• Title/Summary/Keyword: Medical expenditures for the elderly

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The Precautionary Behavior of Korean Households under Health Uncertainty

  • Kong, Moon-Kee;Lee, Hoe-Kyung
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2001.01a
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    • pp.325-329
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    • 2001
  • This paper tests existence of precautionary saving motive under health uncertainty, using household level panel data from Korea. For this purpose, this paper considers a dynamic health capital model with health uncertainty and derives testable equations for changes in consumption and medical expenditures. Under this framework, households who face future health uncertainty will exhibit precautionary behavior by depressing consumption or increasing investment in health. To test this hypothesis, the paper uses the conditional variance of health as the direct measure of health uncertainty, obtained by estimating a multinomial logit model. Empirical results using the Korean Household Panel Study (KHPS, 1993 - 1997) suggest that Korean elderly households follow the precautionary behavior to insure against future health risk.

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Comparative Interrupted Time Series Analysis of Medical Expenses in Patients with Intertrochanteric Fracture Who Underwent Internal Fixation and Hemiarthroplasty

  • Seung-Hoon Kim;Yonghan Cha;Suk-Yong Jang;Bo-Yeon Kim;Hyo-Jung Lee;Gui-Ok Kim
    • Hip & pelvis
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    • v.36 no.2
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    • pp.144-154
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    • 2024
  • Purpose: The objective of this study was to assess postoperative direct medical expenses and medical utilization of elderly patients who underwent either hemiarthroplasty (HA) or internal fixation (IF) for treatment of a femoral intertrochanteric fracture and to analyze differences according to surgical methods and age groups. Materials and Methods: Data from the 2011 to 2018 Korean National Health Insurance Review & Assessment Service database were used. Risk-set matching was performed for selection of controls representing patients with the same sex, age, and year of surgery. A comparative interrupted time series analysis was performed for evaluation of differences in medical expenses and utilization between the two groups. Results: A total of 10,405 patients who underwent IF surgery and 10,405 control patients who underwent HA surgery were included. Medical expenses were 18% lower in the IF group compared to the HA group during the first year after the fracture (difference-in-difference [DID] estimate ratio 0.82, 95% confidence interval [CI] 0.77-0.87, P<0.001), and 9% lower in the second year (DID estimate ratio 0.91, 95% CI 0.85-0.99, P=0.018). Length of hospital stay was significantly shorter in the IF group compared to the HA group during the first two years after time zero in the age ≥80 group. Conclusion: A noticeable increase in medical expenses was observed for patients who underwent HA for treatment of intertrochanteric fractures compared to those who underwent IF over a two-year period after surgery. Therefore, consideration of such findings is critical when designing healthcare policy support for management of intertrochanteric fractures.

Utilization and Out-of-pocket Expenditure of Complementary and Alternative Medicine in Low-income Patients with Osteoarthritis in a City (일개 시지역 저소득 골관절염 환자의 보완대체요법 이용실태 및 비용 -의료급여 및 건강보험하위 20% 대상자를 중심으로-)

  • Kam, Sin;Park, Ki-Soo
    • 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.

An Analysis on the Characteristics of High Cost Patients in the Regional Medical Insurance Program (의료보험 고액진료비 환자의 특성연구)

  • 문옥륜;강선희;이은표;좌용권;이현실
    • Health Policy and Management
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    • v.3 no.1
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    • pp.53-83
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    • 1993
  • A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

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Factors Affecting the Purchase of Indemnity Private Health Insurance and Related Factors of Outpatient Healthcare Utilization among Chronic Disease Patients (만성질환자에서 실손형 민간의료보험의 가입 관련 요인과 외래 의료이용의 관련 요인)

  • Hur, Jung Won;Kwon, Young Dae
    • Korea Journal of Hospital Management
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    • v.24 no.3
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    • pp.1-10
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    • 2019
  • Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.