• Research in Community and Public Health Nursing
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• v.32 no.1
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• pp.95-106
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• 2021

Purpose: The purpose of this study is to investigate the association between unmet healthcare needs due to financial reasons and catastrophic health expenditures. Methods: This study used secondary data from the 2014~2015 Korean Health Panel survey. The subjects of this study were 21,495 people aged 20 or older, and of them, there were 16,227 people aged 20 to 64 and 5,268 people aged 65 or older, which were surveyed between 2014 and 2015. The association between unmet healthcare needs due to financial reasons and catastrophic health expenditures was analyzed through logistic regression. Results: In 2015, 1.7% of people aged 20~64 years and 7.9% of those aged 65 or older experienced unmet healthcare needs due to financial reasons. In the 20~64 age group, people who repeatedly experienced catastrophic health expenditures (=10%,=20%) were less likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=0.50, OR=0.41). However, in the 65-or-older group, people who repeatedly experienced catastrophic health expenditures (=20%) were more likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=1.68). Conclusion: A greater percentage of the elderly repeatedly faced both catastrophic health expenditures and unmet healthcare needs due to financial reasons compared to the non-elderly.

• Korean Journal of Community Nutrition
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• v.28 no.2
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• pp.95-103
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• 2023

Objectives: The budget gap in the health sector of local governments affects the supply of health services, which can cause the health gap. This study classified local governments according to their financial characteristics, such as local financial independence and health budget level. It analyzed the health behaviors and disease prevalence of local residents to examine the effect of local government financial investment on the health of local residents. Methods: To classify types according to the financial characteristics of local governments, financial independence and the health budget data for 17 local governments were collected from the local fiscal yearbook of the Ministry of Public Administration and Security. The prevalence of chronic diseases and healthy behavior was compared using the 16,333 data of adults between the ages of 30 and 65 years among the original data of the National Health and Nutrition Examination Survey (2016-2020). Results: Cluster analysis was used to classify local governments into five clusters according to the health financial capacity type. A comparison of the prevalence of local residents by cluster revealed a similar prevalence of hypertension, diabetes, and hypercholesterolemia. On the other hand, the obesity rate (P < 0.01), high-risk drinking rate (P < 0.01), aerobic physical activity rate (P < 0.001), and healthy eating practice rate (P < 0.001) were significantly different. In addition, an analysis of the odds ratio based on the Seoul area revealed a higher risk of health behavior of non-Seoul residents. Conclusions: It is necessary to review the universal health promotion project budget considering the degree of regional financial vulnerability from the viewpoint of health equity to narrow the health gap among regions.

• Korea Journal of Hospital Management
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• v.22 no.2
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• pp.44-57
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• 2017

The objective of this study is to investigate financial integrity strategies for sustainable development of local public medical centers, and particularly focus on seeking ways to enhance its financial efficiency and publicness. The data which was collected from 33 local public medical centers was analyzed by Data Envelopment Analysis to measure its financial efficiency. Then, Matrix Analysis was used to examine the association of financial efficiency and publicness of local public medical centers with related factors. In the aspects of facilities and location, according to the results, the local public medical centers which have larger number of available hospital beds or located in bigger cities were examined to have higher degree of publicness. In the aspect of human resources, greater number of doctors made both financial efficiency and the degree of publicness decreased, whereas higher participation rate of educational program for doctors affects increasing its financial efficiency and publicness. Lastly, in the aspect of costs, higher labor, material, and administrative cost diminished financial efficiency, but enhanced the degree of publicness. Based on these results, this study concluded that enhancing the publicness of local public medical centers should be pursued by increasing the accessibility with better facilities and location, and also concurrently organizing rational expenditure structure with appropriate cost investment to the resources of local public medical centers. Also, it is necessary to enhance both financial efficiency and publicness simultaneously by improving the quality of health care services through the educational programs for medical staffs.

• International Journal of Human Ecology
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• v.12 no.2
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• pp.77-93
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• 2011

This study investigates the association between chronic health conditions (CHD) and depression with a focus on the mediating effect of financial strain. We tested if age makes any difference in the effect of CHD and financial strain on depression. The data comes from the 2006 Korea Longitudinal Study of Aging (KLoSA) collected by the Institute of Korean Labor Research. The sample consisted of information from 8,961 individuals ages 45-79. Separate analyses were done for middle-age (45-64) and older-adult groups (65-79). There were significant financial portfolio differences among CHD patients and non-CHD, for both age groups, that may constitute the impact of a health event on financial wellbeing; in addition, the associations of CHD on depressive symptoms were different by age groups. The mediating effect of financial wellbeing on the association between CHD and depressive symptoms was verified; in addition, the role of financial wellbeing on the association was especially strong for the older-adult group. The effect of CHD on depression was contingent on the amount of net assets and annual personal income. Implications are discussed based on the findings.

