• Title/Summary/Keyword: Public Expenditure

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Lipid Profiles and Related Factors in Adolescent (청소년의 혈청 지질 분포와 비만, 영양, 운동량의 연관성)

  • Ki, Mo-Ran;Kim, Mi-Kyung;Kim, Ki-Rang;Fang, Jin-Nu;Kang, Yun-Ju;Choi, Bo-Youl
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.83-90
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    • 2000
  • Objectives : To assess the prevalence rate of dyslipidemia and the level of related factors in adolescents groups in Seoul and Yangpyong area. Methods : Design; School based survey during May-Jun 1996 in Seoul and Yangpyong county. Subject; 2,453 boys and girls, aged 13 to 19 years; 1,137 Seoul and 1,316 Yangpyong county. Main Outcome Measures; Prevalence rates of raised serum total cholesterol, triglycerides, LDL-cholesterol, decreased HDL-cholesterol, obesity, and levels of energy intake and expenditure Results : Energy intake and fat intake of boys were higher than those of girls and they were higher in Seoul. Energy expenditure per day of boys was bigger than that of gins too. Prevalence rate of obesity was higher in boys of Seoul(15.2%) and girls in Yangpyong county(14.0%). Serum lipid profiles(total cholesterol, triglycerides, LDL-cholesterol) were higher among girls and all prevalence rates of dyslipidemia were higher in boys in Seoul and in girls in Yangpyong county. Especially, girls(29.1%) in Yangpyong had raised serum cholesterol level$(\geq170\;mg/dl)$. In contrast, boys in Seoul had higher level of decreased HDL-cholesterol(46.8%) compared to Yangpyong(23.6%). The relationships between serum lipid profiles and relative weights and sex are highly significant. And the relationship between triglycerides and energy intake is significant(p=0.038). But, the associations between serum lipid profiles and energy expenditure had borderline significances Conclusions : Hypercholesterolemia rates in girls were higher. Obesity prevalence rate was highest in boys of Seoul. Relative weight and sex are significantly related to lipid profiles. Therefore, Korea is in need of preventive strategies for different obesity and gender groups.

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Effects of reimbursement restriction on pharmaceutical expenditures : A case of Ginkgo biloba (은행잎 제제의 급여제한 정책효과 분석)

  • Kwon, Hye-Young;Lee, Tae-Jin
    • Health Policy and Management
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    • v.21 no.2
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    • pp.249-262
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    • 2011
  • Since May 1st in 2008, the products of ginkgo biloba extract have had to be used with the patient's out-of-pocket payment due to reimbursement restriction guidelines. This study aims to analyze the policy effects of reimbursement restriction on pharmaceutical expenditures using interrupted time series(ITS) analysis. We retrieved monthly NHI claims data for the period between May, 2005 and December 2009. The ingredients identified as a substitute for ginkgo biloba have similar indications based on the similar pharmacological activities. The effects of changes in reimbursement scope were evaluated both for all relevant pharmaceuticals within the same therapeutic class and for 2 separate groups : ginkgo biloba's and its substitutes. According to the study results, restrictions on reimbursement scope resulted in savings of the drug expenditures in the targeted therapeutic class. Direct restriction on ginkgo biloba was associated with a decrease in expenditure level by 60.1% and changes in trend from an average increase rate of 1.4% to an average decrease rate of 1.5% for the therapeutic class, with a dramatic decrease in expenditure level(-191.5%) for ginkgo biloba itself, but with an increased expenditure level(+50.1%) and changes in trend from an average increase rate of 2.0% to an average decrease rate of 1.0% for the substitute group. Further policy to restrict nicergoline was associated with additional decrease in expenditure level for the therapeutic class. Additionally, we could identify the balloon effect - a new policy squeezing one part results in bulging out elsewhere. After the restriction of ginkgo biloba, the utilization of and expenditures on its substitutes increased significantly. In conclusion, we demonstrated that consecutively introduced policies effectively reduced overall expenditures on the therapeutic class of interest. Some ingredients played as a substitute while others did not. Further studies need to be conducted to identify which factors determine a substitute.

