• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.437-461
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• 1997

Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

• 한국노년학
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• v.36 no.3
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• pp.905-926
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• 2016

Although the concept of the elderly varies depending on scholars and laws, as consumption expenditure is deeply associated with income due to the nature of this study, 55 years old was set as the low limit standard for the elderly according to Prohibition of Discrimination on Age in Employment and Employment Promotion for the Aged Act and the elderly households were limited to single-elderly person household and an elderly couple family household for this study. It is considered consumption characteristics as a significant analysis subject in terms of social welfare because it could be understood as an expressed need which was a reflection of desire. Therefore, the present study aimed to investigate the consumption characteristics of the elderly households by stereotyping the consumption pattern of the elderly households, and find the determining factors for consumption patterns and thus contribute to the establishment of related policies through the expressed needs of the elderly households. K-means of cluster analysis was performed by putting the consumption expenditure of the elderly households to investigate inherent structural type of consumption pattern of the elderly households, which were the investigation subjects. As a result, four groups were stereotyped and named as below: 'health care-centered type', 'saving-centered type', 'livelihood-centered type', and 'food expenses-centered type' Binary Logistic Regression analysis was used to identify the factors that influence the decision of consumption pattern of the elderly households. The result of study showed that the elderly households faced all different needs and problems and thus there is a need for various approach plans to solve this situation. In particular, although the elderly have been viewed as economically poor people so far, the study showed that there were also kind of prepared households through saving. Overall, livelihoodcentered type accounted for the highest portion and, as a factor that influenced this, marital state and household income played an important role. Therefore, it is considered that more active efforts to increase the income of the elderly households are needed. In addition, age, owning of house and subjective health state were found to also have significant influence. Through these results of the study, the elderly's own improvement of awareness on health, presentation of overall standard for health state of the elderly, securement of the elderly's access to cultural life, and financial management coordination for improvement of quality of life, development and dissemination of jobs suitable for the elderly, and dissemination of communal life household, which is a cooperation residential type, were presented as institutional task in the conclusion.

• 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.

• Journal of the Korean Data and Information Science Society
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• v.28 no.5
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• pp.1069-1076
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• 2017

Recently, with the development of advanced medical technology and the introduction of most advanced medical equipments, life expectancy increases accordingly. Many people want to live long-lived in health. Therefore, if it is possible to pre-diagnose the sub-health condition and formulate an appropriate treatment plan, we can prevent the disease and reduce social expenditure costs. In this study, we statistically analyzed the data in responding to each questionnaire for healthy biorhythm and sub-health among targeted members of a specific group. The analysis for the effects of healthy biorhythm to male and female showed that there was a significant difference between male and female. In the analysis of the effects of the conditions of healthy biorhythm to the 10 sub-health indicators, the significant effects of good and bad condition has been observed. The results of the decision tree analysis showed that all the respondents with poor hormone and urological sub-health status have bad healthy biorhythms. In summary, in this paper we have shown that it may be possible to improve the sub-health condition and prevent disease in advance if the healthy biorhythm is well controlled.

• Health Policy and Management
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• v.23 no.2
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• pp.152-161
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• 2013

Korea has a single National Health Insurance program and all citizens are covered under this program, accounting 97% of the population, approximately 50 million people. Claims submitted by Health care providers are reviewed by Health Insurance Review and Assessment (HIRA) for the reimbursement. HIRA database contains not only individual beneficiary's information, but also healthcare service information such as diagnosis, procedures, prescriptions and tests for them. HRA database has gained attention as importance source for research due to its rich healthcare information and the demand of HIRA database has increased. Due to its tremendous size, however, researchers have had problems in accessing the database to conduct research. To meet this demand, we conducted a study to develop the inpatient sample data from HIRA database for research. This study has two purposes: 1) to determine a needed sample size; 2) to test reliability and validity of the sample data. We determined an adequate sample size to ensure representativeness and generality with additional consideration for convenience of calculation. The minimum sample size was 729,904 for the generality, and 488,861 for representativeness. After considering the convenience of calculation, our final sample size was 13% of the population, which was about 7.7 million beneficiaries. Age (5 years interval) and gender were used as stratification variables for sampling. In order to examine whether this sample data appropriately reflect population, we tested the reliability and validity of the sample data. From the sample data, we computed average expenditure of total claims per inpatient for 2011, frequency of top 30 disease, estimation of the number of stroke patients from the sample data, and then compared them to those from the population. Results confirmed reliability and validity of the sample data.

• Korean Security Journal
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• no.25
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• pp.109-130
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• 2010

As many countries in the world including the Republic of Korea have used all their national resources in the accelerating economic information warfare, illegal leakage of industrial technologies and information has increased rapidly. The costs required for damage prevention from 2007 to 2008 are estimated at approximately KRW 180 trillion which is expected to increase gradually in future. Because the tricks of leaking key technologies are also getting increasingly systematized, sophisticated and bigger, e.g., simple theft at the individual level or the conspiracy of all the staff taking part in the research activities, we should pay special attention to technology security in addition to technology development. While there are several factors affecting such the brain drain, they usually include personal, social, political and cultural factors, for instance, very heavy educational expenditure of children compared to relatively low pay, the speedy labor market circulation for experienced personnel, or political restrictions on researches. In this context, as part of efforts made to prevent the outflow of core personnel, individual companies and research institutes should establish systematically appropriate core personnel management systems for their own organizational or business goals and principles which are intented to ensure to give better treatment and benefit to core personnel and to exercise closer supervision over them. Furthermore, the conventional personnel management system should be radically and flexibly improved in the manner of encouraging the core personnel returning to the organization to combine their external experiences with practices, instead of penalizing them. At the same time, it is necessary to train and educate core personnel through mutual collaboration and in-house training facilities as well as external academic programs operated jointly at the level of the industry. Finally, as the issues concerning the outflow of core personnel are not just problems of relevant companies and other advanced countries have devoted their best efforts to secure their own key technologies at the national level, it is urgent for the industry and the competent authorities to cooperate closely.

