• 보건행정학회지
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• 제27권1호
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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.

• 보건행정학회지
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• 제23권1호
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• pp.59-65
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• 2013

Background: The purpose of this study was to analyze the related factors which decide the percentage of health care expenditure of the total fiscal expenditure of local governments and to provide the basic data to contribute for the efficient allotment of healthcare budget. Methods: This study was conducted by the percentage of health care expenditure for 3 years by classifying a total of 230 local governments into the metropolitan cities (gu, 69), the counties (si, 75), and the boroughs (gun, 86) all over the country. With the collected data, the general characteristics of independent variables and the dependent variable were analysed using SPSS ver. 18.0, The correlation analysis and multivariate regression analysis were conducted for the characteristics of variables according to regions by year. Results: In correlation between health care expenditure by year and other variables, there was a significant positive correlation with unemployment rate, metropolitan cities (gu) and other regions, the percentage of health center personnel, health care expenditure in last year as a independent factors. On the other hand there was no correlation with social assistance recipients and the percentage of aging population, financial self-reliance, industrialization rate, suicide rate, cardiac disease mortality, cerebrovascular mortality on health care expenditure. Conclusion: The study clearly shows that health care expenditure of local governance was not correlated with health care need factors comparing social welfare expenditure.

• Journal of Preventive Medicine and Public Health
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• 제43권5호
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• pp.423-435
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• 2010

Objectives: The low benefit coverage rate of South Korea's health security system has been continually pointed out. A low benefit coverage rate inevitably causes catastrophic health expenditure, which can be the cause of the transition to poverty and the persistence of poverty. This study was conducted to ascertain the effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea. Methods: To determine the degree of social mobility, this study was conducted among the 6311 households that participated in the South Korea Welfare Panel Study in both 2006 and 2008. The effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea was assessed via multiple logistic regression analysis. Results: The poverty rate in South Korea was 21.6% in 2006 and 20.0% in 2008. 25.1 - 7.3% of the households are facing catastrophic health expenditure. Catastrophic health expenditure was found to affect the transition to poverty even after adjusting for the characteristics of the household and the head of the household, at the threshold of 28% or above. Conclusions: 25.1% of the households in this study were found to be currently facing catastrophic health expenditure, and it was determined that catastrophic health expenditure is a cause of transition to poverty. This result shows that South Korea's health security system is not an effective social safety net. As such, to prevent catastrophic health expenditure and transition to poverty, the benefit coverage of South Korea's health security system needs to the strengthened.

• 보건행정학회지
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• 제33권3호
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• pp.363-369
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• 2023

The term "catastrophic health expenditure" means assessing the extent to which medical costs cause financial hardship for households. The aim of this research is to analyze the percentage of households that faced severe financial strain due to medical expenses from 2006 to 2021. This was achieved by utilizing data obtained from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). A trend analysis was conducted to examine the percentage of households that experienced catastrophic healthcare expenses. The households that experienced the catastrophic health expenditure was 2.49% in 2021 using the NaSTaB data. The trend analysis yielded a statistically significant result, indicating a decreasing trend (annual percent change [APC], -4.79; p<0.0001) in the proportion of households facing catastrophic health expenditures. Also, the results of the 2019 KHP and the 2021 HIES showed 1.09% and 2.44% for the households that experienced catastrophic health expenditure. The trend was increased according to the KHP (APC, 0.55; p=0.0004) and the HIES (APC, 7.04; p<0.0001). As a result, this study proposes that sustained attention and further interventions are necessary to ease the economic pressure caused by catastrophic health expenses, particularly for low-income households.

• 보건행정학회지
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• 제13권3호
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• pp.91-103
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• 2003

The purpose of this study was to provide basic reference data for stabilization scheme of health expenditure through forecasting of health expenditure. The authors analyzed the health expenditure from 1985 to 2000 that had been calculated by Korean institute for health and social affair using transfer function model as ARIMA model with input series. They used GDP as the input series for more precise forecasting. The model of error term was identified ARIMA(2,2,0) and Portmanteau statics of residuals was not significant. Forecasting health expenditure as percent of GDP at 2010 was 6.8%, under assumption of 5% GDP increase rate. Moreover that was 7.4%, under assumption of 3% GDP increase rate and that was 6.4%, under assumption of 7% GDP increase rate.

• International Journal of Contents
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• 제9권1호
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• pp.42-48
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• 2013

This research explores the convergence of health care expenditure in Korea with different income groups and the world level by applying different concepts of convergence, including growth rates, trends, differences as well as rationality and statistical variation of health care expenditure. The empirical evidence shows that, in general, the health care expenditure in Korea seems to be on the right track in terms of both level and difference, given the fact that convergence exists with the expenditures of the high income group and the world level. It is also worth mentioning that the Korean public health care system has been performing much better than its private health care counterpart. Such a result suggests that the private health care system has to be more elaborately and systematically managed through the establishment of an operational policy to stimulate an increase in private health care expenditure.

