The determinansts of expenditure spent on medical care and the ratio of medical care spending to consumption expenditure were investigated using the 2002 House Income and Expenditure Survey by the Korea National Statistical Office, which consisted of a sample of 918 elderly households. There were significant differences in expenditure on medical care and the ratio of medical care spending to consumption expenditure between elderly and nonelderly households. Age, education, overspending were significant factors that determine the expenditure on medical care and the ratio of medical care spending to consumption expenditure. Overspending is the most important factor related to expenditure on medical care and the ratio of medical care spending to consumption expenditure.
Purpose: The purpose of study is to estimate the number of chronic disease patients and medical care expenditure at the time baby-boomers belong to 65 years old aging population, and compare with current 65 year-old aging population. Methods: Analysis method used an estimating formula devised by the researcher and estimated the number of chronic disease patients and medical care expenditure of each generation. Results: When comparing the estimated number of chronic diseases patients of each generation, 40.6% of the first generation, 76.4% of the second generation, 95.2% of third generation are expected to get chronic disease. When comparing each generation's total medical care expenditure, based on the estimated number of chronic diseases patients of each generation, the second generation( 1,206,251,224 thousand won) showed higher than other generation. This study compared the number of chronic disease patients and medical care expenditure between the second generation of the elderly and current elder generation. As a result, the second generation patients was higher than the fourth generation in high blood pressure, diabetes, psychological and behavioral disorder, and neurological diseases whereas the fourth generation is only high the number of patients in heart disease. As for total medical care expenditure, the second generation paid more in high blood pressure, psychological and behavioral disorder while the fourth generation in neurological disease and heart disease. Conclusion: It is desired that considering the number of chronic disease patients and medical care expenditure of baby boomers accounting for 14.6% of total population, in-depth follow-up study is carried out that inquires into what are issues with a current chronic disease management project, what business is needed in order to manage these issues, and how to fund to cover increasing medical care expenditure.
It is very important to estimate the future medical care expenditure, because medical care expenditure escalation is a big problem not only in the health industry but also in the Korean economy today. This study was designed to project the medical care expenditure in view of population age change. The data of this study were the population projection data based on National Census Data(1990) of the National Statistical Office and the Statistical Reports of the Korea Medical Insurance Corporation. The future medical care expenditure was eatimated by the regression model and the optional simulation model. The significant results are as follows : 1. The future medical care expenditure will be 3,963 billion Won in the year 2000, 4,483 billion Won in 2010, and 4,826 billion Won in 2020, based on the 1990 market price considering only the population age change. 2. The proportion of the total medical care expenditure in the elderly over 65 will be 10.4% in 2000, 13.5% in 2010, and 16.9% in 2020. 3. The future medical care expenditure will be 4,306 billion Won in the year 2000, 5,101 billion Won in 2010, and 5,699 billion Won in 2020 based on the 1990 market price considering the age structure change and the change of the case-cost estimated by the regression model. 4. When we consider the age-structure change and inflation compared with the preceding year, the future medical care expenditurein 2020 will be 21 trillion Won based on a 5% inflation rate, 42 trillion Won based on a 7.5% inflation rate, and 84 trillion Won based on a 10% inflation rate. Consideration of the aged(65 years old and over) will be essential to understand the acute increase of medical care expenditure due to changes in age structure of the population. Therefore, alternative policies and programs for the caring of the aged should be further studied.
This study aims to identify the inequalities and characteristics of health care expenditure of the elderly and non-elderly households by income level. As a result, health care expenditure of elderly households was statistically significantly higher than that of non-elderly households. As a result of calculating the concentration index of health care expenditure by income level, inequality was higher in order of non-elderly households, elderly households, and total households. In order to confirm the effect of health expenditure on household income inequality, we calculated the concentration index of income excluding total health care expenditure from total income. As a result, inequality was higher in order of elderly households, whole households, and non-elderly households. There was not much difference in inequality of health care expenditure among elderly households and non-elderly households. And, the health care expenditure of elderly households was much higher than that of non-elderly households. Also, inequality of health care expenditure by income group was serious. There should be no cases where the medical care support policy for elderly households can not use necessary medical services.
This study evaluates the degree of the inequality of medical care expenditure and private health insurance benefits and the relation with household income inequality in korea health care system. This study used the 2014 korea Health Panel survey, and study method is Gini coefficient. The main results are as follow. First, average household income in 1st income quartile is 6,290,000won and 10st income quartile is 101,930,000won. And Gini coefficient of Korea household income is 0.3756. In other words, family income inequality is quite serious. Second, the Gini coefficient of the public institution supported medical care expenditure, such as health insurance and public assistance, is 0.0761, and the Gini coefficient of the expenditure of transportation fee and medical materials etc that don't supported is 0878. The inequality in medical care expenditure in public health care system and without public support aren't serious all. Third, Gini coefficient in excluding household medical care expenditure from household income slightly increased. That is, the medical care expenditure of our country household is the factor of aggravating the inequality of household income. Fourth, Gini coefficient of private health insurance benefits is 0.0927. Therefore, the ineqality in private insurance benefits is low. In addition, the Gini coefficient of the sum of private insurance benefits and household income is 0.3672. it decrease from Gini coefficient(0.3756) of household's. Private health insurance perform the functions somewhat weaken household income inequality. However, it is very little improvement.
Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.
Purpose: To know for what the medical expenditure had been used and to seek the way how it can be efficiently redistributed, I investigated total medical expenditure according to the time period to death in the expired patients for recent 2 years. Methods: 21patients were enrolled in this study. Total medical expenditure including benefit charge and non-benefit charge charged to patients in in-patient department(IPD) and out-patient department(OPD) was counted according to the period for one year by death. Results: 94.7% of the total medical expenditure had been payed for admission-related expenditure and 89% during period 3 and 4 for 6months before death, which may be due to the more days of admission during those periods. 70.1% of the total expenditure had been charged on the admission-fee, room charge, diet, and administration of the fluid, medicines, and blood etc. Conclusion: Majority of medical expenditure has been used in the affairs being unable to improve the survival or quality of life of patients and during the periods closer to death. Here, it would be needed heartily to look for the best ways in detail how the idea of hospice can come true through nation-wide and social consensus.
Sohn, Jungwoo;Cho, Jaelim;Moon, Ki Tae;Suh, Mina;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
Journal of Preventive Medicine and Public Health
/
v.47
no.6
/
pp.327-335
/
2014
Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.
The objectives of this study were analysis of patient\`s characteristics and market segmentation in oriental medical care and western medical care. This study focused on medical utilization using Anderson's health utilization model. The source of data was 1998 National Health and Nutrition Survey which Korean Institute For Health and Social Affairs carried out. A stratified multistage probability sampling design was used in this survey. The analysis was conducted using the statistical software package SPSS version 10.0 and Answer Tree 2.1 which is one of data mining methodology. The results were as follows ; 1) 44.9% of respondents reported visiting oriental medical center within recent two weeks. 3.4% of them used oriental medical care. The group of age, kind of disease and medical expenditure are associated with the difference western and oriental medical utilization rate. 2) There were several factors related to utilization of oriental medical care according to decision tree. Especially, important factors that patient chose his medical center were kinds of disease, kinds of common medical use, and expenditure. 3) in the results of CART analysis, market of oriental medical care were classified by seven categories. The major groups who have a preference for oriental medicine were those musculo-skeletal, cerebra-vascular disease, or chronic headache patients, and they had a preference fur oriental medical care in common use. These results show that oriental and western medical market were divided into various areas by market segmentation.
The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.
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