• Title/Summary/Keyword: Public Expenditure

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Household Out-of-Pocket Payments and Trend in Korea (가계직접부담 비용의 현황과 추이)

  • Park, Yoonsik;Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.3
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    • pp.374-378
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    • 2019
  • After the announcement of Moon Jae-in Government's plan (Moon's Care) for Benefit Expansion in National Health Insurance in August 2017, it is necessary to monitor the effects of the policy, especially household out-of-pocket payments (OOP). This paper aims to observe the current status and trend of OOP in Korea. Current health expenditure (CHE) was 144.4 trillion won in 2018, which accounts for 8.1% of gross domestic product (GDP) increased 9.7% from the previous year. Although GDP's share of CHE has been close to the average of the Organization for Economic Cooperation and Development (OECD) countries, the public fund's share was 59.8% of the total in 2018, which was lower than the OECD average of 73.5%. OOP's share was 32.9% in 2018, which decreased from 37.4% in 2008. The share of OOP of non-covered services was 20.0% in 2018, which decreased from 22.9% in 2008. The share of cost-sharing with third-party payers was 12.9% in 2018, which decreased from 14.5% in 2008. The OOP of non-covered services was significantly decreased in hospital and inpatient curative care, but the OOP of non-covered services was significantly increased in the medical clinic. The effect of Moon's Care was not showed in OOP through the results of 2017 and 2018, but further monitoring is needed because the Moon's Care is progressing and the observational period is short.

Comparison of Approval Process for Nonprescription Drugs in Different Countries (비처방의약품 허가 제도의 국가별 비교 연구 및 고찰)

  • Kim, Joo Hee;Yee, Jeong;Lee, Gwan Yung;Lee, Kyung Eun;Gwak, Hye Sun
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.4
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    • pp.263-272
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    • 2018
  • Nonprescription drugs have become increasingly important in Korean healthcare. By leveraging lower-cost drugs and reducing expenditure associated with fewer physician visits, the nonprescription segment can deliver tremendous value to individual consumers and the Korean healthcare system. Many countries have provided simpler and more rapid routes to market entry for qualifying nonprescription drug products, using the established data on drug safety and efficacy, as well as public and professional opinion. In US, the FDA waived the pre-approval process for over-the-counter (OTC) drugs marketed through the OTC Monograph Process. In Australia and Canada, different OTC product application levels are defined, with a reduced level of assessment required when the risks to consumers are considered low. Japan established a new OTC evaluation system in 2014 to facilitate the Rx-to-OTC switch process. The legislative framework for medicinal products in the European Union allows for drugs to be approved with reference to appropriate bibliographic data for old active substances with well-established uses. Through a comparison of the regulatory framework and the requirements for nonprescription approval process in different countries, several ways to improve regulatory practice for the evaluation of nonprescription drugs in Korea have been suggested.

Korean welfare regime in the conservative administration, 2008-2016 (역진적 선별성의 지속과 확장성의 제약, 2008~2016: 이명박·박근혜 정부시기 한국복지체제의 특성)

  • Yoon, Hongsik
    • 한국사회정책
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    • v.25 no.4
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    • pp.163-198
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    • 2018
  • This study analyzed the change of the Korean welfare regime during the conservative government. It is clear that the welfare expanded during the conservative government, but this expansion was the process of realizing the constraint of expansion that reduces future welfare expenditure in Korea. In addition, as the public welfare centered on social insurance expanded after 10 years of liberal government, the backward selectivity of the Korean welfare regime strengthened in the conservative administration. Expanding social insurance itself does not reinforce the backward selectivity of the Korean welfare regime. However, the industrial structure created by the export-led growth system has intensified the fragmentation of the labor market, and expanding social insurance designed based on regular workers under these conditions has forced the backward selectivity of the social security system. It is for this reason that the backward selectivity has been reinforced during the conservative government.

The difference of the effects of private tutoring expenditure on the change of consumption structure of households depending on income bracket (소득계층별 사교육비 증가에 따른 가구의 소비지출 변화)

  • Baek, Hakyoung;Ahn, Seo Yeon
    • 한국사회정책
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    • v.19 no.3
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    • pp.9-47
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    • 2012
  • The purpose of this study is to analyse the change of consumption structure of households due to spending on private tutoring, then analyse the difference of change depending on income bracket. The results of the study show that the proportion of private tutoring spending of poor households is relatively higher than high or middle income households although the amount is smaller than them. The consumption items adjusted by the change of private tutoring spending are different depending on income level, and adjustment possibility of them of poor households is very lower than other classes. These show their risk of insufficient consumption of food, clothing, and shelter is high. The burden of private tutoring spending of the poor increase the economic insecurity, therefore various supportive approaches such as improvement of the quality of public education, economic support the poor suffering from the burden of private tutoring spending are necessary to prevent the latent problems of the poor and their children.