• Health Policy and Management
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• v.22 no.3
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• pp.383-402
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• 2012

The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

• 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 Korean Journal of Health Service Management
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• v.10 no.1
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• pp.27-37
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• 2016

Objectives : This study applied the research model of Bontis (1998), which has been used to investigate everything from business corporations to hospitals in Korea, examined its generalizability and attempted to verify which factors of the intellectual capital affects organizational performance, represented by indicators for the clinical and financial performance of hospitals. Methods : Primary data for the study were collected from 91 general hospitals through self-administered questionnaires, and secondary data on clinical and financial performance of hospitals were collected form existing statistics. Collected data were analyzed with SPSS 11.5 (ver.) and AMOS 18.0 (ver.). Results : It was found that only human capital and customer capital had indirect effects on hospital performance. It was also revealed that structural capital had a direct effect on clinical performance, and an indirect effect on financial performance. Conclusions : This result means that there is a need to individually consider both the clinical performance and financial performance when measuring the organizational performance of a hospital, and it also shows that positive improvement in the clinical performance can contribute to the improvement of the financial performance through this process.

• Korea Journal of Hospital Management
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• v.16 no.3
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• pp.57-74
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• 2011

The purpose of this study is to analyze the relationship between the BSC model's non-financial factors such as learning and growth, internal process, customer and financial factor in general hospitals. To achieve research purpose, the data were collected from 293 employees of 5 hospitals using a standardized questionnaires which were constructed to include BSC model, and applied the structural equation modeling to examine the relationship between non-financial and financial factor. The results show that the learning and growth factor of the model has positive effects of the internal process and customer factor. The internal process and customer factor are strongly related to financial factor. Hospitals have to know non-financial factor which has positively relate to financial factor. Therefore, the results of this study help to enhance the health care center to become aligned and focused on implementing the long-term competitive strategy. This study proposes an effective performance indicators for general hospitals and it is expected to be likely to have positive influence upon enhancing services of general hospitals.

• Korean Journal of Occupational Health Nursing
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• v.30 no.4
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• pp.224-231
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• 2021

Purpose: The purpose of this study was to identify the psychosocial working environment and mental health of financial workers, and analyze the impact of the former on the latter. Methods: Data of 257 financial clerks were extracted from the 2017 5th Korean Working Conditions Survey. Psychosocial working environment was divided into five fields: demands at work, work organizations, interpersonal relations, workplace violence, and working hour quality. Mental health included sleeping problems, psychological well-being, and job stress. Results: A total of 6.1% subjects reported sleep problems, 28.2% experienced poor psychological well-being, and 39.6% had job stress. More than half the subjects were exposed to tight deadlines, complex tasks, hiding feelings at work, fair treatment, fair distribution of work, colleagues' support, and managers' support. Tight deadlines, workplace violence, long working hours, hiding feelings at work, and managers' support had a significant impact on the mental health of financial clerks. Conclusion: Based on the results of this study, we propose that employers, workers, and health managers in the financial industry should work together to establish a respectful organizational culture, prevent long working hours through recruitment, and conduct programs to protect emotional health.

• Health Policy and Management
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• v.30 no.2
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• pp.192-198
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• 2020

Background: Korea National Health Insurance Service (NHIS) is operated as a social insurance system in which people pay a portion of their monthly income as insurance premiums and receive benefits when they experience illness or injury. Since 2005, the national health insurance remained surplus accumulating cumulative reserves each year. However, as of 2018, NHIS revenue recorded 62.11 trillion won and spending of 62.29 trillion won. The deterioration of NHIS finances is expected to accelerate with the aging population, income growth, new medical technology development, and enhanced security policies. Methods: To examine the financial health and sustainability of NHIS, we estimated the future revenue and spending until 2030 using the data from Korea Health Insurance Review and Assessment Service statistical yearbook. 2004-2018 average percentage change in NHIS revenue and spending was calculated. We estimated the future NHIS financial status using two methods. In the first method, we calculated the revenue and spending of the future NHIS by applying the 2004-2018 average percentage change to the subsequent years consecutively. In the second method, we estimated the future NHIS financial status after adjusting for the predicted demographic changes such as the aging population and declining birth rate in South Korea. Results: The estimates from this study suggest that the NHIS's cumulative reserves will run out by 2024. Conclusion: In terms of spending on current health insurance, there should be a search for ways of more efficient spending and funding options.