• 보건행정학회지
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• 제17권4호
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• pp.31-53
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• 2007

The purpose of a national health care system is to improve health care outcome among population. The objective of the study was to explore the determinants of health outcome in the 24 OECD countries between two health care financing systems. The study employed the pooled time series and cross-sectional analysis with tax-funded and social insurance-funded countries over the period of 1980 to 1999 using OECD Health Data 2002. The study revealed that health expenditure per capita, physicians per 1,000 of the population and calorie intake were positively significantly associated, smoking rate was negatively associated with health outcome while controlling all variables in the tax-funded countries. But in the insurance-funded countries, health expenditure per capita and the number of physicians were not statistically significant factors explaining health outcome. Only the calorie intake was positively associated with, and smoking rate, alcohol consumption per capita, and total nitrogen oxide emission per capita were negatively significantly associated with health outcome. In conclusion, healthy life style factors were much more important to improve health outcome in the both systems.

• 보건행정학회지
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• 제27권3호
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• pp.199-210
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• 2017

Background: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public-private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. Methods: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. Results: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. 'Transfers from government domestic revenue' share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to 'compulsory contributory health financing schemes,' 'Transfers from government domestic revenue' share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. Conclusion: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.

• 서비스연구
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• 제11권4호
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• pp.43-55
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• 2021

본 연구는 OECD 회원국들을 대상으로 의료서비스의 운영효율성과 품질효율성을 비교 분석하였다. 이를 위하여 2017~2019년의 OECD 보건통계(Health Statistics) 자료를 이용하였다. 분석 방법으로는 산출지향형(output-oriented) 규모수익가변(VRS: Variable Returns to Scale) 모형을 적용하여 초효율성(super efficiency)을 측정하였다. 분석결과, 운영효율성의 상위 그룹에는 스위스, 한국, 이탈리아, 노르웨이, 오스트리아, 네덜란드, 중위 그룹에는 캐나다, 그리스, 덴마크, 멕시코, 미국, 영국, 체코, 프랑스, 핀란드, 헝가리, 호주, 하위 그룹에는 벨기에, 독일, 스페인이 포함되었다. 품질효율성의 상위 그룹에는 노르웨이, 스위스, 스페인, 중위 그룹에는 그리스, 덴마크, 멕시코, 미국, 영국, 캐나다, 프랑스, 핀란드, 헝가리, 호주, 하위 그룹에는 네덜란드, 독일, 벨기에, 오스트리아, 이탈리아, 체코, 한국이 해당되었다. 2018년을 기준으로 OECD 회원국별로 효율성을 비교 분석한 결과, 운영효율성이 가장 효율적인 한국은 품질효율성이 비효율적이었다. 한국(0.998)은 그리스(0.422), 스위스(0.207), 스페인(0.371)을 벤치마킹하여 기대수명을 0.2(0.2%), 주관적 건강 인지를 44.2(138.1%)씩 개선하여 품질효율성을 향상시켜야 한다. 이는 국내에서 기대수명이나 유병률 같은 객관적 지표로 건강상태를 측정하고 있지만, 의학적 진단 여부와 별개로 국민들이 본인의 건강에 관하여 주관적으로 평가하는 것을 관리할 필요가 있음을 의미한다. 본 연구는 운영효율성에 초점을 맞춘 대부분의 선행연구들과 다르게 운영효율성과 품질효율성을 함께 측정했다는 점에서 학술적인 시사점을 지닌다. 또한 OECD 회원국별 의료서비스 산업의 효율성을 비교 분석함으로써, 국내 의료서비스 산업의 국제적인 경쟁력 수준을 확인하고 효율성 개선 방안을 제시했다는 점에서 실무적인 시사점을 지닌다.

