2018 Current Health Expenditures and National Health Accounts in Korea / 보건행정학회지

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for 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 analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. ‘Transfers from government domestic revenue’ share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to ‘compulsory contributory health financing schemes,’ ‘transfers from government domestic revenue’ share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

2015 National Health Accounts and Current Health Expenditures in Korea / 보건행정학회지

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.

2015 National Health Accounts and Current Health Expenditures in Korea / 보건행정학회지

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.

1970-2014 Current Health Expenditures and National Health Accounts in Korea: Application of SHA2011 / 보건행정학회지

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.

Trends in Scale and Structure of Korea's Health Expenditure over Last Three Decades (1980-2009): Financing, Functions and Providers

This paper introduces statistics related to the size and composition of Korea's total health expenditure. The figures produced were tailored to the OECD's system of health accounts. Korea's total health expenditure in 2009 was estimated at 73.7 trillion won (US$ 57.7 billion). The annual per capita health expenditure was equivalent to US$ PPP 1,879. Korea's total health expenditure as a share of gross domestic product was 6.9% in 2009, far below the OECD average of 9.5%. Korea's public financing share of total health expenditure increased rapidly from less than 50% before 2000 to 58.2% in 2009. However, despite this growth, Korea's share remained the fourth lowest among OECD countries that had an average public share of 71.5%. Inpatient, outpatient, and pharmaceutical care accounted for 32.1%, 33.0%, and 23.7% of current health expenditure in 2009, respectively. A total of 41.1% of current health expenditure went to hospitals, 28.1% to providers of ambulatory healthcare (15.9% on doctor's clinics), and 17.9% to pharmacies. More investment in the translation of national health account data into policy-relevant information is suggested for future progress.

Endoscopically Exposed Coil after Embolization for Bleeding Duodenal Ulcer / 대한소화기내시경학회지

Endoscopy has been the method of choice for the initial diagnosis and treatment of gastrointestinal bleeding. However, in the case of difficult localization or endoscopic failure, angiographic or surgical alternative may be recommended. The role of angiography has been emphasized recently to control upper GI bleeding. We experienced a case with deep ulcer displaying exposed vessel along the duodenal bulb, which imposed serious rebleeding risk. Although, active bleeding was controlled by the epinephrine injections in that patient, rebleeding risk was still high. So the patient underwent emergency angiography with embolization of the pancreaticoduodenal artery and gastroduodenal artery using multiple microcoils. Follow-up endoscopic examinations showed a coil protruding into the lumen from the ulcer bed, and the exposed coil at the ulcer base was completely by the regenerated epithelium three months later. Here in, we describe the rare case of a endodcopically exposed coil after embolization for bleeding duodenal ulcer which is the first case ever reported in Korea.

Diagnosis of Cervical Tuberculous Lymphadenitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although the incidence of tuberculosis has decreased recently, cervical tuberculous lymphadenitis is one of the most common causes of neck mass in Korea. Its confirmative diagnosis is not common, especially when the presence of acid-bacilli is not proven. So, the treatment of cervical tuberculous lymphadenitis is generally carried out by clinical diagnosis, not by confirmative diagnosis. In this study, we designed to verify theusefulness of fine needle aspiration cytology (FNAC), AFB stain, Mycobacterium tuberculosis polymerase chain reaction (PCR) and excisional biopsy prospectively. MATERIALS AND METHODS: We underwent FNAC, AFB stain and PCR as a first stage work-up through fine needle aspiration in forty-eight patients who were suspected of cervical tuberculous lymphadenits. In patients with positive results on the first stage work-up, we treated the patients with antituberculosis chemotherapy under clinical diagnosis of tuberculosis. In patients with negative test results, we performed excisional biopsy. Also in patients who revealed positive results with no response to the antituberculosis chemotherapy, we performed an excisional biopsy too. RESULTS: The sensitivity and specificity of first stage work-up were 64.9% and 81.8%, respectively. The sensitivity of FNAC, AFB stain and PCR were 8.1%, 13.5% and 56.8 %, respectively. The specificity of PCR was 81.8%. Thirteen (59.1%) of 22 patients who revealed negative results in their first stage work-up were proven to have cervical tuberculous lymphadentis through excisional biopsy, and two of the positive results in PCR were false positive. CONCLUSION: In clinical diagnosis of cervical tuberculous lymphadentis, the first stage work-up used in this study is found to be useful methods which resulted 64.9% sensitivity and 81.8% specificity. Especially, PCR is the most useful tool among them and suggest that, if its result is negative, excisional biopsy should be considered positively.

Osteochondroma of the Atlas Presenting as an Oropharyngeal Mass / 대한이비인후과학회지

Osteochondroma, also known as osteocartilaginous exostosis, or just exostosis, is the most common benign bone tumor. Most of osteochondromas are solitary lesions and affect long bones; however, about 12% of osteochondromas are multiple lesions with the autosomal dominant inheritance. Only 1~4% of solitary osteochondromas originate in the spine. Symptoms vary depending on its location. We experienced a case of osteochondroma of the atlas presenting as an oropharyngeal mass. We report the case with a review of literatures.

A Case of Thyroid Abscess by Staphylococcus Aureus / 대한내분비학회지

Acute thyroid abscess is an uneommon type of neck infection. We experieneed a case of staphylococcal thyroid abscess in 29 year old man, diagnosed by needle aspira~tion and culture of the aspirate. The patient had complained fever and slowly growing anterior neck swelling. Needle aspiration of the cold nodule prior to broad spectrum antibiotics was performed. After Surgical excision combined with antibiotics, he was discharged with elinical improvement. The laboratory diagnosis and clinical course was summarized and is reported with relevent references.