A Study on Strengthening of Health Care Protection and Sustainability Plan (건강보험 보장성 강화 및 지속가능성 제고 방안 연구)

  • Jung, Yong-Ju
    • The Journal of the Korea Contents Association
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    • v.21 no.4
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    • pp.96-110
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    • 2021
  • Korea is faced with the challenge of adapting to the world's fastest - growing low birthrate, aging society, and low growth with low interest rate era. With low fertility and aging population, the factors of financial income of health insurance are decreasing, and the increase of public interest in health, high cost medical technology and the development of medicine are leading to increase expenditure of health insurance. In this study, I will examine the strengthen protection of health insurance, financial stabilization, and fairness of medical care. First, the present status and limitations of health insurance were identified through domestic policy report, domestic and foreign literature, and precedent research. Second, the foreign health insurance policy measures to stabilize the finances were examined separately. Based on this study, in order to maintain sustainable health insurance through reinforcement and financial stabilization of health insurance, the current financial income structure of health insurance must be renovated. It will be necessary to expand government subsidies and discover new tax revenues. In addition, a policy to save finances by reorganizing the medical bill payment system and medical delivery system will also be needed.

New Drug Listing Process and Reimbursement Standard Management (약제의 신규등재 절차와 급여기준 관리)

  • Yoon Kyeong Bai;Mi-Young You
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.104-107
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    • 2023
  • The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug's clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.

The Association Between Low Carbohydrate Diet and Resting Metabolic Rate in Overweight and Obese Women: A Cross-Sectional Study

  • Seyedeh Forough Sajjadi;Atieh Mirzababaei;Sara Pooyan;Niloufar Rasaei;Mir-Saeed Yekaninejad;Farideh Shiraseb;Khadijeh Mirzaei
    • Clinical Nutrition Research
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    • v.11 no.1
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    • pp.50-61
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    • 2022
  • Resting metabolic rate (RMR) accounts for most daily energy expenditure. The low carbohydrate diet (LCD) attenuates decreases in RMR. This study aims to investigate the relationship between an LCD and RMR status among overweight and obese women. We enrolled 291 overweight and obese women in this cross-sectional study. Body mass index (BMI), fat mass, fat-free mass, visceral fat, and insulin level were assessed. RMR was measured using indirect calorimetry. LCD score (LCDS) was measured using a validated semi-quantitative food frequency questionnaire. Analysis of variance, independent sample t-test, and Multinomial logistic regression tests were used. Results showed no relationship between LCDS and deviation of normal RMR (DNR) even after adjust for confounders (increased [Inc.] RMR: odds ratio [OR], 0.97; 95% confidence interval [CI], 0.92-1.01; p = 0.20; decreased [Dec.] RMR: OR, 0.97; 95% CI, 0.94-1.00; p = 0.14). Some components of LCDS had no significant association with DNR, such as carbohydrate and Dec. RMR in adjusted model (OR, 1.62; 95% CI, 0.98-1.37; p = 0.08) and monounsaturated fatty acids and Dec. RMR in adjusted model (OR, 0.48; 95% CI, 0.21-1.10, p = 0.08). However, refined grains had a significant association with Inc. RMR in crude model (OR, 0.87; 95% CI, 0.77-0.99, p = 0.04). There is no association between LCDS and RMR status.

A Research on Political Engagement Index(PEI) Model about Election Strategy's Immersion in Candidate in Perspective of Engagement -Focusing on university students standard of selecting candidate in election for 18th president (인게이지먼트 관점에서 선거전략의 후보자 몰입에 관한 정치 인게이지먼트 모델(PEI)연구 - 제 18대 대통령 선거에서 대학생들이 후보자를 선택한 기준을 중심으로)

  • Kim, Man-Ki;Kim, Gyu-Hyun
    • Journal of Digital Convergence
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    • v.11 no.8
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    • pp.1-10
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    • 2013
  • Even though the importance of reading voters' share of mind increases in political campaign, there is no research which analyzes engagement in perspective of political campaign. Therefore, the purpose of this research is to calculate political engagement index which is qualitative indicator about political campaign's immersion in candidate in perspective of engagement and provide scientific data for political advertisement and publicity strategy. For this purpose, A and B candidates who ran for 18th president in December 19th, 2012 are selected for subjects of the research. The young people whose voter participations are low in this presidential election are selected as subjects for responding questionnaire and are surveyed. This research is qualitative evaluation which tires to supplement a limit of qualitative analysis of content by surpassing quantitative evaluation including advertisement, promotion, public opinion on politics, ratings, etc. Evaluation attribute is designed to distribute 8 PEI into 0~100 score. If PEI is more than 50, then the score indicates immersion above average. If PEI is lower than 50, then the score indicates immersion below average. The model of the research will contribute to development of methodological research of political campaign strategy. Also, in the future, this model can be used as micro-targeting in each political campaign's election strategy.

Socioeconomic Impact of Cancer in Member Countries of the Association of Southeast Asian Nations (ASEAN): the ACTION Study Protocol

  • Kimman, Merel;Jan, Stephen;Kingston, David;Monaghan, Helen;Sokha, Eav;Thabrany, Hasbullah;Bounxouei, Bounthaphany;Bhoo-Pathy, Nirmala;Khin, Myo;Cristal-Luna, Gloria;Khuhaprema, Thiravud;Hung, Nguyen Chan;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.421-425
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    • 2012
  • Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.

A National Chronic Disease Management Model and Evaluation of Validity of Primary Care Physician(PCP) Model in Korea (우리나라 만성질환 관리를 위한 질환주치의 모형의 타당성 분석)

  • Chun, Ki-Hong;Paek, Kyung-Won;Lee, Soo-Jin;Park, Chong-Yon
    • Health Policy and Management
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    • v.19 no.3
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    • pp.92-108
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    • 2009
  • This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.