• 보건행정학회지
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• 제26권2호
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• pp.95-106
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• 2016

A new manual of System of Health Accounts (SHA) 2011, was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. This offers more complete coverage than the previous version, SHA 1.0, within the functional classification in areas such as prevention and a precise approach for tracking financing in the health care sector using the new classification of financing schemes. This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 1970-2014 constructed according to the SHA2011. Data sources for public financing include budget and settlement documents of the government, various statistics from the National Health Insurance, and others. In the case of private financing, an estimation of total revenue by provider groups is made from the Economic Census data and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. CHE was 105 trillion won in 2014, which accounts for 7.1% of Korea's gross domestic product. It was a big increase of 7.7 trillion won, 7.9%, from the previous year. Public share (government and compulsory schemes) accounting for 56.5% of the CHE in 2014 was still much lower than the OECD average of about 73%. With these estimates, it is possible to compare health expenditures of Korea and other countries better. Awareness and appreciation of the need and gains from applying SHA2011 for the health expenditure classification are expected to increase as OECD health expenditure figures get more frequently quoted among health policy makers.

• 한국산학기술학회논문지
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• 제12권7호
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• pp.3138-3148
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• 2011

본 연구에서는 우리나라 사망원인의 1위인 악성신생물 중에서 가장 사망률이 높은 폐암에 대하여 우리나라와 OECD 국가들 간에 2000년 이전(1993-1999)과 2000년 이후(2000-2006)의 사망률과 잠재수명손실연수(PYLL)에 통계학적으로 차이가 있는가를 살펴본 후, 폐암에 대한 국가 간 비교와 변화의 추이를 파악하여 보건정책, 보건교육 등의 자료를 제공하고자 하였다. OECD 30개국을 대상으로 "2009 OECD Health data(2010)"의 자료를 이용하여 윌콕슨 검정(Wilcoxon Singed Ranks Test)방법을 사용하여 폐암으로 인한 사망률과 잠재수명손실연수를 성별에 따라 OECD 국가들에서 2000년 이전과 이후의 차이를 확인하였을 때, 남자의 폐암사망률은 6개국은 통계학적으로 차이가 없었으며, 23개국은 감소하였고 우리나라만 사망률이 증가하였다. 여자의 폐암 사망률은 9개국은 통계학적으로 차이가 없었고 1개국(일본)은 감소하였고, 한국을 포함한 20개국은 사망률이 증가하였다. 남자의 잠재수명손실연수(PYLL)는 4개국은 통계학적으로 차이가 없었으며, 한국을 포함한 26개국은 잠재수명손실연수가 줄었다. 여자의 잠재수명손실연수는 15개국은 통계학적으로 차이가 없었으며, 한국을 포함한 3개국은 감소하였고, 다른 12개국은 늘었다. 우리나라의 폐암으로 인한 사망률 및 잠재수명손실연수에 있어서 남자에 대한 대책이 강력하게 요구되고 있다.

• 환경영향평가
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• 제14권5호
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• pp.347-353
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• 2005

The risk assessment is the qualitative or quantitative evaluation of the risk posed to human health and the environment by the actual or potential presence or release of hazardous substances, pollutants or contaminants. The environmental impact assessment (EIA) is assessed by the environmental criteria, and risk assessment is assessed by the risk rate. Risk rate based on dose-response values may not be easy to apply on regulatory basis like EIA for uncertainty. Internationally there is an example of OECD program. Risk assessment of High Production Volume (HPV) Chemicals has started since the OECD Program with the 1990 Council Act on the Co-operative Investigation and Risk Reduction of Existing Chemicals. These HPV chemicals include all chemicals produced or imported at levels greater than 1,000 tonnes per year in at least one Member country or in the European Union region. The SIDS called the Screening Information Data Set is regarded as the minimum information needed to assess an HPV chemical to determine whether any further work should be carried out or not. All the data elements of SIDS including assessment for environment and health are prepared as three formats of the full SIDS Dossier, the SIDS Initial Assessment Report (SIAR), and the SIDS Initial Assessment Profile (SIAP) of an HPV chemical. In 1998 the global chemical industry through the International Council of Chemical Associations (ICCA) has joined to work with OECD. The OECD has assessed approximately 1,000 chemicals from 1991 through 2004 with ICCA. Till the February of 2005, 592 chemicals of those chemicals completed SIDS reports. Member countries have been targeted the goal of 1,000 new chemicals from 2005 to 2010 and Korea shared 36 chemicals from the 1,000 new chemicals. Currently Korea has completed SIDS reports of 7 chemicals among sponsored 24 chemicals. In conclusion SIDS project will be linked to national program for outputs application with more reliable production. Both the OECD and industry will carry out their commitment to complete assessments for more and the remaining chemicals assessment. The major outputs will contribute to cope with international chemical management.

