Go to the main menu
Skip to content
Go to bottom
REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
Editor in Chief :
Volume & Issues
Volume 24, Issue 4 - Dec 2014
Volume 24, Issue 3 - Sep 2014
Volume 24, Issue 2 - Jun 2014
Volume 24, Issue 1 - Mar 2014
Selecting the target year
Current Status and Issues on Public-Private Partnership of Global Health
Lee, Hyun-Sook ; Kim, Chun-Bae ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 4~12
DOI : 10.4332/KJHPA.2014.24.1.4
Background: The purpose of this study is to investigate current status and investigation of government agencies, communities, corporates, hospitals, non-governmental organization, non-profit organization, and so on which performed Corporate Social Responsibility to global health issues. Methods: This paper focuses on analyzing definition and principle of public-private partnership (PPP), types of PPP, challenge of PPP through delphi survey and interview which need to be discussed by professional groups such as private groups, universities and researches, government decision makers, corporates, and hospitals for successful PPP. Results: Based on this analysis on global health issues of 237 groups, the results were shown that main global health issues of many hospitals were aids of the developing countries (48%). Main program was activities of overseas volunteers (30%) and most 152 groups (42%) supported Asia. Also, this paper gives a definition of PPP that is the growth together in PPPs as a way of fulfilling public tasks in partnership between the state administration and private enterprises to apply both strengths behind transparency, accountability. Conclusion: In conclusion, from the results of analysis, we suggest as prior setting of global issues for both demand and supply side and are served as the effective way by PPP on global health issues. Moreover, this study will be expanded on the sections of findings, multiple researches, discussion, and policy recommendations.
The Impact of Supplier Induced Demand on Increase in Medical Aid Expenditure
Shin, Hyunwoung ; Yoon, Jangho ; Noh, Yunhong ; Yeo, Ji-Young ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 13~23
DOI : 10.4332/KJHPA.2014.24.1.13
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.
The Relief Effect of Copayment Decreasing Policy on Unmet Needs in Targeted Diseases
Choi, Jae-Woo ; Kim, Jae-Hyun ; Park, Eun-Cheol ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 24~34
DOI : 10.4332/KJHPA.2014.24.1.24
Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.
The Association between Health Examination and Personal Medical Cost through Panel Survey
Lee, Hwan Hyung ; Park, Jae Yong ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 35~46
DOI : 10.4332/KJHPA.2014.24.1.35
Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.
Socioeconomic Determinants of Korean Medicine Ambulatory Services: Comparing Panel Fixed Effect Model with Pooled Ordinary Least Square
Park, Min Jung ; Kwon, Soon Man ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 47~55
DOI : 10.4332/KJHPA.2014.24.1.47
Background: Korea is considered to have an integrative health system where both western medicine and Korean (traditional) medicine are officially recognized and provided. Although Korean medicine has been covered by National Health Insurance over 20 years, equity in the utilization of Korean medical care has rarely been examined. Methods: We examined medical care utilization and expenditure of outpatient Korean medicine using panel fixed effects model to remove selection bias. Then we compared it with pooled ordinary least square (OLS) model. This study used Korea Health Panel data, which provides accurate information on out-of-pocket health care payment, including non-covered medical services. Results: Principal findings indicate that the frequency of the utilization of Korean medicine is related with unobservable individual choices different from western medicine, so the panel fixed effect model is appropriate. But pooled OLS model is better fitted for the expenditure of Korean medicine, after controlling for western medical care expenditure. After adjusting for the selection bias, socioeconomic status (income, education) was significantly associated with the expenditure of Korean medicine, but not with the frequency of the utilization of Korean medicine. Conclusion: This study shows that expenditure of Korean medicine utilization is inequitable across socioeconomic groups, which implies that health insurance coverage of Korean medicine is not sufficient.
A Panel Study on Determinants of Catastrophic Health Expenditure of the Middle- and Old-Aged Households
Park, Jin Yeung ; Jung, Kee Taig ; Kim, Yong Min ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 56~70
DOI : 10.4332/KJHPA.2014.24.1.56
Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.
Factors Related to Family Caregivers' Burden with the Community-Dwelling Disabled Elderly under the Long-Term Care Insurance System
Han, Eun-Jeong ; Lee, Jung-Myun ; Kwon, Jin-Hee ; Shin, Seul-Bi ; Lee, Jung-Suk ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 71~84
DOI : 10.4332/KJHPA.2014.24.1.71
Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (
). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.
West African Pregnancy Experienced Women's Self-Rated Health and Related Factors: Case of Democratic Republic of the Congo
Lee, Hyeong Il ; Nam, Eun Woo ; Song, Jin Sung ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 85~91
DOI : 10.4332/KJHPA.2014.24.1.85
Background: This study aims to analyze West African pregnancy experienced women's self-rated health and related factors in Democratic Republic (DR) of the Congo, and provide basic data which can be used in developing maternal and child heath projects and health promotion programs to enhance women's self-rated health in the DR Congo. Methods: A survey was conducted among 400 women, 300 of whom were from Kenge and 100 from Boko in Bandundu Province. Three hundred and fifty-two questionnaires were administered on factors expected to affect the self-rated health, categorized into basic information and economic status of respondents, healthcare service, and illness patterns. The hierarchical logistic regression analysis was performed taking each variable into account. Results: The results show that those who have had nutrition education, work in the office, have no health insurance, or have had no illness for the last one year perceive themselves to be in good health. Conclusion: To improve the self-rated health status and promote maternal and child health in DR Congo, the results suggest that the government or relevant agencies should develop programs to educate people regarding health and nutrition, and policies based on the right status of each country. Systems are also required for healthcare at all social levels along with aspects to avoid illness in daily life.
An Analysis on Patients Trend and Income of Primary Care Clinic
Lim, Sun Mi ; Im, Geum Ja ; Park, Kwan Jun ; Park, Yoon Hyung ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 92~99
DOI : 10.4332/KJHPA.2014.24.1.92
Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.
Defining the Concept of Primary Care in South Korea Using a Delphi Method: Secondary Publication
Lee, Jae Ho ; Choi, Yong-Jun ; Volk, Robert J. ; Kim, Soo Young ; Kim, Yong Sik ; Park, Hoon Ki ; Jeon, Tae-Hee ; Hong, Seung Kwon ; Spann, Stephen J. ;
Health Policy and Management, volume 24, issue 1, 2014, Pages 100~106
DOI : 10.4332/KJHPA.2014.24.1.100
Background: There is no consensus on the definition of primary care in South Korea. This study's objective was to define the concept of primary care using a Delphi method. Methods: Three expert panels were formed, consisting of 16 primary care policy researchers, 45 stakeholders, and 16 primary care physicians. Three rounds of voting, using 9-point appropriateness scales, were conducted. The first round involved rating the appropriateness of 20 previously established attributes of primary care. In the second round, panelists received a summary of the first-round results and were asked to once again vote on the 10 undetermined attributes and the provisional definition. The final round involved voting on the appropriateness of the revised definition. The Korean Language Society reviewed the revised definition. Results: Four core (first-contact care, comprehensiveness, coordination, and longitudinality) and three ancillary (personalized care, family and community context, and community base) attributes were selected. The Korean definition of primary care was accomplished with all three panel groups arriving at a 'very good' level of consensus. Conclusion: The Korean definition of primary care will provide a framework for evaluating performance of primary care in South Korea. It will also contribute to resolving confusion about the concept of primary care.