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Position Value for Relative Comparison of Healthcare Status of Korea in 2014.

Health Policy and Management.2017;27(1):88-94. doi:10.4332/KJHPA.2017.27.1.88

The aim of this study was to investigate the current and trend of healthcare status of South Korea compared to Organization for Economic Cooperation and Development (OECD) countries. We used the position value for relative comparison (PARC) method for measuring the healthcare status of South Korea by five parts of healthcare policy (demand, supply, accessibility, quality, and cost). Additionally, we conducted Mann-Kendall test for analyzing the trend of PARC from 2000 to the present. Demand, supply, accessibility, and quality of healthcare of Korea were located upon the average of OECD countries, and showed an increasing trend from 2000 to the present. However, primary care and screening for cervical cancer were placed at a lower level compared the OECD average. In conclusion, the current state of healthcare in Korea seems to be generally beyond the average among OECD countries. However, some parts, including primary care, need to be improved.
Delivery of Health Care* ; Korea* ; Mass Screening ; Methods ; Organisation for Economic Co-Operation and Development ; Primary Health Care ; Quality of Health Care ; Uterine Cervical Neoplasms

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Catastrophic Health Expenditure Status and Trend of Korea in 2015.

Woorim KIM ; Eun Cheol PARK

Health Policy and Management.2017;27(1):84-87. doi:10.4332/KJHPA.2017.27.1.84

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.
Delivery of Health Care ; Family Characteristics ; Health Expenditures* ; Korea* ; Public Health ; Taxes

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Unmet Healthcare Needs Status and Trend of Korea in 2015.

Hyo Jung YOON ; Sung In JANG

Health Policy and Management.2017;27(1):80-83. doi:10.4332/KJHPA.2017.27.1.80

The proportion of people who reported unmet healthcare needs is an important indicator to measure the access problem in healthcare service. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, ‘2007–2015); the Community Health Survey (CHS ‘2008–2015); the Korea Health Panel Survey (KHP ‘2011–2013); the Korean Welfare Panel Study (KOWEPS ‘2006–2015). The proportion of individual reporting unmet healthcare needs as of 2015 was 12.6% (KNHNES), 11.7% (CHS), and 16.3% (KHP, as of 2013). Annual percent change which characterizes trend for follow-up period was -9.4%, -3.4%, and 7.6%, respectively. The proportion of individual reporting unmet healthcare needs due to cost was 2.8% (KNHNES), 1.7% (CHS), and 4.6% (KHP). The proportion of household reporting unmet healthcare needs due to cost was 1.2% (KOWEPS). Annual percent change was -9.0%, -14.9%, 9.4%, and -18.2%, respectively. Low income population reported about 5 times more unmet needs than high income population. Therefore for decreasing the unmet healthcare needs, strategies focusing on low income population were needed.
Delivery of Health Care* ; Family Characteristics ; Follow-Up Studies ; Health Surveys ; Korea* ; Nutrition Surveys ; Population Growth ; Poverty ; Socioeconomic Factors

