• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• Health Policy and Management
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• v.24 no.3
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• pp.228-241
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• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

• Journal of Nutrition and Health
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• v.5 no.4
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• pp.161-168
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• 1972

The study was made to analyse the trend of food consumption in Korea from 1960 to 1970. Six kinds of statistical yearbooks in Korea was quoted for the basic data of this study. The results of this study are as follows: 1) The growth rate of populations in Korea from 1960 to 1970 was $2.0{\pm}0.4%$. 2) The production of foods in Korea was irregular by climate and natural phenomania. 3) There were the reverse trade phenomenia except vegetables, fruits and fishery products in export and import of food. 4) The monthly consumption expenditure per family in all city in Korea was \7,080 in 1963, and \29, 900 in 1970. 5) Food consumption in all expenditure was \3,840 in 1963, and \12,120 in 1970. 6) Percentage of food consumption of all expenditure was 54.2% in 1963, and 40.5% in 1970. 7) Cereal in food expenditure was \1,770 in 1963, and \5,060 in 1970. 8) By the growth of western style of life, there was a increase of western food consumption. 9) Engel index in Korea was 54.25 in 1963, and 40.46 in 1970. 10) We found slightly consumptional trend in plant origin food and highly trend in animal origin food. 11) Among the animal food consumption, chickens, canned meat, milk, eggs, and dried milk were highly consumed.

• Health Policy and Management
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• v.24 no.1
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• pp.35-46
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• 2014

Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.5
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• pp.19-27
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• 2022

The size of the government is one of the most fundamental debates of open economies. In any economy, government plays an important role, but a pertinent level of economic prosperity has never been obtained in history without government. Therefore, the objective of this paper investigates the association of government size, economic volatility, and institutional quality for 182 economies from the time period 1996-2016 is collected from the World Bank database. GE is defined as the General government's final consumption expenditure. Health expenditure is represented by HE. Government expenditure on education is denoted by EDUEXP. The economic volatility is measured by the rolling standard deviation of GDP per capita growth rate, Population growth, Trade openness, GINI represented Gini index which measures the degree to which the income distributed or consumption expenses among citizens deviates from a perfectly equal distribution. The results proposed that economic volatility has a significant effect on government size and institutional qualities. Moreover, the paper extends the investigation by finding the link between economic volatility with government health and education expenditure separately. The policy implication drawn from this analysis is that controlling economic volatility may reduce the size of government and also significantly affect health and education expenditures.

• Health Policy and Management
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• v.10 no.3
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• pp.50-67
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• 2000

This study aims to estimate the consumption of antibiotics in Korea and to suggest the further studies. To measure the amount of antibiotics consumption, we referred to the statistic of NFHI(National Federation of Health Insurance) and a private institute of pharmaceutical information(Korea Intercontinental Medical Statistics; IMS Korea). There were 1,563 antibiotics produced in Korea in 1997. The total amount of antibiotics production was 1,197 billion won in 1997. Antibiotics accounted for 17.6% of the total pharmaceutical productions in 1997. Cephalosporins have taken the largest part of antibiotics production since 1992. The estimation using NFHI data showed that the total expenditure of antibiotics used in health facilities was 268 billion won, 608 billion won, 911 billion won in 1990, 1994, 1997 respectively. Tertiary hospitals spent 246 billion won, general hospitals 287 billion won, hospitals 78 billion won, clinics 300 billion won in 1997. The amount of expenditure and the intensity of antibiotics consumption in hospitals have increased more steeply than any other health facilities. The total expenditure of antibiotics consumption in health facilities and pharmacies was 778 billion won when estimated using the data from IMS Korea, and 999 billion won from NFHI. Cephalosporins was the fast growing antibiotics group in all of the market- hospitals, clinics, pharmacies since 1991. To measure the amount and patterns of antibiotics consumption more precisely, a pharmaceutical monitoring or surveillance system is needed.

• Journal of Society of Preventive Korean Medicine
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• v.14 no.1
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• pp.77-96
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• 2010

Objectives : This paper recommends a global budget based payment system for reimbursing oriental medical services in the national health insurance. Methods : We analyzed previous research outcomes related to oriental medical services and payment system We reviewed the experiences of other countries' global budget system in terms of their strength and weakness. In addition, we developed a reimbursement method for oriental medical services based on global budget. Results : Our reviews focused on global budget system of Germany, the Netherlands, the United Kingdom, Canada, France, and Taiwan. The estimation of global budget in the national health insurance was described in two scenarios. First scenario was to allocate oriental medical services in scale after signing a contract for global budget. In this case, 4.16% of the national health insurance expenditure was allocated for the oriental medical services. Second scenario was to estimate the global budget in a historical context. As a result, the first scenario in total budget was higher than the second, and we proposed a retrospective adjustment method for the gap between the budget and the actual expenditure Conclusions : The payment system for oriental medical services is recommended to shift from fee-for-service to global budget.

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.239-240
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• 1996

• Health Policy and Management
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• v.30 no.3
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• pp.311-325
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• 2020

Background: Health statistics of pharmaceutical use and expenditure are essential to make and implement evidence-based pharmaceutical policy. This study aims to demonstrate the methods and results of pharmaceutical consumption and sales in 2018 according to the sources and methods given by the Organization for Economic Cooperation and Development (OECD). Methods: The medication list contains 39,346 medicines both reimbursed and non-reimbursed by the National Health Insurance in 2018. We used the therapeutic categories based on Anatomic Therapeutic Chemical Classification of World Health Organization. This study analyzed National Health Insurance claims data and supply data generated from wholesalers to health care facilities. The indicators are defined daily dose (DDD), per 1,000 inhabitants per day and US$ per capita. Results: In South Korea, the number of medications to which DDD were assigned was 18,055 and it was 45.9% of the total number of medications on the list. The consumption in anti-infective for systemic use (J) and musculo-skeletal system (M) was higher than the mean consumption among the OECD countries. The pharmaceutical sales per person in Korea was also higher than the mean sales per person across the OECD countries. Conclusion: We sought to explain the methods to produce pharmaceutical consumption and sales statistics which we had submitted annually to OECD. Considering the characteristics of pharmaceutical statistics, a direct comparison should be approached with caution. Since the growth in pharmaceutical spending has greatly increased over the past decade, we need to monitor pharmaceutical consumption and expenditure consistently.

• Health Policy and Management
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• v.22 no.4
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.