• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.19 no.4
• /
• pp.483-492
• /
• 2012

Purpose: This study was done to identify the relationship of perceived health status, leisure satisfaction, loneliness and life satisfaction and to identify predictors of life satisfaction for elders. Method: The research design for this study was a descriptive survey design using a convenience sample. Data collection was done using self-report questionnaires with 297 elders from 6 community health practitioner posts. Data were analyzed using ANOVA, t-test, Pearson correlation coefficients and hierarchical multiple regression with the SPSS Win 18.0 Program. Results: Life satisfaction had significant negative correlations with age (r=-.31, p<.001) and loneliness (r=-.73, p<.001), and positive correlations with monthly spending money (r=.44, p<.001), health status (r=.63, p<.001), and leisure satisfaction (r=.62, p<.001). The explained variance for life satisfaction was 72%. Variables of monthly spending money, health status, leisure satisfaction, and loneliness significantly predicted the degree on life satisfaction of these elders. Conclusion: Findings of this study provide a comprehensive understanding of life satisfaction and related factors for elders in Korea. However, further studies with a larger random sample and more detailed research design are necessary.

• Journal of International Area Studies (JIAS)
• /
• v.21 no.1
• /
• pp.39-72
• /
• 2017

The purpose of this study is to conduct an empirical analysis on the effect of aid proliferation on government spending on health by the recipient nations using panel data and acquire information on the direction of future ODA operations. In this study, calculated excessive foreign aid index with regard to the health sector of Sub-Sahara African nations and conducted an empirical analysis on the effect of aid fragmentation on government spending on health sector. The result of the analysis disclosed that aid fragmentation significantly reduced government spending on health. It is anticipated that such trend came from the mutual pursuit of profit between the attribute (the needs of the donor nation) of ODA projects after new businesses and the governments of recipient nations that want ODA funding. Because competitive and excessive supports in ODA projects induce distortion in the government budget operation of the recipient nations and thereby trigger disutility in ODA projects, Based on the result of the analysis, We proposed to incorporate a more comprehensive deliberation with regard to the capacity of the recipient nations as well as a need for the role of mediating body such as DAC.

• Journal of Preventive Medicine and Public Health
• /
• v.38 no.4
• /
• pp.408-414
• /
• 2005

Objectives : The purpose of this study was to determine the impact of the sociodemographic and health characteristics on the out-of-pocket health spending of the individuals aged 20 and older in Korea. Methods : We used the data from the 2001 National Public Health and Nutrition Survey. The final sample size was 26,154 persons. Multiple linear regression models were used according to the age groups, that is, one model was used for those people under the age of sixty-five and the other was used for those people aged sixty-five and older. In these analyses, the expenditures were transformed to a logarithmic scale to reduce the skewness of the results. Results : Out-of-pocket health expenditures for those people under the age of 65 averaged 14,800 won per month, whereas expenditures for those people aged 65 and older averaged 27,200 won per month. In the regression analysis, the insurance type, resident area, self-reported health status, acute or chronic condition and bed-disability days were the statistically significant determinants for both age groups. Gender and age were statistically significant determinants only for the non-elderly. Conclusions : The findings from this study show that the mean out-of-pocket health expenditures varied according to the age groups and also several diverse characteristics. Thus, policymakers should consider the out-of-pocket health expenditure differential between the elderly and non-elderly persons. Improvement of the insurance coverage for the economically vulnerable subgroups that were identified in this study should be carefully considered. In addition, it is necessary to assess the impact of out-of-pocket spending on the peoples' health care utilization.

• Health Policy and Management
• /
• v.22 no.2
• /
• pp.275-296
• /
• 2012

Graduate School of Public Health, Seoul National University The national health insurance system in Korea is characterized as relatively high out-of-pocket payments, which are the principal source of catastrophic health expenditure (CHE). The objectives of this study are to estimate the incidence of household CHE and to clarify the characteristics that affect the occurrence and recurrence of household CHE using the Seoul Welfare Panel Survey database for 2008 and 2010. Thresholds to estimate CHE were 10% and 20% of the total household income (T/X), and 25% and 40% of the income excluding food share (T/Y). Determinants of the occurrence and recurrence of CHE at the threshold of T/X=10% were analysed using multiple logistic regression models. Out of the 3,665 households that responded in 2008 survey, households with CHE were 12.07% (T/X${\geq}$10%), 5.34% (T/X${\geq}$20%), 6.84% (T/Y${\geq}$25%), and 4.44% (T/Y${\geq}$40%). Risk factors associated with household CHE included living with a spouse, non-Medicaid beneficiary, householder unemployment, low household income, the number of disabled members, poor subjective health, and the number of chronic diseases. A total of 41.78% of households with CHE in 2008 repeatedly experienced CHE in 2010. Risk factors of CHE recurrence included decreased household income and an increase in chronic diseases over the two time periods, the number of members with disability or chronic diseases, and the presence of cancer patients in 2008. Households with lower socioeconomic and health status had a higher financial burden on health care than do their counterpart households. There is a need to enhance society-wide financial protection from health spending among vulnerable citizens in Seoul, particularly, households with low income, disabled members or cancer patients.

