• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.107-116
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• 1994

The United States adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses (1) The PPS decelerated the increase in the hospital expenditure (Part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (Part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the Part A expenditure were greater than losses in the Part B expenditure. The dependent variables are per capita hospital expenditure, per capita Part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows : (1) The annual increase in the per capita Part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significient (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita Part B expenditure was accelerated by $1.73 (t=1.91) after the implementation of the PPS. (3) The increase in the total Medicare expenditure per capita was reduced by $4.26 (t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.

• Korean Journal of Social Welfare
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• v.46
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• pp.7-36
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• 2001

The current benefit expenditure of National Pension Scheme is comparatively small, as it stands in the early stage in reference to the historical development. On the other hand, the current contribution rate of National Pension is set up beyond which is sufficient to cover the current benefit expenditure. Therefore, National Pension makes big surplus every year such that the size of accumulated fund increases very fast. Nevertheless, the apprehension of financial instability of National Pension prevails these days. If so, is it really well-grounded? In terms of the method of financing. public pension schemes of most of all nations in the world are based on pay-as you go or partial funding. Under these financing methods, financial soundness fundamentally depends on the power that the government is able to impose the burden which is equivalent to benefit expenditure and the attitude of the public which represents whether they will admit it or not. Under this perspective, the judgement of financial soundness of public pension can not be made arithmetically and technically only on the basis of the balance between receipts and expenditure but should be accomplished considering the very complex and diverse aspects. In these context, this paper defines what the financial soundness of public pension means specifically and presents the objective indices which help judge it, that is, implicit debt, cost rate, summarized cost rate, pension expenditure as percentage of GDP, and fund rate. Then, applying the indices, this paper analyzes the long-term financial situation of National Pension empirically and evaluates its financial soundness in exploratory perspective.

• Korean Journal of Social Welfare
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• v.68 no.1
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• pp.5-22
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• 2016

We examined how public social expenditure and individual socio-demographic factors affect individual voluntary activities(volunteering, giving). Hierarchical linear model(HLM) was employed to a nested data set with 37,648 individual subjects and 16 local governments in Korea. HLM analyses yield an insignificant direct effect of public expenditure to volunteering and giving, while individual factors all have significant effects on them. Finally, this study discussed why public social expenditure factor does not have significant influence in this data, and suggested policy implications for promoting volunteering and giving.

• Journal of Families and Better Life
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• v.14 no.2
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• pp.171-171
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• 1996

The Purpose of this study is to find out factors which affect the expenditure on educations for children's human capital and to provide fundamental information to make a policy for education. Data are obtained from 2484 maried couples with children on the pre-school or over. The results of this study are as follows: 1) If the eldest child was in pre-school or public school, the expenditure on private education was higher than that of public education. While in the beyond junior high school, the expenditure on public education was much higher. 2) Life-cycle, the number of children, region, earned income, non-earned income, real assets, Engel's coeeficient were significant impact on the expenditure of education.

• Health Policy and Management
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• v.28 no.1
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• pp.95-97
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• 2018

Catastrophic health expenditure refers to when a household spends more than 40 percent of disposable income for out-of-pocket-expenses for healthcare. This study investigates the percentage of South Korean household which experienced the catastrophic health expenditure between 2006 and 2016 with the National Survey of Tax and Benefit and the Household Income and Expenditure Survey data. Percentage of households with the catastrophic health expenditure and tread tests were conducted with weight variable. The results of the National Survey of Tax and Benefit and the Household Income and Expenditure Survey showed 2.17% and 2.92% of households experienced the catastrophic health expenditure in 2016. In trend analysis, the National Survey of Tax and Benefit showed a statistically significant decreasing trend in the proportion of households with the catastrophic health expenditure (annual percentage change [APC]=-4.03, p<0.0001). However, the Household Income and Expenditure Survey revealed a statistically significant increasing trend (APC=1.43, p<0.0001). In conclusion, this study suggests that optimal healthcare alternatives are needed for the catastrophic health expenditure and monitoring low-income households.