• Korea journal of population studies
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• v.18 no.2
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• pp.115-168
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• 1995

It is a common wisdom that the long-term economic development of Korea chiefly depends not only on the steady increase of the capital formation but also on the stable increase of the national saving. And also it is a widely accepted opinion that household saving plays a significant role for the smooth supply of investment funds. For the empirical analysis on the determining factors of household saving, consumption function of the household of Korea was utilized indirectly. The reason is that consumption function is regarded as a stable function whereas saving function is considered to be an unstable function of the relevant independent variables. In order to carry out the regression process of the consumption functions, data on the family income and expenditure survey and the farm household economy survey was used. The regression result could be summarized as follows : Firstly, household income and the number of the employed in the household have the negative effect in determining the consumption ratio of the Korean households. On the other hand, ages and the educational attainment of the household heads as well as the number of the household members have the positive effect. During the early part of 21st century, the consumption ratio of the Korean households is expected to be decreased because of the increasing trend of household income, and the ever increasing number of the employed member of the household based on the increasing trend of the labor force participation rate of women and the decrease of the average size of the number of household members owing to widespread nuclear family system. On the other hand, the consumption ratio of the household of Korea is expected to be increased because of the continuous increase of the average ages of the household heads caused by the population aging phenomena and improvement of the educational attainment of the household heads. But on the whole, household saving ratio is expected to be increased owing to the secular downward trend of the consumption and therefore no significant difficulties are anticipated for the smooth provision of investment resources needed to have long-term economic progress of Korea.

• Health Policy and Management
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• v.17 no.2
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• pp.1-17
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• 2007

Limited coverage for health care services of National Health Insurance(NHI) in Korea has been ongoing policy issue but additional NHI financing through raising contribution or taxes in order to improve coverage faces substantial obstacles. Private health insurance(PHI) is often considered as an alternative financing source to improve coverage. Recent reform that attempted to stretch the role of PHI allowed life insurance companies to provide complementary PHI, indemnity plan which will pay for uncovered services by NHI and out-of-pocket spending for covered services. Although complementary PHI may relieve financial burden of patients, it may significantly raise NHI spending as well as total health expenditure since little out-of-pocket spending may increase utilization of health care. So far, there has not been enough discussion about concerns of potential adverse effect resulting from extended role of PHI. This study investigated potential increase of NHI spending followed by extension of complementary PHI through sensitivity analysis. The amount of NHI spending for services that would be covered by complementary PHI was calculated using 2005 NHI statistics and expected complementary PHI enrollment rate by age and sex. Expected utilization increases were obtained based on price elasticities$(-0.2{\sim}-0.5)$ from previous studies and expected coverage rate$(50{\sim}80%)$ of complementary PHI and then converted to monetary figures. Because coverage rate of complementary PHI has not been determined yet, we employed the sensitivity analysis using coverage rate of $50{\sim}80%$. Findings demonstrate that additional spending for health care services is expected to be $426{\sim}1,702$ billion won, corresponding amount payed by NHI $298{\sim}1,192$ billion won. In conclusion, since complementary PHI may raise NHI spending significantly, there should be an agreement whether this additional cost would be accountable and acceptable in our society. Potential inefficiency resulting from extended role of complementary PHI should be considered since public and private financing do not operate in isolation and there should be more discussion on proper role of PHI in Korea.

• Journal of Preventive Medicine and Public Health
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• v.38 no.4
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• pp.391-400
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• 2005

Objective : This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. Methods : A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Results : Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. Conclusions : The perceived economic hardships predicted the health status among the eighth graders of South Korea. The overall satisfaction of life was associated with the socioeconomic position indicators. Further research efforts are needed to explore the mechanisms on how and why the socioeconomic position affects the health and health related behaviors in this age group.

• Environmental and Resource Economics Review
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• v.29 no.2
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• pp.113-144
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• 2020

Throughout various data sources, it is widely observed that air quality in South Korea has become improved. Koreans, however, insist that their health status and economic burden due to worsened air quality get degenerated. This study aims to explain the mismatch between perception and measured data, air pollution-led medical expenses, and consumption behaviors in the economics perspectives. First, we demonstrated data-driven evidence of mismatch in the perceived severity of air pollution and its enhancement in measured data. Second, using the health demand model, we theoretically derived and empirically showed a co-rising relation between air pollution severity and medical expenses. Last, we analyzed that the perception led to increased defensive expenditures in consumption. This result implies the possibility of overestimation in air pollution impacts on socioeconomic losses and its possible reverse interpretation from increased social benefit after improved air quality. Our results recommend policy consideration to strengthen air quality standards, to support socially vulnerable groups regarding defensive expenditures, and to improve the accessibility and credibility of air pollution information.