• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5265-5270
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• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.

• 한국시스템다이내믹스연구
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• 제9권1호
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• pp.93-105
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• 2008

This study suggests a Causal Loop Diagram(CLD) of Causality Mechanism which are intergrating matter of for-profit hospital, non-for profit hospital, healthcare development, national medical spending. To coordinate each part theory, we suggest more developed medical system in our study. Through the system thinking, development of hospital as research center in industry can lesson the rise of medical spending effectively.

• 실천공학교육논문지
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• 제16권5_spc호
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• pp.635-641
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• 2024

OECD 국가의 GDP 대비 경상의료비 비중은 코로나19 팬데믹 지출로 인해 9%대에 진입하였다. 우리나라도 2022년 9.4%에 이르러, OECD 가입 이후 처음으로 OECD 평균(9.2%)을 뛰어넘어 섰다. 전체 의료비 중에서 코로나19 관련 의료비 지출이 차지하는 비중은 7.8%로 OECD 평균(5.1%)을 훨씬 상회하는 가운데, 의료비 지출 구조와 변동 패턴이 사뭇 다른 OECD 국가와 차이를 보여 보건의료제도적 관점에서 두 가지 시사점을 남긴다. 첫째, 보건 위기라는 특수한 상황을 전제하고라도 가파른 의료비 증가세가 제도의 지속 가능성에 미칠 수 있는 영향력을 검토해야 한다. 둘째, 보건 위기에 맞선 다양한 보건의료적 중재 중에서 우리나라의 상황에 적합한 대응 방안을 모색하여 보건의료제도의 회복탄력성을 높여야 한다.

• Safety and Health at Work
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• 제13권1호
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• pp.51-58
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• 2022

Introduction: Previous studies on occupational health focussed predominately on the occurrence of occupational diseases. Relatively few studies have measured how employment is associated with the use of healthcare services. This study investigates the association between employment and the extent and range of healthcare use, such as medical expenditures, of women in South Korea. Methods: We analyze data of the Korean Health Panel, an ongoing longitudinal national representative survey, from 2008 to 2017, to identify the status of economic activity of women by year and age group. We estimate the association between female employment status and medical expenditures by using random effect panel Tobit models. Furthermore, we investigate the association between employment status and the range of healthcare services in biomedicine and traditional Korean medicine (KM) by conducting conditional fixed-effects logistic regression analyses. Results: For women aged between 25 and 65 in 2017, the majority of them were employed or self-employed. (The proportion of employment of self-employment equals 64.80%). In addition, working women spent 11.6% less on healthcare than nonworking women, and self-employment lowered the healthcare expenditure by 13.1%. Neither work nor the type of work is related to the types and range of healthcare service use. Being employed or self-employed is negatively associated with women's expenditure on healthcare. Conclusions: The findings show that employment is associated with less spending on healthcare. They imply that employment has a positive impact on women's health.

• 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.

• The Journal of Asian Finance, Economics and Business
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• 제7권8호
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• pp.705-714
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• 2020

This study aims to investigate the main factors that affected the government health expenditures in Gulf Cooperation Council (GCC) countries (Kingdom of Saudi Arabia (KSA), United Arab Emirates (UAE), Oman, Qatar, Bahrain and Kuwait), during the period from 2005 to 2019. The study employs a panel data technique in order to monitor the pooled determinant variables of healthcare expenditures in these countries. The study's results indicate, by using FMOLS approach for panel data, that the average healthcare expenditures per capita in GCC countries have a positive and a significant relationship with the government revenues, the size of the population, and the governments' public debt. The positive and the significant relationships of governments' public debt may be explained even if the governments of the GCC countries suffer from a budget deficit; the GCC countries continue to increase the healthcare expenditure. The study suggests that the policymakers of the GCC countries must take into consideration those variables when they develop their healthcare policies. Also, the GCC countries urgently need to have high levels of foreign exchange reserves to maintain the expected level of spending on the healthcare sector, because their public revenues depend mainly on the oil revenues, which are fluctuating continuously.