• 보건행정학회지
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• 제24권1호
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• pp.13-23
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• 2014

Background: A need arises to efficiently control health expenditure for medical aid due to a sharp increase in medical aid expenditure. This study experimently analyzes the impact of physician behavior on medical use for medical aid beneficiaries using supplier induced demand (SID) theory. Methods: This study looks into analyze SID effect using expenditure factor analysis of medical aid for the years between 2003 and 2010 in comparison with health insurance. Moreover, this study analyzes the existence and scale of SID using econometrics modeling with panel data on 16 cities and provinces's health expenditure data for medical aid from 2003 1/4 to 2010 4/4. Results: This study finds that the growth rate of visit days per capita and treatment amount per visit days for medical aid is higher than health insurance. Furthermore, the result of econometrics modeling analysis shows the existence of SID in general hospital, hospital, clinic, oriental clinic. Conclusion: In order to efficiently control expenditure for medical aid, it is required to reinforce macro polices such as the introduction of 'target management' and micro policies such as the strengthen of management on medical institutes in the perspective of suppliers as well as regulations of demanders.

• 보건행정학회지
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• 제17권3호
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• pp.50-67
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• 2007

This study investigated income elasticity of household health expenditures and differences by income level from 1998 through 2003. Data from Korean Labor and Income Panel Study was used for empirical analyses. To estimate the income effects on health expenditure, the two-part model was employed: a logistic regression for any health expenditure-first part-and a Ordinary Least Square regression for health expenditure conditional on any spending-second part. To estimate income elasticity, both health expenditure and income were log transformed in the second part. In addition, the random effects(RE) model was used for a longitudinal panel which was continuously followed from 1998 through 2003 to estimate income effects on health expenditures controlling for within and between unobservable household characteristics. Furthermore, difference in income effects on health expenditure across income level was investigated. Although income slightly increased odds of any health expenditure, there was not no table differences across income level. Income significantly increased health expenditures during study period(overall income elasticity: about 0.2) and the highest 20% income group presented higher income elasticity than the lowest 20% income group.

• 디지털융복합연구
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• 제16권10호
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• pp.49-57
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• 2018

본 연구는 소득계층별 노인 가구와 비 노인 가구의 보건의료비 지출의 불평등과 그 특징을 확인함으로써 노인 가구 특성에 맞는 보건의료이용 불평등 해소정책을 제안하기 위해 수행되었다. 분석결과 노인 가구의 보건의료비 지출이 비 노인 가구에 비해 통계적으로 유의하게 많았다. 또한, 소득계층별 보건의료비 지출의 불평등을 확인하기 위해 집중지수를 산출한 결과 비 노인 가구, 노인 가구, 전체의 순으로 불평등이 컸다. 보건의료비 지출이 가구소득불평등에 미친 영향을 확인하기 위해 총 소득에서 보건의료비 지출액을 제외한 소득의 집중지수를 산출한 결과 노인 가구, 전체 가구, 비 노인 가구의 순으로 불평등이 컸다. 따라서 노인 가구와 비 노인 가구 각각의 보건의료비 지출의 불평등 차이가 크지 않았다. 또한, 노인 가구의 보건의료비 지출액이 비 노인 가구에 비해서 많고, 노인 가구의 소득계층별 보건의료비 지출의 불평등 정도가 심각한 것으로 나타났다. 따라서 노인 가구에 대한 의료비 지원정책으로 필요한 의료서비스를 이용하지 못하는 사례가 없도록 함으로서 불평등을 해소하기 위해 노력하여야 한다.

• 보건행정학회지
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• 제22권4호
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• pp.538-560
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• 2012

This study tried to find out the level of national health expenditure and associated factors in the OECD countries and then to derive lessons for Korea's health financing based on the cross-national comparison. As a result, Korea's health expenditure in 2010(7.1% of GDP) accounted for 74.7 percent of the OECD average and ranked as countries to spend less on health. At the same time, the socio-economic indicators such as GDP per capita, elderly population ratio and the total tax revenue to GDP also remained between 72 ~ 82 percent of the OECD average. The public share of health financing(58.2%) was relatively lower than those of other countries. However the health expenditure and the public share have grown 1.9 ~ 2.4 times higher than the OECD average over the past decade. According to the quantitative analysis, countries with relatively high income and elderly population turned out to have high health expenditure. Whereas, an inverse relationship was found between the total health expenditure and the public funding. It was estimated that the value of national health expenditure to GDP decreases 0.083 when the rate of public funding increases 1 percent point. Further, the share of public funding was affected positively by the total tax burden. Based on these findings, this study suggests that the sustainable spending on health and alleviating households' direct burden could be ensured by enhancing the share of public funding along with adjusting the tax burden of the people.