BACKGROUND: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public- private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. METHODS: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. RESULTS: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. ‘Transfers from government domestic revenue’ share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to ‘compulsory contributory health financing schemes,’‘Transfers from government domestic revenue’ share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. CONCLUSION: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.
Ambulatory Care ; Belgium ; Censuses ; Classification ; Delivery of Health Care ; Family Characteristics ; Financing, Government ; Gross Domestic Product ; Health Expenditures* ; Healthcare Financing ; Humans ; Information Storage and Retrieval ; Inpatients ; Insurance ; Insurance, Health ; Japan ; Korea* ; Organisation for Economic Co-Operation and Development ; World Health Organization

BACKGROUND: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public- private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. METHODS: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. RESULTS: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. ‘Transfers from government domestic revenue’ share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to ‘compulsory contributory health financing schemes,’‘Transfers from government domestic revenue’ share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. CONCLUSION: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.
Ambulatory Care ; Belgium ; Censuses ; Classification ; Delivery of Health Care ; Family Characteristics ; Financing, Government ; Gross Domestic Product ; Health Expenditures* ; Healthcare Financing ; Humans ; Information Storage and Retrieval ; Inpatients ; Insurance ; Insurance, Health ; Japan ; Korea* ; Organisation for Economic Co-Operation and Development ; World Health Organization

A new manual of System of Health Accounts (SHA) 2011, was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. This offers more complete coverage than the previous version, SHA 1.0, within the functional classification in areas such as prevention and a precise approach for tracking financing in the health care sector using the new classification of financing schemes. This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 1970-2014 constructed according to the SHA2011. Data sources for public financing include budget and settlement documents of the government, various statistics from the National Health Insurance, and others. In the case of private financing, an estimation of total revenue by provider groups is made from the Economic Census data and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. CHE was 105 trillion won in 2014, which accounts for 7.1% of Korea's gross domestic product. It was a big increase of 7.7 trillion won, 7.9%, from the previous year. Public share (government and compulsory schemes) accounting for 56.5% of the CHE in 2014 was still much lower than the OECD average of about 73%. With these estimates, it is possible to compare health expenditures of Korea and other countries better. Awareness and appreciation of the need and gains from applying SHA2011 for the health expenditure classification are expected to increase as OECD health expenditure figures get more frequently quoted among health policy makers.
Budgets ; Censuses ; Classification ; Delivery of Health Care ; Family Characteristics ; Financing, Government ; Gross Domestic Product ; Health Care Sector ; Health Expenditures* ; Health Policy ; Information Storage and Retrieval ; Korea* ; National Health Programs ; Organisation for Economic Co-Operation and Development ; World Health Organization

BACKGROUND: Supplier induced demand (SID) indicates the case when doctors increase the demand of the patients, following their (physicians') own best interests rather than patients'. This may occur when asymmetry of information exists between suppliers and consumers. This study aims to confirm whether SID exists in the Korean setting, particularly by dividing SID into both 'induced demand effect' and 'availability effect.' METHODS: Induced demand effect and availability effect are differentiated following Carlsen & Grytten's theoretical frame which divides doctor density regions into high and low ones. RESULTS: Positive correlation between doctors' density and utilization of their services was found, which could be interpreted as 'availability effect.' CONCLUSION: The result suggests that additional medical use for additional doctor, particularly in the area of low doctor density, can be interpreted to occur to meet the basic medical need of the people rather than as a result of unnecessary induced demand. It is important to make more medical doctors provided and to distribute them appropriately across the region in such a country like Korea where doctor's density is relatively low.
Humans ; Korea* ; Sudden Infant Death

PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.
Delivery of Health Care ; Education ; Human Rights ; Mortality ; Occupations ; Quality of Life ; Social Discrimination ; Socioeconomic Factors*

