The Development Path of China’s Private Health Insurance and Its Role in the Health Care System / 보건행정학회지

This article summarizes the structure of China’s current social health insurance system and reviews the development status of China’s private health insurance (PHI). China’s medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

Achievement and Future Tasks of Healthcare Industry Globalization Policies / 보건행정학회지

In 1994 Korea government began to develop the healthcare industry, since then the government has tried to create opportunities to promote the industry through various political efforts and policies. The biggest achievement was attracting foreign patients from 2009 to 2016 with a cumulative 1.56 million and total revenue of 3 trillion won. But Korea still loses the opportunity to become a global leader in the health care industry due to regulations and various ideological disputes. Accordingly, it is necessary to facilitate policy understanding and present a practical road map so that Korea's healthcare industry become a new growth engine that will lead the trend of global market in the future. It also suggests a national economic development paradigm, the health economy as health and economic value are rotated through a shift in view of health care. At this point, 20 years after the beginning of the healthcare industry development, it is necessary to evaluate the related policies and discuss effective future directions. In this sense, the purpose of this study is to examine the policies and limitations of the healthcare industry by each government division, and based on it, to propose political tasks for the future.

Prediction of Changes in Health Expenditure of Chronic Diseases between Age group of Middle and Old Aged Population by using Future Elderly Model / 보건행정학회지

BACKGROUND: The purpose of this study is to forecast changes in the prevalence of chronic diseases and health expenditure by age group. METHODS: Based on the Future Elderly Model, this study projects the size of Korean population, the prevalence of chronic diseases, and health expenditure over the 2014-2040 period using two waves (2012, 2013) of the Korea Health Panel and National Health Insurance Service database. RESULTS: First, the prevalence of chronic diseases increases by 2040. The population with hypertension increases 2.04 times; the diabetes increases 2.43 times; and the cancer increases 3.38 times. Second, health expenditure on chronic diseases increases as well. Health expenditure on hypertension increases 4.33 times (1,098,753 million won in 2014 to 4,760,811 million won in 2040); diabetes increases 5.34 times (792,444 million won in 2014 to 4,232,714 million won in 2040); and cancer increases 6.09 times (4,396,223 million won in 2014 to 26,776,724 million won in 2040). Third, men and women who belong to the early middle-aged group (44-55 years old) as of 2014, have the highest increase rate in health spending. CONCLUSION: Most Korean literature on health expenditure estimation employs a macro-simulation approach and does not fully take into account personal characteristics and behaviors. Thus, this study aims to benefit medical administrators and policy makers to frame effective and targeted health policies by analyzing personal-level data with a microsimulation model and providing health expenditure projections by age group.

Cost-Effectiveness of Recombinant Tissue Plasminogen Activator in the Management of Acute Ischemic Stroke: A Systematic Review

BACKGROUND AND PURPOSE: This work was undertaken to review the current cost-effectiveness analysis data on thrombolysis by intravenous (IV) therapy with recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke. METHODS: PubMed was searched for articles published between 1995 and 2008. The cost-effectiveness analysis data from eight eligible studies were reviewed, paying particular attention to their modeling assumptions and the quality of the source data. RESULTS: The reviewed studies were from six countries: USA (n=2), UK (n=2), Canada (n=1), Australia (n=1), Spain (n=1), and Denmark (n=1); most were performed from the healthcare-system and/or societal perspectives. IV rtPA was associated with an acceptable increase in short-term cost [range: US$ 36-236/patient; US$ 29,148-55,591/quality-adjusted life-years (QALYs)], and a net long-term cost saving that was higher from a societal perspective (range: -US$ 12,043 to -US$ 630/patient; -US$ 207,253 to -US$ 21,938/QALYs) than from a healthcare-system perspective (range: -US$ 5,811 to -US$ 5,415/patient; -US$ 41,137 to -US$ 4,662/QALYs). CONCLUSIONS: IV rtPA seems to be a cost-effective strategy for the management of acute ischemic stroke, and might reduce the associated healthcare costs as well as patients' disabilities. Further cost-effectiveness research and the development of a public health strategy are warranted to optimize the use of rtPA in Korea.