• Journal of Preventive Medicine and Public Health
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• 제56권6호
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• pp.515-522
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• 2023

Objectives: The pandemic caused by coronavirus disease 2019 (COVID-19) has exerted an unprecedented impact on the health of populations worldwide. However, the adverse health consequences of the pandemic in terms of infection and mortality rates have varied across countries. In this study, we investigate whether COVID-19 mortality rates across a group of developed nations are associated with characteristics of their healthcare systems, beyond the differential policy responses in those countries. Methods: To achieve the study objective, we distinguished healthcare systems based on the extent of healthcare decommodification. Using available daily data from 2020, 2021, and 2022, we applied quantile regression with non-additive fixed effects to estimate mortality rates across quantiles. Our analysis began prior to vaccine development (in 2020) and continued after the vaccines were introduced (throughout 2021 and part of 2022). Results: The findings indicate that higher testing rates, coupled with more stringent containment and public health measures, had a significant negative impact on the death rate in both pre-vaccination and post-vaccination models. The data from the post-vaccination model demonstrate that higher vaccination rates were associated with significant decreases in fatalities. Additionally, our research indicates that countries with healthcare systems characterized by high and medium levels of decommodification experienced lower mortality rates than those with healthcare systems involving low decommodification. Conclusions: The results of this study indicate that stronger public health infrastructure and more inclusive social protections have mitigated the severity of the pandemic's adverse health impacts, more so than emergency containment measures and social restrictions.

• Safety and Health at Work
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• 제2권2호
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• pp.148-157
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• 2011

Objectives: Although compensation for occupational injuries and diseases is guaranteed in almost all nations, countries vary greatly with respect to how they organize workers' compensation systems. In this paper, we focus on three aspects of workers' compensation insurance in Organization for Economic Cooperation and Development (OECD) countries - types of systems, employers' funding mechanisms, and coverage for injured workers - and their impacts on the actual frequencies of occupational injuries and diseases. Methods: We estimated a panel data fixed effect model with cross-country OECD and International Labor Organization data. We controlled for country fixed effects, relevant aggregate variables, and dummy variables representing the occupational accidents data source. Results: First, the use of a private insurance system is found to lower the occupational accidents. Second, the use of risk-based pricing for the payment of employer raises the occupational injuries and diseases. Finally, the wider the coverage of injured workers is, the less frequent the workplace accidents are. Conclusion: Private insurance system, fixed flat rate employers' funding mechanism, and higher coverage of compensation scheme are significantly and positively correlated with lower level of occupational accidents compared with the public insurance system, risk-based funding system, and lower coverage of compensation scheme.

• Human Ecology Research
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• 제60권4호
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• pp.595-607
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• 2022

This study aims to clarify the relationship between family policy and children's quality of life through an international comparison and to determine which family policy factors contribute to children's quality of life. The research question is "How can family policies be combined to improve children's quality of life in terms of health and economy?" It includes nine categories of family policies related to money, service, and leave. Measures of children's quality of life include low birth weight, infant mortality, and child poverty. Using the OECD Family Database, and the OECD Child Well-being Data, fuzzy-set Qualitative Comparison Analysis (fsQCA) was used among 20 OECD countries. Combinations of family policies significant to the children's quality of life were derived from the results. This study contributes to the literature by revealing the effectiveness of states' investment in family policy. In addition, the study indicates that since family policies interact with each other, those policies combine to improve children's quality of life.

• 한국경영과학회지
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• 제37권4호
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• pp.125-138
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• 2012

Health care that is considered to be one of the major factors for the quality of life is nowadays receiving a great deal of attention, and thus there is a growing need in Korea to identify the efficiency of national medical service and enhance the competitiveness. Although there exist studies on the medical service efficiency about general hospitals and local hospitals, they mostly deal with the efficiency problems from a domestic and regional perspective. In response, this paper analyzes the competitive efficiency of national medical service with respect to 16 OECD countries, by exploiting Data Envelopment Analysis (DEA) and Malmquist Productivity Index (MPI). Building on the DEA and MPI analysis results, this paper identifies the competitive position of Korean national medical service and suggests implications for the medical service improvement.