Feasibility of Enhancing Fishing Household Income Through Leports-fishing Development (레포츠피싱을 통한 어가소득 증대에 관한 연구)

  • Park, Seong Kwae;Kim, Soo Jin;Kim, Young Ja
    • Journal of Fisheries and Marine Sciences Education
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    • v.19 no.2
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    • pp.180-196
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    • 2007
  • This study aims at analyzing the potential of leports-fishing for improving fishing household income. Leports-fishing is a composite concept which is combined with those of leisure, sports and fishing. Korean on-shore resources have also a composite characteristic. The properties of the east, west and south coastal waters are quite different in geography, biology and ecology. There is a array of leports-fishing development potentials of utilizing their characteristics. At present, angling forms a main activity of leports-fishing, but coastal seas would be an emerging space for the public. In order for them to be a ground of fun, enjoyment and festivals, it would be necessary to supply a wide range of activities and facilities including angling, scuba diving, fish barbecue, ecological experience, fishing experience, cruise, and so forth. As seen in the survey results, the participants have strong desire for fun and enjoyment through leports-fishing activities. The proportion of people participating in one or two times a year amounts to 40 percent. Most coastal places visited are close to medium/large cities and two-days leports-fishing/tourism accounts for some 77 percent. However, it turned out that conflicts between leports-fishing participants and fishermen are not serious. The results of expenditure function estimation appear that the elasticity of per capita income is very high with 1.2660 and that there are negative relationships between leports-fishing expenditure and transportation/food/lodging costs. Assuming the annual national economic growth rate of 4 percent, it is anticipated that Korean leports-fishing population will increase to 3.18 million in 2010 and 4.07 million in 2015. Korean leports-fishing market potential in 2015, which is calculated based on per capita expenditure on leports-fishing, appears to amount to 1,400 billion won~1,600 billion won. The contribution of such market potential to the fishing households is expected to be 62.3~74.2 percent(934.5 billion won~111.3 billion won).

Factors associated with changes in pharmaceutical expenditures of outpatient care in clinic setting : Focusing on the incentive scheme to reduce total prescribed drug expenditure and the drug utilization review system (의원 외래환자의 약품비 변화 관련요인: 처방총액 절감 인센티브제도와 DUR 제도 시행 전후를 중심으로)

  • Yi, Myung-Hyun;Chung, Woojin;Cho, Eun;Kim, Roeul;Lee, Sunmi
    • 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.

The Effect of Gender on Catastrophic Health Expenditure in South Korea: Gender-Based Approach by Subgroup Analysis (개인의 성별이 재난적 의료비 지출 여부에 미치는 영향: 세부집단분석을 통한 젠더적 접근)

  • Kim, Yeonsoo;Kim, Hyeyun
    • Health Policy and Management
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    • v.28 no.4
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    • pp.369-377
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    • 2018
  • Background: Catastrophic health expenditure (CHE) occurs when medical expenditure of a household passes over a certain ratio of household income. This research studied the effect of gender on CHE based on Korea Health Panel data. Methods: This study implemented binary logistic regression model to figure out whether gender affects CHE and how different gender groups show pattern of CHE process. With gender, age, marital status, income level, economic activity, membership of private insurance, existence of chronic disease, and self-rated health were included in the model. Results: Results showed that females faced CHE 1.5 times more than males (odds ratio, 1.241). Also, main determinants of CHE in female groups were marital status, while age and economic activity status were significant in male groups. Subgroup analysis displayed that married female under 35 years old are located in intersectionality of CHE including pregnancy and delivery, multiple health risk behaviors, mental stress, and relatively vulnerable social status due to lower income. Meanwhile, both gender above 50 years old faced remarkably high chance of CHE, which seems to be caused by complex health risk behaviors and chronic diseases. Conclusion: Such results implied not only that gender is an important determinant of CHE, but also other determinants of CHE differ according to gender, which suggests a necessity of gender-based CHE support and rescue policy.

The Long-term Care Utilization of the Elderly with Dementia, Stroke, and Multimorbidity in Korea (치매, 중풍 노인의 장기요양서비스 이용현황과 이용수준 관련 요인)

  • Jeon, Boyoung;Kwon, Soonman;Kim, Hongsoo
    • Health Policy and Management
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    • v.23 no.1
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    • pp.90-100
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    • 2013
  • Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.

