• Journal of Preventive Medicine and Public Health
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• v.22 no.4 s.28
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• pp.542-554
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• 1989

The skyrocketing inflation of medical costs has become a major health problem among most developed countries. Korea, which recently covered the entire population with National Health Insurance, is facing the same problem. The proportion of health expenditure to GNP has increased from 3% to 4.8% during the last decade. This was remarkable, if we consider the rapid economic growth during that time. A few policy analysts began to raise cost containment as an agenda, after recognizing the importance of medical cost inflation. In order to Prepare an appropriate alternative for the agenda, it is necessary to find out reasons for the cost inflation. Then, we should focus on the reasons which are controllable, and those whose control are socially desirable. This study is designed to articulate the theory of medical cost inflation through literature reviews, to find out reasons for cost inflation, by analyzing aggregated data with a deterministic model. Finally to identify determinants of changes in both medical demand and service intensity which are major reasons for cost inflation. The reasons for cost inflation are classified into cost push inflation and demand pull inflation, The former consists of increases in price and intensity of services, while the latter is made of consumer derived demand and supplier induced demand. We used a time series (1983-1987), and cross sectional (over regions) data of health insurance. The deterministic model reveals, that an increase in service intensity is a major cause of inflation in the case of inpatient care, while, more utilization, is a primary attribute in the case of physician visits. Multiple regression analysis shows that an increase in hospital beds is a leading explanatory variable for the increase in hospital care. It also reveals, that an introduction of a deductible clause, an increase in hospital beds and degree of urbanization, are statistically significant variables explaining physician visits. The results are consistent with the existing theory, The magnitude of service intensity is influenced by the level of co-payment, the proportion of old age and an increase in co-payment. In short, an increase in co-payment reduced the utilization, but it induced more intensities or services. We can conclude that the strict fee regulation or increase in the level of co-payment can not be an effective measure for cost containment under the fee for service system. Because the provider can react against the regulation by inducing more services.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.617-626
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• 2015

This study examined the relationship between the physical activity levels and health care utilization in Korean elderly based on the data from The fifth Korean National Health and Nutrition Examination Survey (K-NHANES V). As a result, physically active participants were 0.54 times (OR;95% CI, p<0.001) less likely to use inpatient health care and 0.73 times (OR;95% CI, p=0.040) less likely to use outpatient health care and 0.75 times (OR;95% CI, p<0.007) less likely to use drugstores than physically inactive participants, and the frequency of health care use was lower. In addition, physically minimal active participants were 0.64 times (OR;95% CI, p<0.001) less likely to use inpatient health care than physically inactive participants; the frequency of other health care facilities was lower. In conclusion, the relationship between being physically active and lower health care utilization among Korean elderly identified in this study. This suggests that being physically active is helpful to the elderly, not only in health promotion and improving quality of life, but also in reduced medical expenditure.

• Journal of the Korean Society of School Health
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• v.13 no.2
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• pp.341-347
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• 2000

Background : One-quarter of Koreans are either students or school employeeS. Therefore, school health programs for them have high levels of cost-benefit. School health programs, though, are focused on services such as vaccination and physical examination according to administrational regulations without systemic planning. Futhermore, college health programs run autonomously, not under the supervision of the Ministry of Education. It is my intention to analyse the current status of college school health service centers and use the basic data so generated to model how they might operate at an optimal level of efficiency. Methods : I intended to investigate all 29 colleges in Seoul except some specialized colleges such as theological schools in the two-month period of August and September, 1999. I used the telephone interview method to ask questions relating to personal composition, medical equipment in use, annual expenditure and the provision of school health services. School health services were composed of three items; health servies, health education and a healthy school environment. Results : 27 college health service centers were surveyed. The median number of medical personal in each center was 2, the range was 1-31. 7 centers(25.9%) have only nurses with no doctors. Annual expenditures of 11 centers(50.1%) was less than 10 million won, 19 center(70.4%) were maintained by support from their college. Thirteen centers(48.1%) provided doctor's examinations, 6 centers(22.2%) provided dental care services, laboratory services were provided by seven centers(25.9%). Some 81.5% of the centers had vaccination programs and 44.5% had health education programs. There was no school environment program except insecticide provisions. College health service centers with school doctors differed from centers without school doctors in terms of medical equipment range, annual expenditures and annual case loads. Conclusion : The structure and function of college health service centers in Seoul are diverse. However, no center has a well-organized school health plan.

