• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3173-3177
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• 2016

Background: The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total case-load. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Materials and Methods: Using utilization and spending data accumulated at MOPH during 2008-2013, the cost to the public budget of cancer drugs was assessed per case and per drug type. Results: The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and Non-Hodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Conclusions: Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.

• Journal of Preventive Medicine and Public Health
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• v.42 no.2
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• pp.123-129
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• 2009

Objectives : This study aimed to examine the association between public social expenditure(PSE) and suicides in the 27 countries of the Organization for Economic Cooperation and Development(OECD) from 1980 to 2003. Methods : The age-standardized suicide rates and their annual change(%) were obtained from the OECD Health Data 2007. As a measure of social protection, the PSE(% GDP) was used. The covariates included the annual divorce rate(/100,000 population), fertility rate(number of children/woman aged 15 to 49 years), GDP per capita(US$ PPP), male unemployment rate(%), life expectancy(years) and alcohol consumption(liter/capita) for each country, which were all obtained from the OECD Health Data 2007 and the OECD Social Indicators 2006. Using hierarchical linear models that included these covariates, the effects of PSE on suicides(Model 1) and the annual percent change (Model 2) were examined(Model 3). Also, sub-sample analyses were done for six countries that experienced political/economic transition. Results : We could not find significant effects of PSE on suicides(Model 1), but we observed significantly negative effects on the annual percent change for men and women(Model 2). Such findings were replicated in the sub-sample analysis, and moreover, the effect size was much larger(Model 3). Conclusions : Our finding suggests that social welfare protection can be a pivotal factor for suicide epidemiology, and especially in countries experiencing a social crisis or transition.

• Health Policy and Management
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• v.30 no.4
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• pp.451-459
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• 2020

Background: Although Korean government have been adopting several policies to expand coverage of National Health Insurance (NHI) program, the coverage rate is still below average across Organization for Economic Cooperation and Development countries. This study was to identify public perception on appropriateness of coinsurance rate and factors associated with coinsurance rate in National Health Insurance. Methods: For this cross-sectional study, 507 participants over aged 20 years were recruited from telephone surveys. Respondents experienced at least one and more visiting medical facilities due to medical problems in last 12 months. Demographic factors, socioeconomic positions, and experiences on medical utilization were measured in order to identify factors associated with perception appropriateness of coinsurance rate. Results: The 49.9% (n=209) of the public responded that the coinsurance rate of NHI program was appropriate. There were no differences in positive perception according to socio-demographic factors and experiences on medical utilization except for gender, residential area, and felt expensive when using medical services. People who felt burden of medical expenditure were more likely to perceive coinsurance rate inappropriate (odds ratio, 2.33; 95% confidence interval, 1.52-3.58) Conclusion: In spite of the relatively low coverage rate of NHI, this study identified that 49.9% of the public perceived the current coinsurance rate was adequate. However, people who felt the burden of medical expenditure were still had a negative perception of the coinsurance rate needed to decrease the coinsurance rate.

• Health Policy and Management
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• v.18 no.4
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• pp.23-48
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• 2008

Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.

• The Journal of the Korea Contents Association
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• v.15 no.12
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• pp.560-571
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• 2015

This study aims to examine primary determinant for medical expenditure depending on different age and income brackets. The age and income brackets are simultaneously taken into account for a forming of structural models, and GARCH methodology is utilized in analyzing the model. Empirical evidence reveals that no matter how general medical care system is appropriately operated, medical expenditure is vulnerable in taking care of potential socially-disadvantaged class and the group of catastrophic medical expenditure as long as the age and income brackets concern, simultaneously. It signifies that more elaborately designed medical-related policy seems to be established to improve its effectiveness. On the contrary, ageing society is comparatively well-treated by public health law and act on long-term care insurance for the aged.

• Journal of Distribution Science
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• v.16 no.9
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• pp.79-99
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• 2018