Time-activity Patterns and PM2.5 Exposure of the Elderly in Urban and Rural Areas (도시와 농촌 거주 노령인구의 시간활동양상 차이와 초미세먼지 (PM2.5) 노출)

  • Lim, Chaeyun;Guak, Sooyoung;Lee, Kiyoung;Hong, Yun-Chul
    • Journal of Environmental Health Sciences
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    • v.42 no.1
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    • pp.1-9
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    • 2016
  • Objectives: Personal exposure to air pollution is affected by contact over time and by location. The purpose of this study was to determine the relationship between personal exposure to $PM_{2.5}$ and the time-activity patterns of the elderly in urban and rural areas. Methods: A total of 44 elderly participants were recruited for a 24-hour $PM_{2.5}$ personal exposure measurement. Twenty-four were from Seoul (urban area) and 20 were from Asan (rural area). Energy expenditure and spatiotemporal positioning were monitored through $PM_{2.5}$ measurement. Spearman correlation analysis was conducted to determine the relationship between $PM_{2.5}$ and time-activity pattern. Results: Daily average $PM_{2.5}$ personal exposures were $19.1{\pm}9.7{\mu}g/m^3$ in Seoul and $29.1{\pm}16.9{\mu}g/m^3$ in Asan. Although outdoor exposure was higher in Seoul than in Asan, residential indoor exposure was higher in Asan than in Seoul. Higher $PM_{2.5}$ personal exposure in Asan could be explained by longer time in residential indoor environments and higher indoor $PM_{2.5}$ concentrations. Seoul elderly had higher energy expenditure, which may be due to the use of mass transportation. Conclusion: Personal exposure to $PM_{2.5}$ was higher among Asan elderly than Seoul elderly because of high residential indoor concentrations and longer residential time. Lack of energy spent and higher personal exposure to $PM_{2.5}$ might have led to higher risk among the Asan elderly.

A Study on the IT Investment Management System in Korean Public Sector (공공부문의 정보화 투자관리 체계 구축 방향 제안)

  • Oh, Kang-Tak;Park, Sungbum
    • Journal of Information Technology Services
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    • v.12 no.3
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    • pp.165-178
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    • 2013
  • The interest in economics and efficiency of IT investment is growing as the amount of overall governmental IT investment steadily increase. Accordingly, there is a strong need to determine whether the expenditure incurs effectively for IT investment and to accurately analyze the economics of IT investment, In this perspective, this study discusses the prior researches on concepts regarding the analysis of IT investment management framework as proposed from academic and professional perspectives in advanced countries' government sectors. Thereafter, an adoption of IT investment management (ITIM) framework has been considered so as to enhance the performance of ICT initiative projects in the public sector. In the suggested IT investment management framework, we suggest economics and efficiency of public IT investment should be improved by integrating ICT project selection and control as well as evaluation stage into single governance framework.

Workplace Health Promotion in Thai Occupational Health Nursing

  • Surintorn, Kalampakorn
    • Korean Journal of Occupational Health Nursing
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    • v.13 no.1
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    • pp.70-78
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    • 2004
  • The increase of health care expenditure for Thai worker calls for the need of workplace health promotion. The purpose of this article is to describe the status of workplace health promotion in Thailand, emphasizing the roles of occupational health nurse. Secondary data analysis and extensive literature reviews were conducted. Results showed that Thailand is committed with implementing health promotion concepts in various settings including workplace. Several public organizations have developed national workplace health projects with different strategies and approaches. Role of occupational health nurses in workplace health promotion has gradually expanded. The new law specifying the functions of occupational health nurse in providing comprehensive health services is in the process. Occupational health nursing standard as related to workplace health promotion has been developed. A research based case study on workplace health promotion program is also presented to elaborate the proactive roles of occupational health nurse. Findings of this study suggest the transitional roles of Thai occupational health nurses in which training and technical supports from related organizations are in need.

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Implementable Strategy on Asset Management of Domestic Public Rental Housing (국내 공공임대주택의 자산관리 도입 방안)

  • Shin, Yoon-Seok;Cho, Hun-Hee;Kang, Kyung-In
    • Journal of the Korea Institute of Building Construction
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    • v.9 no.2
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    • pp.103-110
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    • 2009
  • Recently, maintenance of public rental housing becomes a critical issue because its expenditure possesses the majority proportion of life cycle cost. The countries, such as USA and Singapore, have introduced the approaches for advanced property management, which are cost-effective in the maintenance management. However, as maintenance management system becomes advanced, risks associated with its application are also increased. Therefore, it is needed to assess the appropriate applicability of public rental housing maintenance management considering the constrains in domestic construction industry. The main objective of this study are to investigate international cases and systems and to propose strategic introduction, which satisfies the regulations and policies for domestic public rental housing. In order to evaluate the suitability of the investigated systems, practitioners' opinions were reviewed through the questionnaire surveys using analytic hierarchy process (AHP). The surveys indicate that advanced asset management was the suitable process for managing efficiently domestic public rental housing. Moreover, the results showed each weights of considerable criteria for assessing the effective application of maintenance management, and would contribute to further detailed and systematic management.