey (CHS '2008-2015); the Korea Health Panel Survey (KHP '2011-2013); the Korean Welfare Panel Study (KOWEPS '2006-2015). The proportion of individual reporting unmet healthcare needs as of 2015 was 12.6% (KNHNES), 11.7% (CHS), and 16.3% (KHP, as of 2013). Annual percent change which characterizes trend for follow-up period was -9.4%, -3.4%, and 7.6%, respectively. The proportion of individual reporting unmet healthcare needs due to cost was 2.8% (KNHNES), 1.7% (CHS), and 4.6% (KHP). The proportion of household reporting unmet healthcare needs due to cost was 1.2% (KOWEPS). Annual percent change was -9.0%, -14.9%, 9.4%, and -18.2%, respectively. Low income population reported about 5 times more unmet needs than high income population. Therefore for decreasing the unmet healthcare needs, strategies focusing on low income population were needed.