This article aims to extract some lessons from the last five years' experience of Japan in its implementation of Long-term Care Insurance scheme(LTCI). Although both Korea and Japan are facing the most rapid ageing of the population among the OECD countries, the Japan precedes Korea in many aspects by about thirty years. Long-term care(LTC) services had been provided through two schemes in Japan before the introduction of LTCI in April 2000: Welfare Service Programs and the Health Service System for the Elderly(HSSE). LTCI incorporated both the previous social or welfare services and the long-term care services under the HSSE. Japanese LTCI started with the aims of introducing improved insurance coverage for home care, extending such coverage for the first time to nursing homes and further reducing the dependency of the elderly on beds in hospitals. In Korea, due to the lack of infrastructure to support the LTC services in Korea as well as the yet immature ageing of population, it would be quite risky to make haste in introducing LTCI in Korea. Rather the main focus of the Korean LTC policy should be put on establishing and enlarging both facilities and human resources to support the LTC services.
Aged ; Asian Continental Ancestry Group* ; Health Services ; Home Care Services ; Humans ; Insurance Coverage ; Insurance, Long-Term Care* ; Japan ; Korea ; Long-Term Care* ; Nursing Homes

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.
*National Health Programs ; Program Development ; Quality Improvement/*economics ; Quality of Health Care/economics ; Reimbursement, Incentive/*organization & administration/standards ; Republic of Korea

OBJECTIVES: This study was designed to assess the epidemiology of DSM-IV posttraumatic stress disorder(PTSD), including information on lifetime and current prevalence, the kinds of traumas most often associated with PTSD, and sociodemographic correlates. METHOD: For this survey, an urban area with total population of 611,921 persons was chosen. Modified version of traumatic event checklist and Clinician Administered PTSD Scale were administrated to a representative sample of 850 persons aged 15 to 65 years above through home visiting. RESULTS: The lifetime and current prevalence of PTSD in survey area was 4.71% and 2.12%. the lifetime and current prevalence in male and female were of no significant statistical differences(p>.05). And the lifetime prevalence by age, and education were of no significant statistical differences. Only the lifetime prevalence by marital status was of significant statistical differences(p<0.001). The lifetime prevalence to any traumatic exposure was 78.79%. Sudden unexpected death of a close person was the most prevalent traumatic event(51.06%). Among the traumas, natural disaster, fire and explosion, motor vehicle accident, serious accident at work or home, physical assault, assault with a weapon, combat, life-threatening illness, and serious injury to death you caused to someone else were more commonly associated with male sex, and sexual assault was more commonly associated with female sex. The traumas commonly associated with PTSD were natural disaster, fire and explosion, motor vehicle accident, serious accident at work or home, physical assault, sexual assault, combat, and life-threatening illness. CONCLUSION: The lifetime and current prevalence in survey area were lower than those of previous studies. This study found differences between men and women on the type of trauma experienced, and the type of trauma associated with PTSD. Future epidemiological studies to assess PTSD from all lifetime traumas rather than from only a small number of retrospectively reported ones will be required, and larger sample size covering the country will be required for better estimation.
Checklist ; Diagnostic and Statistical Manual of Mental Disorders ; Disasters ; Education ; Epidemiologic Studies* ; Epidemiology ; Explosions ; Female ; Fires ; House Calls ; Humans ; Male ; Marital Status ; Motor Vehicles ; Prevalence ; Retrospective Studies ; Sample Size ; Stress Disorders, Post-Traumatic* ; Weapons

This is a case report of a 50-year-old female who presented to our clinic with headache and left temporal pulsatile mass. Aneurysm was revealed incidentally on a computed tomography angiography of her head. Open surgical resection with aneurysmal trapping was performed under local anesthesia. Histological examination demonstrated a true aneurysm of the superficial temporal artery. There was loss of normal elastin in the internal elastin layer. This case report describes the rare entity along with a review of the literature.
Anesthesia, Local ; Aneurysm ; Angiography ; Elastin ; Female ; Head ; Headache ; Humans ; Middle Aged ; Temporal Arteries

Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion “Reducing the readmission rate” is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.