The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.
Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
In Korea, the institutional reform for the national medical insurance system is in process. Eventually, three kinds of the national medical insurance system, i.e., medical insurance program for the industrial workers, the govemment employees and the private school teachers, and the self-employeds, would be merged into an unifed system. In this study, I analyzed the annual trends of the finance in the medical insurance system in Korea, in which I found the financial instability especially in the medical insurance program for the self-employeds. The regression analysis was carried out to forecast the accumulated reserve at the end of this year for the medical insurance program for the self-employeds. I also analyzed the economic effect of the merge of the medical insurance program for the self-employeds by using the case of Japan and Korea. I found that the medical insurance for the self-employeds is expected to have financial deficit at the end of the year 1998 after the merge. In onclusion, it seems to be quite difficult to solve the financial instability in the medical insurance program for the self-employeds after it would be merged. That means that there would be a lot of problems on the way to the merge.
The Journal of Asian Finance, Economics and Business
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제8권1호
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pp.665-673
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2021
Default has become an extreme concern in the current world due to the financial crisis. The previous prediction of companies' bankruptcy exhibits evidence of decision assistance for financial and regulatory bodies. Notwithstanding numerous advanced approaches, this area of study is not outmoded and requires additional research. The purpose of this research is to find the best classifier to detect a company's default risk and bankruptcy. This study used secondary data from the Pakistan Stock Exchange (PSX) and it is time-series data to examine the impact on the determinants. This research examined several different classifiers as per their competence to properly categorize default and non-default Pakistani companies listed on the PSX. Additionally, PSX has remained consistent for some years in terms of growth and has provided benefits to its stockholders. This paper utilizes machine learning techniques to predict financial distress in companies listed on the PSX. Our results indicate that most multi-stage mixture of classifiers provided noteworthy developments over the individual classifiers. This means that firms will have to work on the financial variables such as liquidity and profitability to not fall into the category of liquidation. Moreover, Adaptive Boosting (Adaboost) provides a significant boost in the performance of each classifier.
Background: Suicide is one of important health problems in Korea. Previous studies showed factors associated with suicide in individual levels. However, suicide was influenced by society that individuals belong to, so it was required to analyze suicide in local levels. The purpose of this study was to analyze the regional disparities of suicide mortality by gender and the association between local characteristics and suicide mortality. Methods: This study included 229 city county district administrative districts in Korea. Age- and sex-standardized suicide mortality and age-standardized suicide mortality (male/female) were used as dependent variables. City county district types, socio-demographics (number of divorces per 1,000 population, number of marriages per 1,000 population, and single households), financial variable (financial independence), welfare variable (welfare budget), and health behavior/status (perceived health status scores and EuroQol-5 dimension [EQ-5D]) were used to represent the local characteristics. We used hot-spot analysis to identify the spatial patterns of suicide mortality and negative binomial regression analysis to examine factors affecting suicide mortality. Results: There were differences in distribution of suicide mortality and hot-spot regions of suicide mortality by gender. Negative binomial regression analysis provided that city county district types (city), number of divorces per 1,000 population, financial independence, and EQ-5D had significant influences on the age- and sex-standardized suicide mortality per 100,000. Factor influencing suicide mortality was the number of divorces per 1,000 population in both male and female. Conclusion: Study results provided evidences that suicide mortality among regions was differed by gender. Health policy makers will need to consider gender and local characteristics when making policies for suicides.
Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.
The Journal of Asian Finance, Economics and Business
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제8권10호
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pp.97-107
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2021
Nowadays, with the constant enhancement in the health of the economy, the average income and living standard have accordingly increased, making the need for financial independence a favorable choice. This research aims to identify the factors affecting the financial independence of young people. The authors implement quantitative analysis, with a set of primary data collected from a survey of 2664 Vietnamese people aged from 18 to 28. The research results demonstrate the considerable impact of monetary, psychological, group-related, and family-related factors on the financial independence of young people. The results of the sample analysis provide adequate evidence to reject the correlative relationship between family and group factors and the financial independence of young people. In addition, there are 3 factors, including demographic factors, monetary factors, and psychological factors, all have varying degrees and directions of influence on young people's financial independence. Most of the mentioned variables reflect a positive effect on financial independence. The only exception is the education variable, illustrated by its negative standardized beta value. A significant difference in financial independence between genders also is reported, suggesting that males seem to have a higher level of financial independence than females.
Purposes: The hospitals needs to generate a minimum profit, in order to perform its own role such as providing high-quality medical services. The demand for hospital management is increasing, as the social demands are diversified and the financial transparency is emphasized. The purpose of this study is to compare hospitals management based on Dupont Identity, by various hospital classification. Methodology: This study is based on '2016 Statistics for Hospital Management' provided by the Korea Health Industry Development Institute. The hospitals were classified according to the scope of care, the type of establishment, the location, and the number of beds. We analyzed the general and financial characteristics of over 337 hospitals using the method of Dupont Identity. Findings: Net profit margin (PM) has the biggest impact on return of equity (ROE). By the number of beds, general hospital with 160-299 beds have the highest return on equity (ROE). By location, hospitals in local municipalities have higher return on equity than hospitals in urban municipalities. According to the type of establishment, public hospitals have lower business performance, and although they invest more than private hospitals. Practical Implications: This study can inspire interest and provide understanding in hospital management and financial structure, by analyzing through an intuitive indicator named Dupont identity. It is possible to provide basic data for hospital management methods for each financial elements, in order to increase the profitability of hospitals.
The purpose of this study was to explore the concepts of health among people with mobility disabilities in order to develop a new holistic model of health and to identify implications for social work practice. A qualitative study based on face-to-face interviews with people with mobility disabilities was conducted. Nine consumers and nine social workers with mobility disabilities participated in the study. Social constructionism, heuristic paradigm, empowerment paradigm, and strength perspectives were used to form conceptual foundations to guide the study. Study participants' holistic descriptions of the concept of health encompassed five domains: biological/physical, mental/emotional, financial, relationships with others, and spiritual. Participants described health as harmony among these five domains. Harmony indicates that all five domains contribute to the concept of health, and that each domain is related to the others. Participants also viewed disability and health as an interconnected whole, not separate concept. The conceptual model developed in this study expands on the existing concepts of health by considering multiple factors at the personal and environmental levels, as well as interactions among the factors and between the levels. The personal level has five domains: biological/physical, mental/emotional, spiritual, financial, and relationships with others. The environmental level has also five domains: relationship with others, financial, social programs, social attitudes toward peoplewith disabilities, and physical environment. All factors under the personal and environmental levels also affect each other. The holistic concept of health for people with disabilities is not solely a part of the person, but rather is a function of the interaction between the person and their environment. The study demonstrated that people with disabilities have strength and resiliency, and health is an attainable goal for them, particularly when environmental and cultural barriers are addressed. The focus of social work practice should be the removal of those barriers encountered by their consumers with disabilities, as well as, the enhancement of internal factors that facilitate well-being.
With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.
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