• The Journal of Asian Finance, Economics and Business
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• 제7권5호
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• pp.119-130
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• 2020

The study seeks to evaluate the impacts of three types of credit - formal, semi-formal, and informal credits - on the well-being of households in Vietnam's rural areas. Based on data from the Vietnam Household Living Standard Surveys in 2014 and 2016, the research uses the instrumental variable fixed-effect models to estimate the effects of three kinds of credit on household's per capita income and expenditure. There are some significant findings. First, in rural areas, formal credit is the most popular source with stable and cheap borrowing costs. Informal credit is a complement to formal credit to meet urgent needs. Funding agriculture activities is the most commonly cited purpose of borrowing, followed by purchasing assets. The highest misuse rate belongs to the group of loans for agriculture production. Second, the results show that credit helps smoothen consumption rather than generate income for rural households. Three types of credit have insignificant or negative effects on household's per capita income. Formal loans significantly improve total expenditure and spending on healthcare and education. Informal and semi-formal credits show a little influence on consumption. Informal loans have a significantly positive effect on healthcare expenditure. In contrast, having semi-formal loans tends to decrease spending on foods.

• 보건행정학회지
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• 제32권3호
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• pp.245-246
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• 2022

Concerns about a global economic recession are rising following the coronavirus disease 2019 (COVID-19) pandemic. Accordingly, government entities, which are committed to overcome two barriers to severe inflation and economic recession, are showing high interest in spending management so as not to undermine fiscal soundness. Since the health care sector especially accounts for a large proportion of fiscal expenditure, it should be managed in a manner that the expense is appropriately spent. The National Health Insurance System and Healthcare System have secured international competitiveness and reliability by effectively responding to the COVID-19 pandemic. Likewise, considerable efforts should be made to reorganize the welfare and healthcare systems so that they can be sustainable during the post-COVID-19 era and the recession.

• 보건행정학회지
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• 제32권1호
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• pp.107-112
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• 2022

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 2020 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. In the NaSTaB 2020 data, households who experienced catastrophic health expenditure was 1.73%. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -5.55; p<0.0001) in the proportion of households with the catastrophic health expenditure. Also, in the 2018 KHP and the 2016 HIES, households who experienced catastrophic health expenditure was 2.21% and 2.92% respectively. In contrast, the trend was significantly increased in the KHP (APC, 0.55; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, the findings suggest the need to strengthen public health care financial support and monitor catastrophic healthcare expenditures, especially for low-income group.

• Journal of Preventive Medicine and Public Health
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• 제52권4호
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• pp.214-223
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• 2019

Objectives: Equity in financial protection against healthcare expenditures is one the primary functions of health systems worldwide. This study aimed to quantify socioeconomic inequality in facing catastrophic healthcare expenditures (CHE) and to identify the main factors contributing to socioeconomic inequality in CHE in Iran. Methods: A total of 37 860 households were drawn from the Households Income and Expenditure Survey, conducted by the Statistical Center of Iran in 2017. The prevalence of CHE was measured using a cut-off of spending at least 40% of the capacity to pay on healthcare services. The concentration curve and concentration index (C) were used to illustrate and measure the extent of socioeconomic inequality in CHE among Iranian households. The C was decomposed to identify the main factors explaining the observed socioeconomic inequality in CHE in Iran. Results: The prevalence of CHE among Iranian households in 2017 was 5.26% (95% confidence interval [CI], 5.04 to 5.49). The value of C was -0.17 (95% CI, -0.19 to -0.13), suggesting that CHE was mainly concentrated among socioeconomically disadvantaged households in Iran. The decomposition analysis highlighted the household wealth index as explaining 71.7% of the concentration of CHE among the poor in Iran. Conclusions: This study revealed that CHE is disproportionately concentrated among poor households in Iran. Health policies to reduce socioeconomic inequality in facing CHE in Iran should focus on socioeconomically disadvantaged households.