• Health Policy and Management
• /
• v.22 no.2
• /
• pp.207-224
• /
• 2012

This study estimates the total health expenditure of ambulatory dental care and explores the factors related to disbursements. The study used two waves of a 2008 Korea Health Panel (KHP) survey, of which each wave is composed of 7866 households and 24,659 persons. The KHP includes missing expanses of reimbursement data of the National Health Insurance (NHI), such as out-of-pocket, drugs, and private health insurance. The study estimates total monthly ambulatory dental expenditure and the sub-special categories of dental care. For influential factors analyses, the study exploits log-linear model with age, gender, education, job, equivalence income, the status of chronic diseases, means-tested benefit recipients, private insurance, and the composite deprivation index as independent variables. The total monthly outpatient health spending is estimated to be 102,468 won per household, and for dental, each household spends 31,115 won per month. Older age, means-test recipients, non-regular workers are more likely to spend less money on dental care, whereas private insurers, high income, and those who live in less deprived areas are more likely to spend more money for dental services. From the study we found that the KHP data are more suitable to estimate the total amount of health care markets, especially when the NHI coverage is low, such as for dental care in Korea.

• Health Policy and Management
• /
• v.27 no.4
• /
• pp.359-365
• /
• 2017

Background: Computed tomography (CT) is one of the most efficient diagnostic methods for stroke patients. The number of CT scanners in South Korea, however, is higher than in other countries, and may cause the overuse of this tool in healthcare. We aim to study the relationship between using CT and various patient and hospital characteristics among patients with cerebral infarction. Methods: We analyzed nationwide health insurance claims data for patients due to cerebral infarction during the second half of 2013 for up to 3 months. We performed multilevel analysis, including both inpatient and hospital-level variables, to determine how factors affect CT spending and utilization. Results: The data used in our study consisted of 17,046 hospitalizations at 583 hospitals. Inpatients who visited more than one hospital had higher CT utilization numbers and cost (number: ${\geq}3$: ${\beta}$ hospitals, 2.27; p < 0.05; 2 hospitals: ${\beta}$, 0.70; p < 0.05; cost: ${\geq}3$ hospitals: ${\beta}$, 251,108; p < 0.05; 2 hospitals: ${\beta}$, 77,299; p < 0.05). People who visited a general hospital had higher numbers and cost of CT utilization than people who visited a smaller hospital. Conclusion: Increased sharing of records and improved continuity of care between hospitals are needed to help curb the overuse of CT.

• The Journal of the Korea Contents Association
• /
• v.16 no.10
• /
• pp.411-419
• /
• 2016

This study tried to find the relationship between household income level and medical expense to household income ratio. For data analysis, it used 2010 and 2011 yearly data beta version of Korea Health Panel, co-managed by Korea Institute for Health and Social Affairs and National Health Insurance Corporation. To find out how the effect of independent variable changes in 2010 and 2011, the interaction effect between year and independent variable was examined, and separating the factors that showed interaction effect into each year, linear regression analysis was conducted using generalized estimating equations method. As a result of reviewing the factors that were related to medical expense to household income ratio among the people who used medical services, it was found that the higher the household income level, the lower the medical expense. It indicates that policy measures are needed to lessen the medical burden of low-income families.

• Health Policy and Management
• /
• v.3 no.1
• /
• pp.53-83
• /
• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• Journal of Intelligence and Information Systems
• /
• v.19 no.2
• /
• pp.141-156
• /
• 2013