• Health Policy and Management
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• v.27 no.1
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• pp.84-87
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• 2017

Catastrophic healthcare expenditure refers to out-of-pocket spending for healthcare exceeding a certain proportion of a household's income and can lead to subsequent impoverishment. The aim of this study was to investigate the proportion of South Korean households that experienced catastrophic healthcare expenditure between 2006 and 2015 using available data from the Korea Health Panel, National Survey of Tax and Benefit, and Household Income and Expenditure Survey. Frequencies and trend tests were conducted to analyze the proportion of households with catastrophic healthcare expenditure. Subgroup analysis was performed based on income level. The results of the Household Income and Expenditure Survey revealed that around 2.88% of households experienced catastrophic healthcare expenditure in 2015 and that this proportion was highest in the low income group. Results also showed a statistically significant increasing trend in the number of households with catastrophic healthcare expenditure (annual percentage change= 0.92%, p-value < 0.0001). Therefore, the findings infer a need to strengthen public health care financing and to particularly monitor catastrophic healthcare expenditure in the low income group.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6985-6989
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• 2013

Background: This study aimed to examine out-of-pocket expenditure for cancer treatments of hospitalized patients and to analyze changing patterns over time. Materials and Methods: This study examined data of all cancer patients receiving inpatient care from two tertiary hospitals from January 2003 to December 2010. Medical expenditures per admission were calculated and classified into those covered and uncovered by the Korean National Health Insurance (NHI) and co-payment. Results: The medical expenditure per admission increased slowly from 3,455 thousand Korean won (KRW) to 4,068 thousand KRW. While expenditures covered by the NHI have increased annually, co-payments have generally decreased. The out-of-pocket expenditure ratio, which means the proportion of uncovered expenditure and co-payment among total medical expenditure dropped sharply from 2005 to 2007 and was maintained at a similar level after 2007. Medical expenditures, NHI coverage, and the out-of-pocket expenditure ratio differed across cancer types. Conclusions: It is necessary to continually monitor the expenditure of uncovered services by the NHI, and to provide policies to reduce this economic burden. In addition, an individual approach considering cancer type-specific characteristics and medical utilization should be provided.

• Health Policy and Management
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• v.30 no.1
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• pp.126-130
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• 2020

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2018 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. The households experienced the catastrophic health expenditure 2.08% in 2018 using the NaSTaB data. Trend analysis was significant with the decreasing trend (Annual Percentage Change [APC], -4.88; p<0.0001) in the proportion of households with the catastrophic health expenditure. On the other hand, the results of the HIES showed 2.92%, and KHP showed 2.48% of households experienced the catastrophic health expenditure in 2016. The trend was significantly increased in HIES (APC, 1.43; p<0.0001) and KHP (APC, 6.68; p<0.0001). Therefore, this suggests that further interventions to alleviate the burden of catastrophic health expenditure to the low-income group are needed.

• Journal of the Korean Geographical Society
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• v.40 no.1 s.106
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• pp.47-62
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• 2005

This paper aims at analyzing the economic effect of the public financial expenditure on the national industrial complexes. Since public finance support is indirectly supplied to the national industrial complexes, the economic effect of the public financial expenditure on the national industrial complexes may be analyzed indirectly and circuitously In this contort, this paper uses 3 stage analysis method. In the first stage, the economic effect that the public financial expenditure influence the allotment, production and employment of companies residing in the national industrial complexes is analyzed by multiple regression analysis. In the second stage, the economic effect that the investment on the national industrial complexes influence the national and regional economies is analyzed by multiple regression analysis. In the third stage, the economic effect of the public financial expenditure on the national industrial complexes is analyzed through the compromising the results of the first and second stage. The main results of this paper are as follows. Firstly, public financial expenditure on the infrastructure of national industrial complexes leaded to positive growth of the allotment of companies residing in the national industrial complexes. Additionally, growth of the allotment of companies leaded to the positive effect on the production and employment of companies. And secondly, growth of the allotment of companies leaded to the positive effect on the gross regional domestic production. Finally, financial expenditure on the infrastructure of national industrial complexes leaded to positive effect on the national and regional economic growth through the compromising the results of the first and second stage.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.227-232
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• 2007

Objectives : The purpose of this study was to determine the population-attributable risk (PAR) and estimate the total medical expenditure of the Korean National Health Insurance (KNHI) due to smoking. Methods : We used data from the Korean Cancer Prevention Study of 1,178,138 Koreans aged 30 to 95. These data were available from 1992 to 2003 and covered a long-term follow-up period among the Korean population. Results : The total medical expenditure of KNHI related to smoking increased by 27% from $324.9 million in 1999 to $413.7 million in 2003. By specific diseases, smoking-attributable KNHI medical expenditure was the highest for lung cancer ($74.2 million), followed by stroke ($65.3 million), COPD ($50.1 million), CHO ($49 million) and stomach cancer ($30 million). A total of 1.3 million KNHI patients were suffering from smoking-related diseases in 2003. We predicted rises in total KNHI medical expenditure related to smoking to $675.1 million (63% increase compared with that of 2003) and in the total number of KNHI patients suffering from smoking-related diseases to about 2.6million (an approximate 100% increase compared with those in 2003) in 2015. Conclusions : We found a substantial economic burden related to the high smoking prevalence in South Korea.