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.63-70
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• 2017

Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.325-333
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• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

• Journal of the Korean Home Economics Association
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• v.28 no.1
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• pp.89-104
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• 1990

This study was a succession of the paper of Reference 1), and was an attempt to quantify the Level of Need of Living through the relation bet ween Ds(Degree of Sufficietncy) and Di(Degree of Importance). The relation formula was: Level of Need of Living=Di×(5-Ds)＋Di×lrl. From the caculated values, some indicators of highest and lowest Level of Need of Living could be cleared and by them the Level of Consumers' Life and Conciousness could be presumed. The main results are as follows. 1. The Level of Need of Living that the indicators of the equity of income allocations, social mobility, judicial equality, and residential amenity showed was the highest, and that of the life of planned expenditure, the development of transportation, the longevity, an the high level of education was the lowest. 2. The rural residents showed the highest Level of Need on the indicators of medical care, culture and basic living expenditures. 3. The higher the perception of social class and the satisfaction of living was, the lower the Level of Need Living was. 4. In general, it was presumed that the Level of Consumer's Life was in the term of sufficiency of the second need, which durable electric consume products were purchased under the intended conciousness of consumers to be as like as others.

• KDI Journal of Economic Policy
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• v.32 no.1
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• pp.51-68
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• 2010

We use data from the Indonesian Family Life Survey (IFLS) to examine the relationship between child health and household economic resources, and find that economic resources as measured by equivalized expenditure have a statistically significant positive effect on child health and protect children from acute health conditions. We make additional use of the data (where extensive data on children's nutrition, household sanitation, the utilization of medical care, and family health status are available) to assess the mechanisms through which economic resources may affect child health. We find evidence that economic resources have a sizable and significant effect on these potential intermediary factors, and that they, particularly household sanitation, partly explain the protective role of economic resources in child health.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.1
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• pp.57-66
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• 2017

Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.

• Journal of agricultural medicine and community health
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• v.33 no.2
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• pp.181-192
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• 2008

Objective: The use of complementary and alternative medicine (CAM) is common especially among patients with osteoarthritis The aim of this study was to investigate the utilization rate and expenditures of patients who use CAM. Method: Two hundred seventy four patients with osteoarthritis were interviewed by a telephone survey. A structured questionnaire about sociodemographic features and type, cost, satisfaction and reason of CAM utilization was used Results: Among 274 patients with osteoarthritis, 251 patients(91.6%) had used at least one type of CAM during six months. There was a significant difference in sex (female), age (70 years), medical security (insurance), educational level between the user and non-user of CAM. Hyperthermia was the most use. The average cost for CAM utilization was 120 thousands won/person during six months and there was no difference in sociodemographic features among the out-of-pocket cost of users. The scores of satisfaction for CAM use were ranged between 60-70. Conclusions: CAM became a popular source of health care because of elderly and lay referral system. And Korean spent a substantial amount of out-of-pocket money on CAM without benefit. Health care system and professionals should pay more attention to CAM, make a evidence for CAM.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.111-119
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• 2019

Purpose : The aim of this study was to investigate patterns of medical use among juveniles and adolescents, including for chronic disease, in Korea. The study sought to do the following: (a) investigate the extent to which chronic diseases account for medical expenditures, (b) investigate and the socio-demographic characteristics associated with medical use, and (c) identify the differences in medical use between juveniles and adolescents. Methods : We used data from the 2015 Korean Health Panel and selected 12 variables. The socio-demographic characteristics investigated included, growth period (juvenile, adolescents), gender, family income, national basic livelihood act status, disability registration, and degree of disability. There were five medical factors that were considered: emergency room use, hospitalization use, hospital outpatient use, chronic disease, and medical expenditure. Data were analyzed using stepwise multiple and logistic regression. Results : The prevalence of chronic disability in juveniles and adolescents was 31.1 % and 1 %, respectively. The factors affecting medical expenditures included hospitalization use, hospital outpatient use, family income, disability, gender, chronic disease, and emergency room use ($R^2=.160$, p<.05). For national basic livelihood act recipients, the probability of having chronic disease was about 1.6 times higher (OR=1.597, 95 % CI=1.092-2.335, p=.016), compared with non-national basic livelihood act recipients. People with disabilities were 6.6 times more likely than those without disabilities to suffer from chronic disease (OR =6.571, 95 % CI=2.776-15.556, p<.001). Hospital outpatient user was 2.3 times higher than non-user (OR=2.260, 95 % CI=1.702-3.001, p<.001). Juveniles had a 1.7 times and 6.2 times higher likelihood of emergency rooms user (OR=1.654, 95 % CI=1.270-2.155, p<.001), and hospital outpatient user than adolescents (OR=6.208, 95 % CI=4.443-8.676, p<.001). Conclusion : The findings of this study suggest that health care services for juveniles is needed to manage chronic diseases that have an effect on medical expenditures.