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Yeong Jun JU ; Sung In JANG

Health Policy and Management.2017;27(1):75-79. doi:10.4332/KJHPA.2017.27.1.75

Suicide is becoming a public health issue in many countries, and even more so in Korea. Korea has the highest suicide rate in the Organization for Economic Cooperation and Development countries. To address these issues, we investigated the recent trends in suicidal ideation and suicide attempts among the adult population. We used data from four sources: Korean National Health and Nutrition Examination Survey (KNHANES, ‘2007–2012, ‘2013, ‘2015), Korean Community Health Survey (KCHS, ‘2008–2009, ‘2013), Korean Wealth Panel Study (KOWEPS, ‘2012–2015), and Korea Health Panel Survey (KHP, ‘2010–2013). Weighted frequencies and trend tests were used. The rate of suicidal ideation as recent year was 5.10% (KNHANES, ‘2015), 8.95% (KCHS, ‘2013), 2.34% (KOWEPS, ‘2015), or 5.39% (KHP, ‘2013). Regarding the suicide attempts, the rate of suicide attempts as recent year was 0.61% (KNHANES, ‘2015), 0.41% (KCHS, ‘2013), or 0.04% (KOWEPS, ‘2015). Average percent change of suicidal ideation during survey year was -2.80% (KNHANES, ‘2007–2012), 5.78% (KNHANES, ‘2013–2015), 0.62% (KCHS, ‘2008–2013), -5.63% (KOWEPS, ‘2012–2015), and -10.94% (KHP, ‘2010–2013). Average percent change of suicide attempts during survey year was -3.84% (KNHANES, ‘2007–2012), 4.55% (KNHANES, ‘2013–2015), -2.54% (KCHS, ‘2008–2013), and -18.96% (KOWEPS, ‘2012–2015). Those who had lower income level were more likely to have self-reported suicidal ideation and suicide attempts. Our results suggest that further efforts are needed for more effective intervention to identify and manage low income strata with suicide problem.
Adult ; Health Surveys ; Humans ; Korea* ; Nutrition Surveys ; Organisation for Economic Co-Operation and Development ; Public Health ; Suicidal Ideation ; Suicide*

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Factors Affecting International Patient's Satisfaction with Korea Medical Services, Revisit and Recommendation Intention.

Myo Gyeong KIM ; Yun Kyoung CHOI ; Jung Won AHN ; Keum Soon KIM

Health Policy and Management.2017;27(1):63-74. doi:10.4332/KJHPA.2017.27.1.63

BACKGROUND: This study aims to analyze quality of and satisfaction with Korea medical services and identify factors affecting medical service satisfaction, revisit, and recommendation intention among international patients. METHODS: Secondary analysis of survey data conducted by Korea Health Industry Development Institute from June 10th to July 17th in 2013 was done using multiple regression and logistic regression analysis. The 191 international patients from 9 medical institutions in Seoul were enrolled. RESULTS: The results showed that international patients were satisfied with 85.6 points out of 100.0 points. International patients appraised higher in staff service rather than other services. Factors influencing medical service satisfaction were gender, religion, medical specialty, length of stay, and quality of medical services. Quality of medical service explained 29.8% of medical service satisfaction and especially, ‘doctor's care’ and ‘communication and patient respect‘ were significantly related to medical service satisfaction. Medical specialty had a significant influence on revisit intention. There were no statistically significant influencing factors of recommendation intention. Additionally, more satisfied patients were associated with higher revisit and recommendation intention. CONCLUSION: This study implies that quality of medical services is a critical factor for patient satisfaction and that satisfaction with medical services is an important factor for increasing revisit and recommendation intention among international patients. In addition, health care providers should consider cultural differences to enhance satisfaction with medical services for international patients. Therefore, multidimensional strategy is required to strengthen the cultural competency of healthcare providers.
Cultural Competency ; Health Personnel ; Health Services ; Humans ; Intention* ; Korea* ; Length of Stay ; Logistic Models ; Patient Satisfaction ; Seoul

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A Panel Study on the Determinants of the Regional Variation in the Rate of Certification in Long-Term Care Insurance.

Jin SAKONG ; Hyunjong SONG

Health Policy and Management.2017;27(1):56-62. doi:10.4332/KJHPA.2017.27.1.56

BACKGROUND: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. METHODS: The panel data of the year 2010–2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. RESULTS: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. CONCLUSION: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.
Aged ; Certification* ; Checklist ; Hospitals, Convalescent ; Humans ; Insurance, Long-Term Care* ; Long-Term Care* ; National Health Programs

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The Effects of the Metabolic Syndrome on the Total Medical Charge.

