• Health Policy and Management
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• v.30 no.1
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• pp.62-71
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• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• YAKHAK HOEJI
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• v.52 no.2
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• pp.160-164
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• 2008

This study investigated the current status and drug expenditure of the drug shortage prevention program in Korea. National health insurance claims data from 2001 to 2005 were analyzed for the drugs with inadequate supply, which were designated as shortage prevention drugs (SPDs). Drug use of SPDs have increased every year, but the average increase rate of drug expenditure for SPDs, 13.5% was lower than that for all the reimbursed drugs, 18.6%. Drugs with price increase based on production cost were more actively used than drugs with prescription incentives for doctors.

• Journal of Preventive Medicine and Public Health
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• v.25 no.3 s.39
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• pp.303-311
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• 1992

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.

• Human Ecology Research
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• v.57 no.1
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• pp.143-157
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• 2019

This study analyzed per capita expenditure (food expenses, housing expenses, health care costs, and cultural & entertainment expenses) by the consumption quintile for middle and older elderly households in addition to personal characteristics, household characteristics and economic factors affecting it. A sample collected from the 6th KLoSHA in 2016, was 2,983 households. First, among each per capita expenditure, the largest expenditure was food expenses, followed by housing expenses, health care costs and cultural & entertainment expenses. Compared with the first quintile of personal consumption expenditure, the largest increase in the fifth quintile was food expenses, followed by cultural & entertainment expenses, housing expenses, and health care costs. Second, compared to the fifth quintile of per capita food expenses, all other quintile had negative effects, and only the first quintile showed a negative effect compared to the fifth quintile of per capita housing expenses. The first, the second, and third quintile had a negative effect compared to the fifth quintile of per capita health care costs. Compared with the fifth quintile of per capita cultural & entertainment expenses, only the third quintile showed a negative effect. Third, in all quintile of per capita food expenses, the most influential variable from the first quintile to the third quintile was marital status, while in the fourth and fifth quintile included household income. In all quintile of per capita health care costs, health status was the most influential variable from the first quintile to the fourth quintile, and residence was in the fifth quintile.

• Korea journal of population studies
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• v.25 no.1
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• pp.257-289
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• 2002

In this study we analyse how the tobacco prices have an effect on the national health. The level of tobacco price will fluctuate its consumers demand and eventually affect the national health status. We estimate tobacco consumption function as well as households'demand system in which tobacco and health expenditure functions are included. Demand elasticities are estimated and evaluated in order to find future policies to improve the national health by controlling the national tobacco consumption There are two econometric approaches app1ied in this study. The lent tobacco demand analysis method is mm tobacco consumption function model. Using national indices of tobacco price, tobacco consumption and other related variables, tobacco consumption function is estimated. The other is micro demand system analysis by using Korean urban households expenditure data during the period of 1991 to 1999. The own price elasticity which is estimated from national tobacco demand per capita is -0.19 for all people and -0.176 for the adults over 18, which means 100% price increase will cause decease of tobacco demand at 19% and 17.6% per each The cross vice elasticity which is estimated between tobacco and health expenditure of urban households demand system is -0.2328, which implies 100% of tobacco price increase will decrease 23.28% of health expenditure. The low price elasticities imply that tobacco price increase will increase total tobacco sales volume. 100% of tobacco price increase will bring about 79% increase of total tobacco sales volume according to our scenario. Korea's tobacco demand is negatively responsive to fluctuations in its price. The health expenditure is also negatively relatedto the tobacco price fluctuation. These empirical outputs could be utilized as the basis of government's tax policy to control national tobacco consumption in the future.

