Aging Risk and Health Care Expenditure in Korea

Tchoe, Byongho; Nam, Sang-Ho

doi:10.3390/ijerph7083235

Cited by 28 publications

(29 citation statements)

References 31 publications

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“…We find that, with the exception of Mexico, Estonia is the country with the lowest per capita HCE in our sample. For Korea, besides the determinants we consider in this study, some studies have concluded that the introduction of national health insurance is another factor that boosts the HCE growth (see, e.g., Tchoe & Nam, ). In addition, Figures and depict slowly positive growth in Canada, Denmark, and Finland, and moderately positive growth in other 18 countries.…”

Section: Resultsmentioning

confidence: 99%

A quantile regression approach to panel data analysis of health‐care expenditure in Organisation for Economic Co‐operation and Development countries

2018

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This paper investigates the variation in the effects of various determinants on the per capita health-care expenditure. A total of 28 Organisation for Economic Co-operation and Development countries are studied over the period 1990-2012, employing an instrumental variable quantile regression method for a dynamic panel model with fixed effects. The results show that the determinants of per capita health-care expenditure growth, involving the growth of lagged health spending, of per capita gross domestic product (GDP), of physician density, of elderly population, of life expectancy, of urbanization, and of female labor force participation, do vary with the conditional distribution of the health-care expenditure growth, while the changing patterns are dissimilar. Moreover, we show that Baumol's model of "unbalanced growth" has a significantly positive effect on per capita health spending growth, and its effect is quite stable over the entire distribution. However, the correlation between the components (wage growth and labor productivity growth) of the "Baumol variable" and health expenditure growth is more varied. As a comparison, only the growth of lagged health spending, per capita GDP, and the Baumol variable (or its components) are found related to health spending growth in conditional mean regressions. The prediction results were also quite different between the quantile regression dynamic panel instrumental variable models and linear panel data models. More attention needs to be paid to the varying influence of determinants in health expenditure study.

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Section: Resultsmentioning

confidence: 99%

A quantile regression approach to panel data analysis of health‐care expenditure in Organisation for Economic Co‐operation and Development countries

2018

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“…Since then, many health indicators in Korea, including access to medical care, have improved dramatically, adding pressure on the health care budget: from 1989 to 2005, the number of physicians and beds available (per 10 000 persons) more than doubled and the number of physician visits and admissions per capita also nearly doubled . Additionally, the rapidly aging population was considered a major challenge to the national health insurance system . In 2006, the elderly aged 65 years and older accounted for only 8.6% of the population, but they were responsible for 25.9% of health insurance expenditure, which was an increase from 17.7% in 2001 .…”

Section: Introductionmentioning

confidence: 99%

“…5 Additionally, the rapidly aging population was considered a major challenge to the national health insurance system. 6 In 2006, the elderly aged 65 years and older accounted for only 8.6% of the population, but they were responsible for 25.9% of health insurance expenditure, which was an increase from 17.7% in 2001. 5 The national health insurance system in Korea began to run a significant budget deficit in 1996 that has grown bigger into the following decade.…”

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confidence: 99%

The impact of change from copayment to coinsurance on medical care usage and expenditure in outpatient setting in older Koreans

Bae

Choi

Song

2017

Health Planning & Management

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Patient cost-sharing change was implemented on August 1, 2007, for outpatient care in the clinic setting in Korea from copayment to coinsurance. This study aims to estimate the effect of the policy change on medical care usage and expenditure in older Koreans. By using national health insurance claims data from the Health Insurance Reimbursement Assessment Service, this study analyzed the entire 137 million claims for a total of approximately 4.1 million patients aged 60 to 69 years who had been diagnosed and/or treated for outpatient care in clinics from January 1, 2007, to December 31, 2008. Medical care usage was defined as the proportion of all beneficiaries in each group who visited clinics and the mean number of visit days per beneficiary. Medical care expenditure per visit day was expressed as total costs, reimbursed amount, and patient's out-of-pocket payment. Data on January through June of 2008 were analyzed as compared with the same months of 2007. Raw difference-in-difference and multiple regression analyses were performed. The interaction coefficients, which measured the impact of cost-sharing change, was -0.078 in model 1 and -0.039 in model 2 (P < .0001). In conclusion, a cost-sharing change from copayment to coinsurance reduced medical care usage and expenditure.

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“…[1][2][3][4][5][6][7][8][9][10][11][12] While some studies have suggested that rapid growth in the older adult population (defined as ages 65 and above) is a significant cost-driver for healthcare services, through mechanisms such as increased utilisation due to longer lifespan, [1][2][3]6,8,10 some have argued that the ultimate effect on healthcare expenditure is mild. 5,7,9,11,12 In either case, the magnitude and rate of the increases in the demand for healthcare services relating to age-associated medical conditions has left many countries unprepared. [13][14][15][16][17][18] This has placed a significant financial burden on many governments.…”

Section: Introductionmentioning

confidence: 99%

The Contribution of Ageing to Hospitalisation Days in Hong Kong: A Decomposition Analysis

Kwok

Lee

et al. 2016

Int J Health Policy Manag

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Background: Ageing has become a serious challenge in Hong Kong and globally. It has serious implications for health expenditure, which accounts for nearly 20% of overall government expenditure. Here we assess the contribution of ageing and related factors to hospitalisation days in Hong Kong. We used hospital discharge data from all publicly funded hospitals in Hong Kong between 2001 and 2012. Methods: A decomposition method was used to examine the factors that account for the change of total hospitalisation days during the two periods, 2001-2004 and 2004-2012. The five factors include two demographic factors – population size and age-gender composition – and three service components – hospital discharge rate, number of discharge episodes per patient, and average length of stay (LOS) – which are all measured at age-gender group level. In order to assess the health cost burden in the future, we also project the total hospitalisation days up to 2041, for a range of scenarios. Results: During the decreasing period of hospitalisation days (2001-2004), the reduction of LOS contributed to about 60% of the reduction. For the period of increase (2004-2012), ageing is associated with an increase in total hospitalisation days of 1.03 million, followed by an increase in hospital discharge rates (0.67 million), an increase in the number of discharge episodes per patient (0.62 million), and population growth (0.43 million). The reduction of LOS has greatly offset these increases (-2.19 million days), and has become one of the most significant factors in containing the increasing number of hospitalisation days. Projected increases in total hospitalisation days under different scenarios have highlighted that the contribution of ageing will become even more prominent after 2022. Conclusion: Hong Kong is facing increasing healthcare burden caused by the rapid increase in demand for inpatient services due to ageing. Better management of inpatient services with the aim of increasing efficiency and reducing LOS, avoidable hospitalisation and readmission, without compromising patient satisfaction and quality of service, are crucial for containing the rapid and enormous increases in total hospitalisation days for Hong Kong. The results would be relevant to many rapidly ageing societies in this region.

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Aging Risk and Health Care Expenditure in Korea

Cited by 28 publications

References 31 publications

A quantile regression approach to panel data analysis of health‐care expenditure in Organisation for Economic Co‐operation and Development countries

A quantile regression approach to panel data analysis of health‐care expenditure in Organisation for Economic Co‐operation and Development countries

The impact of change from copayment to coinsurance on medical care usage and expenditure in outpatient setting in older Koreans

The Contribution of Ageing to Hospitalisation Days in Hong Kong: A Decomposition Analysis

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