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정완교 ( Wan Kyo Chung ) 한국보건경제정책학회 2012 보건경제와 정책연구 Vol.18 No.4
Rising medical costs due to aging population have been a growing concern to both elderly households and the National Health Insurance (NHI). While previous research is preoccupied with forecasting medical costs under the assumption of constant or constantly rising age-medical cost profile, this paper analyzes the medical cost of the elderly taking account of end-of-life medical cost, the more important factor affecting their medical costs. Among the results, the medical cost for the elderly has increased significantly since 1999 to represent 31.58% of the total NHI cost in 2009. Simultaneously, the medical cost for the poor elderly under the Medical Aid Program increased to 41.4% of its total cost in 2009. Increased use of medical care, especially inpatient care, is shown to have contributed significantly to these results. Furthermore, the distribution of medical cost is skewed to the right for the elderly and spreads out as their age increases. In addition, the medical cost during the last year of life is significantly high but declines with age at death. These results mean that for the sake of better health policy on rising medical costs with aging population, both distribution of medical cost and end-of-life medical cost should be taken into consideration together with such factors as income, health status, and health insurance coverage.
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정완교 ( Wan Kyo Chung ) 한국보건경제정책학회 2013 보건경제와 정책연구 Vol.19 No.1
Presently, there is a growing emphasis on prevention and preventive medical care as a financial stability measure for National Health Insurance. This paper studies the status of Korean prevention and preventive medical care, and estimates the determinants of them. Moreover, it examines the relationship between prevention and other medical care use. The results show that the proportion of alcohol drinkers has risen since 1999 while that of smokers has fallen. Simultaneously, the proportion of regular exercisers has risen and that of the people who undergo regular health check-up has significantly risen since 2003. In addition, the analysis on the demand for prevention and preventive medical care shows that as people grow older, they increasingly tend to undergo health check-up, cancer screening, and vaccinations. Also, the more they age, the less men smoke and women drink. It turns out also that the private medical insurance contributes to more use of preventive medical care for women, such as health check-up and cancer screening. In the meantime, people with less education and income undergo less health check-up and cancer screening This paper also estimates a common factor through factor analysis using correlation matrix between prevention and preventive medical care, and then examines the impact of the estimated common factor on the use of curative medical services. The results show that the common factor increases the use of outpatient service and pharmacy, but has no statistically significant effect on the use of inpatient service. Therefore, it is not desirable to blindly emphasize the use of prevention and preventive medical care to reduce medical expense. Only after measuring the cost and benefit of each prevention and preventive medical care service, the ones with more cost effectiveness should be introduced with priority.
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김지훈 ( Ji Hoon Kim ),정완교 ( Wan Kyo Chung ) 한국보건경제정책학회 2014 보건경제와 정책연구 Vol.20 No.3
Presently, there is a growing concern on smoking and obesity as global health risks. Both are responsible for worsening individual health, growing medical cost and productivity-decline related social cost. Recently, few research have paid attention on the inverse relationship between declining smoking rate and increasing obesity rate. This paper uses 2005 Korea National Health and Nutrition Examination Survey to study the relationship between secondhand smoking and obesity. Secondhand smoking is studied because it is important itself and less likely to be subject to endogeneity problem than smoking. The results show that secondhand smoking is positively related to obesity measured by BMI and waist circumference, contrary to the expectation that smoking helps to control weight. In addition, smoking regulation is introduced at working places in 2003 and its effect is found to have reduced secondhand smoking. Therefore, smoking regulation is shown to be effective in reducing not only smoking but also secondhand smoking. Driven by this effect of smoking regulation, this paper use smoking regulation as an IV for secondhand smoking and find statistically insignificant relationship between secondhand smoking and obesity. This result is robust to the selected sample analysis of people aged 64 and under to reduce selective bias due to the fact that the old are more likely to unhealthy and lean and (secondhand) smokers are more likely to die earlier.
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