• Health Policy and Management
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• v.26 no.3
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• pp.172-184
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• 2016

Background: The objective of this study was to examine the effect of occurrence and reoccurrence of catastrophic health expenditure (CHE) on transition to poverty and persistence of poverty in South Korea. Methods: The data of the year 2008-2011 from the Korea Health Panel were used. CHE was defined as the share of total health expenditure in a household out of a household's total income at various threshold levels (more than 5%, 10%, 15%, and 20%). The effect of catastrophic expenditure on transition to poverty and persistence of poverty was analyzed through multivariate logistic regression. Results: The shares of households facing CHE at various threshold levels have increased gradually with 37.7%, 21%, 13.1%, and 9.5% in 2011. Households facing CHE were more likely to experience transition to poverty at thresholds level of more than 5% and 20% in 2010 set. Households facing CHE seemed to experience persistence of poverty, but it was not statistically significant. About 40% of households facing CHE in 2009 encountered another shock of CHE in 2010. Households without CHE seemed to experience more transition to poverty and persistence of poverty, but it was not statistically significant. For household with multiple CHE, those with medical aid were more likely to experience transition to poverty with statistical significance, but the statistical significance disappeared in case of persistence of poverty. Conclusion: The Korean health system needs to be improved to serve as a social security net for addressing transition to poverty and persistence of poverty due to facing CHE.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.45-56
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• 2021

Purpose: Repeated hospitalization could be a proxy of unnecessary or preventive admission in South Korea where barriers to hospitalization are relatively low. This study aimed to estimate the current status of repeated hospitalization due to ambulatory care sensitive conditions (ACSC) in South Korea. Methods: Using the National Health Information Database, repeated hospitalization databases were constructed in units of episodes for patients who had been admitted more than twice between January 2017 and December 2018. The number of hospitalizations, total in-hospital days, and total medical expenditure were calculated and compared by patient characteristics in both of the entire patient group and the ACSC patient group. Results: Of total hospitalization episodes, 26.6% reported repeated admission, and 6.7% of repeated hospitalization was due to ACSC. A total of 183,110 patients with ACSC had been admitted an average of 2.9 times and spent an average of KRW5,630,118. In other words, KRW1,309 billion had been spent for repeated hospitalization due to ACSC. The scale of medical expenditure was relatively large in the highest and lowest socioeconomic status. Conclusion: Repeated hospitalization for ACSC can be considered a simple and intuitive indicator when assessing unnecessary hospitalizations or evaluating healthcare policy.

• Health Policy and Management
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• v.26 no.4
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• pp.333-342
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• 2016

Background: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. Methods: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. Results: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. Conclusion: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4067-4076
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• 2015

This study aims to examine the trend in household catastrophic medical expenditure according to the healthcare coverage types and its associated factors based on the raw data of the Korean Health Panel over the years 2008 to 2011. Correspondence analysis was used to investigate the trend in the incidence rates of annual catastrophic medical expenditure and generalized estimating equation to examine the factors influencing the incidence of catastrophic medical expenditure. The annual mean incidence rates of household catastrophic medical expenditure were 25.1%, 15.4%, 10.1%, 5.4% and 3.2% in the threshold levels of 10%, 15%, 20%, 30%, and 40% respectively. The incidence rate of household catastrophic medical expenditure was higher when the total annual household income was lower, the education level of the householder was lower, the healthcare coverage type was National Health Insurance, the householder had disability, the age of the householder was older, the number of household members was smaller, the subjective health status of household members was lower, and the prevalence rate of the chronic disease of the household was higher(p<0.05). Therefore, a policy for vulnerable households with older or patient members of chronic diseases should be established.

• The Korean Journal of Applied Statistics
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• v.23 no.1
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• pp.1-11
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• 2010

This study aims to improve the more confident and efficient projection method that is to estimate the Number of Household per Family scales(NHF) in projecting the Household Heath care Expenditure(HHE). For this purpose, this paper suggested three results of the research. First, because projecting the NHF does not reflect the recent socio-demographic trends in the process of projecting the National Health Expenditure(NHE),the prior projection results have serious problem in the confidence and political availability. Second, the projection results about the HHE might be underestimated relative to the real one. Third, in order to estimate the more confident and efficient estimates of the HHE, the estimated NHF reflecting the socio-demographic trend must be used to project the one. There is an alternative method that the NHF and the increasing or decreasing rate of them which are regularly surveyed and suggested by the KOSIS should be used to project the process.