Purpose - Food consumption in Korea has changed in paradigm as it has grown qualitatively in the past in quantitative shortages. Consumer food consumption patterns are rapidly changing due to changes in economic, social and population conditions, scientific and technological development, climate change, and market opening. At the same time, there is a need to actively respond to these changes in terms of the food industry, market, and government policy. The purpose of this study is to examine the changes and characteristics of food consumption expenditure of Korean consumers in-depth and depth in order to provide implications for agriculture, food market and policymakers. Research design, data, and methodology - We analyzed various food consumption changes from the 1980s to 2015 through Household Income and Expenditure Survey raw data from MDIS(Microdata Integrated Service) of Statistics Korea. and conducted the age effect, generation effect, and year effect by cohort analysis. We also conducted comparisons with OECD countries on several indicators. Results - Food consumption spending was slow, and there was no significant change in home consumption, while eating out consumption increased about 20 times in 2015 compared to 1980. Income, age, residential area, number of household members showed significant changes in food consumption. According to the cohort analysis, the changes in the food consumption structure are largely due to age effect, and the year, age, and generation effects are different for each food item. Conclusions - Food consumption has a significant impact on not only the nutritional status of consumers but ultimately the public health. Therefore, they should be regarded as a strategic policy area of central government rather than a matter of size and change of food consumption expenditure.

• The Journal of the Korea Contents Association
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• v.19 no.7
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• pp.559-573
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• 2019

The aim of this study is to investigate how social welfare expenditure affects to economic growth in Northern European countries, and such implication might be compared with Korean episode. ARDL cointegration model is employed for emplrical analysis. The model is usefully utilized to analyze short-run and long-run relationships of the variables in general. The result suggests that private welfare expenditure is effective in Korea and Finland even though the magnitude of effectiveness is quite a small scale. On the other hand, public welfare expenditure is effective in Denmark and Norway. However, none of social welfare expenditures affects in economic growth in Sweden. And, therefore, it could be concluded that although social welfare expenditures contribute to improve income inequality, these hardly support income-led growth strategy.

• Health Policy and Management
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• v.5 no.1
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• pp.80-105
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• 1995

Assuming that we introduced integration of medical insurance society for self-employed, this study was conducted to examine effects and results after the integration and to research more effective method for integration. To assess effects and results of the finacial status of 266 insurance societies after intergration, the data were obtained from "The Medical Insurance Program for Self-Employeds Statistical Yearbook in 1992". The major finding are as follows : 1. Three alternative integration proposals were made. First alternative proposal was consisted of 232 medical insurance societies, second was 187, and third was 115. 2. As the results of average number of the insured per insurance societies of medical insurance program for self-employed every alternative proposal, first was 88, 119 persons, second was 108, 576, and third was 178, 967 from 76, 576 persons of present socienties. 3. It was true that the more average size of societies increased, the more average administration expenditure per 1, 000 insured reduced. 4. The average size of societies grew bigger, the rate of general expenditure to general revenue more improved. Also, the rate of benefits to contributions was changed for better. But if not to have had correct analysis and precise preparation for integration, effects and results of integration were always not optiized. 5. According to results of simple regression formulas, it was proved that the more the average size of societies was increased, the more result was advantaged. 6. The law of majority and the economy of scale were applied in this study, and it was necessary to analyze and assess effectiveness and efficiency of integration. Therefore, when the integration of medical insurance societies for self-employeds will be performed, it must be taken into consideration. Among three alternative proposals, third was showed more effective alternative than anothe, second was presented more ineffective result than present system. To achieve more effective and efficient integration of regional medical insurance societies throughout the result of the regression formula on present cost curve, it is necessary to operate well-integrated societies and to know appropriative countermeasures of present situation of each societies. Also, for integrating regional medical insurance societies, it is necessary to continue more deep research through practical model activity and to investigate the effective size and managed method of the societies.societies.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

• Journal of Preventive Medicine and Public Health
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• v.26 no.3 s.43
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• pp.332-346
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• 1993

This study was attempted to observe leisure time physical activity pattern and its relationship to coronary risk factors (BMI, systolic blood pressure, diastolic blood pressure, serum total cholesterol, triglycerides, fasting blood sugar). Subjects participated in this study were 277 adult male workers of an industry in Kyungpook province, Korea. Energy expenditure were measured using modified Physical Activity History questionnaire of CARDIA study by interviewing. Serum total cholesterol, triglycerides and blood sugar level were tested with 5 ml fasting blood and height, weight and blood pressure were masured. Data on smoking and drinking habits and others were obtained. Geometric mean of leisure time physical energy expenditure were estimated as 212.80 kcal per week for study subjects and only 22.4% of them expended 2,000 kcal or more per week in leisure time physical activity. Taking walks or hikes and jogging or running were more frequent leisure time physical activities in study subjects. Statistically significant mean differences in total weekly leisure time physical activity for all coronary risk factors were not found among three groups. Because energy expenditure of leisure time was generally low in this subjects and most of them were healthy men, we did not found that leisure time physical activity was significantly associated with coronary risk factors.