BACKGROUND: This study aims to identify the monthly average medical expenses of public pension recipients, and analyze the determinants of total health and medical expenses and Western and Oriental medicine expenses, medical service expenses, and medical supplies expenses. METHODS: This study used the fifth year data of 2013 out of the raw data of the Korean Retirement and Income Study collected by the National Pension Research Institute. This study conducted t-test, analysis of variance, and linear regression to verify publicly the relevance between pension recipients' general characteristics and health and medical expenses status using IBM SPSS ver. 21.0 for data analysis. RESULTS: It was analyzed that there is a difference in the spending of expenditure and health care costs according to public pension recipients. Medical expenses of the national pensioners was higher compared to the special corporate pensioners. The national pensioner is related expenditure size, education level, family members living together, residential areas, status of spouse, number of chronic illness, and status of limitation in daily life with psychological health status. CONCLUSION: Therefore, fairness does not occur fire to the medical use between the special corporate pensioners and national pensioners, aggressive of government such as health policy and financial support for the retiree pension policy that reflects the reality intervention would be required.
Academies and Institutes ; Chronic Disease ; Education ; Equipment and Supplies ; Financial Support ; Fires ; Health Care Costs ; Health Expenditures ; Health Policy ; Humans ; Linear Models ; Medicine, East Asian Traditional ; Pensions* ; Retirement ; Spouses ; Statistics as Topic

With the growth of aging population in Korea, a better care of chronic and other degenerative illnesses is urgently needed. Evidences suggest that this can be achieved through incorporating a wide range of care options, expanding beyond medical interventions. The aim of this study is to analyze the distribution of publically funded research to understand if the Korean research and development funding system matches various approaches and purposes to successfully tackle the chronic care needs of an aging society. We complied the list of funded projects to be analyzed by searching the National Technical Information Service database with key words such as aging society/senescence, chronic diseases, disability, and health promotion. Most projects were based on the biomedical approach with the purpose of establishing the etiology and clinical (treatment) interventions. Health promotion projects showed a distinctive distribution with more percentage of projects based on psycho-behavioral approaches while research on chronic diseases predominantly biomedical. It would be necessary to diversify publically-funded research projects to develop effective and efficient care technologies for the future.
Aging ; Chronic Disease ; Financial Management ; Health Promotion ; Information Services* ; Korea

To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.
Adenosine-5'-(N-ethylcarboxamide) ; Administrative Personnel ; Consensus* ; Health Policy ; Humans ; Insurance Coverage ; Korea ; Laparoscopy ; Quality of Life ; Stomach Neoplasms*

No abstract available.
Delivery of Health Care* ; Emergencies* ; Public Health*

'Health in All Policies' is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as 'Health in All Policies' and 'Sustainable Development Goals.' Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing 'Health in All Policies' in local, national, and international circumstances.
Cooperative Behavior ; Health Promotion* ; Institutionalization ; Leadership ; Policy Making ; Public Health ; Public Policy ; Social Determinants of Health ; Socioeconomic Factors

The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.
Comorbidity* ; Complement System Proteins ; Consensus ; Diagnosis ; Follow-Up Studies ; Health Services Research ; Humans ; Inpatients ; Insurance, Health* ; Mortality ; Outpatients ; Prevalence

BACKGROUND: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery Cultrasonic shears, electrothermal bipolar vessel sealers for gastric cancer patients covered since December 2014. METHODS: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. RESULTS: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. CONCLUSION: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.
Electrosurgery ; Health Expenditures* ; Humans ; Inpatients ; Insurance Benefits* ; Laparoscopy ; National Health Programs ; Stomach Neoplasms* ; Uncertainty

BACKGROUND: The publicness concept in healthcare has been built to its social consensus relying on historical context, with the result that the meaning of publicness has a great diversity and heterogeneous nature in Korea. Thus it needs to be addressed to clarify the meaning and boundary of the publicness concept in healthcare, so as to discuss its social implication. METHODS: In order to investigate whether or how the publicness concept is used in healthcare, we conducted a text network analysis in 779 news articles from 8 Korean daily newspapers over a recent 5-year period. RESULTS: The publicness concept was closely related to medicine and medical institution, and formed a conceptual network with public health, medicine, welfare, patient, government, Jin-ju city, and health. Keywords relating publicness tended to be similar between four major newspapers; however, the association with Jin-ju city, government, and society was noticeable in Kyunghyang Shinmun and Hankyoreh, and so was patient and service in Dong-A Ilbo. CONCLUSION: Publicness and medicine was closely associated, and government seemed to remain as a main actor for public interest. Publicness was related with a variety of actors and values, with its expanded boundary. The different contexts of publicness by newspapers might reflect each ideological inclination. The textual importance of publicness was relatively low in part, which suggests that publicness was used in a loose sense or as a routine.
Consensus ; Delivery of Health Care* ; Health Care Sector* ; Humans ; Korea ; Periodicals ; Public Health

BACKGROUND: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. METHODS: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). RESULTS: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. CONCLUSION: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.
Cognition ; Female ; Humans ; Insurance, Health ; Korea* ; Length of Stay ; Long-Term Care* ; National Health Programs

This study purposed to analyze the relationship between spatial distribution of Diabetes prevalence rates and regional variables. The unit of analysis was administrative districts of city·gun·gu. Dependent variable was the age- and sex- adjusted diabetes prevalence rates and regional variables were selected to represent three aspects: demographic and socioeconomic factor, health and medical factor, and physical environment factor. Along with the traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for the spatial analysis. Analysis results showed that age- and sex-adjusted diabetes prevalence rates were varied depending on regions. OLS regression showed that diabetes prevalence rates had significant relationships with percent of population over age 65 and financial independence rate. In GWR, the effects of regional variables were not consistent. These results provide information to health policy makers. Regional characteristics should be considered in allocating health resources and developing health related programs for the regional disease management.
Diabetes Mellitus ; Disease Management ; Health Policy ; Health Resources ; Prevalence* ; Socioeconomic Factors ; Spatial Analysis