Ki Young KIM ; Jae Yong DONG ; Seung Yeon HAN ; Kwang Soo LEE

Health Policy and Management.2017;27(1):47-55. doi:10.4332/KJHPA.2017.27.1.47

BACKGROUND: This study purposed to analyze the effects of metabolic syndrome on the total medical charge of patients. METHODS: 2013 National Health Insurance Service sample research database (eligibility database, medical database, and health examination database) was used for this study. Gamma regression was applied to analyze the effects of metabolic syndrome on the total medical charge and logistic regression was used to determine the probability of medical charge which was higher than the third quartile. Sociodemographic characteristics (age and household income), health behavior factors (smoking, drinking, exercise, and body mass index), and disease related factors (family history and metabolic syndrome) were included as the independent variables. RESULTS: people who had metabolic syndrome spent more medical expenses than those without metabolic syndrome both in man and woman group. The standard regression coefficient was 0.09 (p<0.001) in man with metabolic syndrome and 0.16 (p<0.001) in woman. In addition, woman with metabolic syndrome spent more than the third quartile of medical charge. The odds ratios was 1.04 (p=0.16) for man with metabolic syndrome and 1.18 (p=0.013) for woman. CONCLUSION: people with metabolic syndrome spent more medical charge, so it will need to consider policy interventions for preventing the incidence and management of metabolic syndrome in Korean people.
Drinking ; Family Characteristics ; Female ; Health Behavior ; Humans ; Incidence ; Logistic Models ; National Health Programs ; Odds Ratio

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Analysis of New Patient's Willingness to Pay Additional Costs for Securing Satisfactory Consultation Time.

Chan Hee LEE ; Hyunsun LIM ; Youngnam KIM ; Soojin YOON ; Yang Sook PARK ; Sun Ae KIM ; Eun Cheol PARK ; Jung Gu KANG

Health Policy and Management.2017;27(1):39-46. doi:10.4332/KJHPA.2017.27.1.39

BACKGROUND: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. METHODS: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (≤3 minutes, 3–5 minutes, 5–10 minutes, and >10 minutes), and SCT into 3 groups (≤5 minutes, 5–10 minutes, and >10 minutes). On the basis of WPAC, we estimated new patient's SCT. RESULTS: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5–10 minutes was higher than that RCT ≤3 minutes (odds ratio=1.78). Payable amount was highest in RCT >10 minutes (6,950 Korea won) and SCT >10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). CONCLUSION: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.
Fees and Charges ; Hope ; Hospitals, General ; Humans ; Korea ; Logistic Models ; Time Factors

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Changes in Providers' Behavior after the Reviewer Unification of Auto Insurance Medical Benefit Claims.

Jae Sun KIM ; Won Sik SUH

Health Policy and Management.2017;27(1):30-38. doi:10.4332/KJHPA.2017.27.1.30

BACKGROUND: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. METHODS: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. RESULTS: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. CONCLUSION: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.
Health Personnel ; Humans ; Inpatients ; Insurance* ; Outpatients

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A Comparative Analysis for Projection Models of the Physician Demand and Supply Among 5 Countries.

Kyung Hwa SEO ; Sun Hee LEE

Health Policy and Management.2017;27(1):18-29. doi:10.4332/KJHPA.2017.27.1.18

BACKGROUND: In Korea, the problem of physician workforce imbalances has been a debated issue for a long time. This study aimed to draw key lessons and policy implications to Korea by analyzing projection models of physician demand/supply among five countries. METHODS: We adopted theoretical framework and analyzed detail indicators used in projection models of demand/supply comparatively among countries. A systematic literature search was conducted using PubMed and Google Scholar with key search terms and it was complimented with hand searching of grey literature in Korean or English. RESULTS: As a results, Korea has been used a supply-based traditional approach without taking various variables or environmental factors influencing on demand/supply into consideration. The projection models of USA and Netherlands which considered the diversity of variables and political issues is the most closest integrated approach. Based on the consensus of stakeholder, the evolved integrated forecasting approach which best suits our nation is needed to minimize a wasteful debate related to physician demand/supply. Also it is necessary to establish the national level statistics indices and database about physician workforce. In addition, physician workforce planning will be discussed periodically. CONCLUSION: We expect that this study will pave the way to seek reasonable and developmental strategies of physician workforce planning.
Consensus ; Forecasting ; Hand ; Korea ; Netherlands

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