Researchers in welfare services of local government in Korea have rather been on isolated issues as disables, childcare, aging phenomenon, etc. (Kang, 2004; Jung et al., 2009). Lately, local officials, yet, realize that they need more comprehensive welfare services for all residents, not just for above-mentioned focused groups. Still cases dealt with focused group approach have been a main research stream due to various reason(Jung et al., 2009; Lee, 2009; Jang, 2011). Social Security Information System is an information system that comprehensively manages 292 welfare benefits provided by 17 ministries and 40 thousand welfare services provided by 230 local authorities in Korea. The purpose of the system is to improve efficiency of social welfare delivery process. The study of local government expenditure has been on the rise over the last few decades after the restarting the local autonomy, but these studies have limitations on data collection. Measurement of a local government's welfare efforts(spending) has been primarily on expenditures or budget for an individual, set aside for welfare. This practice of using monetary value for an individual as a "proxy value" for welfare effort(spending) is based on the assumption that expenditure is directly linked to welfare efforts(Lee et al., 2007). This expenditure/budget approach commonly uses total welfare amount or percentage figure as dependent variables (Wildavsky, 1985; Lee et al., 2007; Kang, 2000). However, current practice of using actual amount being used or percentage figure as a dependent variable may have some limitation; since budget or expenditure is greatly influenced by the total budget of a local government, relying on such monetary value may create inflate or deflate the true "welfare effort" (Jang, 2012). In addition, government budget usually contain a large amount of administrative cost, i.e., salary, for local officials, which is highly unrelated to the actual welfare expenditure (Jang, 2011). This paper used local government welfare service data from the detailed data sets linked to the Social Security Information System. The purpose of this paper is to analyze the factors that affect social welfare spending of 230 local authorities in 2012. The paper applied multiple regression based model to analyze the pooled financial data from the system. Based on the regression analysis, the following factors affecting self-funded welfare spending were identified. In our research model, we use the welfare budget/total budget(%) of a local government as a true measurement for a local government's welfare effort(spending). Doing so, we exclude central government subsidies or support being used for local welfare service. It is because central government welfare support does not truly reflect the welfare efforts(spending) of a local. The dependent variable of this paper is the volume of the welfare spending and the independent variables of the model are comprised of three categories, in terms of socio-demographic perspectives, the local economy and the financial capacity of local government. This paper categorized local authorities into 3 groups, districts, and cities and suburb areas. The model used a dummy variable as the control variable (local political factor). This paper demonstrated that the volume of the welfare spending for the welfare services is commonly influenced by the ratio of welfare budget to total local budget, the population of infants, self-reliance ratio and the level of unemployment factor. Interestingly, the influential factors are different by the size of local government. Analysis of determinants of local government self-welfare spending, we found a significant effect of local Gov. Finance characteristic in degree of the local government's financial independence, financial independence rate, rate of social welfare budget, and regional economic in opening-to-application ratio, and sociology of population in rate of infants. The result means that local authorities should have differentiated welfare strategies according to their conditions and circumstances. There is a meaning that this paper has successfully proven the significant factors influencing welfare spending of local government in Korea.

• Korean Journal of Health Education and Promotion
• /
• v.17 no.2
• /
• pp.17-33
• /
• 2000

The aim of this study is having the status, knowledge and attitude of the high school attendees toward smoking be analyzed, helping to make effective health education methods to diminish adolescent smoking habits. The field self-questionnaire investigation has been performed from Oct 10th through 23rd in 1999. The whole 427 cases were distributed to 1st and 2nd grade students of randomly selected men's high school in Seoul. And 414 cases (97%) were finally selected for analysis after exclusion of cases with insufficient information. The main contents of questionnaire are composed of several sectors; the general characteristics of the interviewees, the relationship with parents, the life style and the peer relationship in school. And smoking-related characteristics are taken into consideration, too. The major findings of the study are as follows: The smoking/non-smoking related factors are, in socio-demographical terms, the grade, average spending per month of the interviewees. And the degree of satisfactory relationship with parents is significant on smoking behavior. The higher, the degree of satisfaction on school life and relationship with designated teacher, the more chances of non-smoking habit. Poor academic grades and peer group dependability of interviewees cause higher smoking habit rate in other way. The self-interviewees grade and cohabitation with parents are also significant on both the attitude toward smoking habit and the knowledge on smoking statistically. The academic history and vocations of the parents and the academic grades of interviewees are also effective variables, but don't make any gap between groups knowledge on smoking. Smoking groups used to have positive attitude toward smoking habit. Both the attitude and knowledge on smoking by the consideration of Quit-smoking have statistically significance. The groups which have negative attitude and high knowledge on smoking quit-smoking into consideration. And the primary cause of quit-smoking is on health by smoking. Depression, stress, adult smoking in the house, peer group pressure, cigarettes advertisements on papers and magazines and smoking scenes on TV have positive correlation on forming smoking habit (p〈0.001) But the knowledge on diseases triggered by smoking has negative correlation on forming smoking habit. (p〈0.05, p〈0.001). Social factors as monthly spending, relationship and communication with parents, the degree of satisfaction in school life, academic grades and student-teacher relationship have crucial negative correlation on smoking habit. That is to say, the higher, the monthly spending is, the worse, the relationship with parents and teachers is, the lower, the academic grades of the student is, the percentage of the interviewees who have smoking habit seems to get higher.