Health Status and Health Care Services in Republic of Korea with comparison to the United States

HSM310 Introduction to Health Services Management Course Project
Date submitted: 2/27/2015

Table of Contents

Executive Summary……………………………………………3
Demographics………………………………………………….5
Mortality, Infant mortality data………………………………..7
Causes of death………………………………………………..8
Other…………………………………………………………..9
Quality of Life………………………………………………..10
Analysis of trends…………………………………………….13
Conclusion……………………………………………………14
References: ………………………………………………….16

Executive Summary

This report will provide an overview of the policies and the practices that supports the quality of care in the Korean healthcare. As of 2014, Republic of Korea has a population of 49.3 million, which is a slight decrease of an estimate of 50 million in 2013. With the rapid economic development and less than thirty years, the Korean Healthcare system has gone from inadequate medical infrastructure and a fragmented health financing system to an established health care system characterized by universal coverage and substantial acute medical facilities.
The Korean health system has not slowed down after it had achieved universal coverage in 1989. In 2000, the national government has continued to adjust the health care system structure and delivery mechanism in response to the social and political changes, culminating a single-payer system. The priority for improving the quality care in Korea is to develop a strong ordinary care sector, which is critical to ensure that the Korean Health care system is able to support their patients and coordinating their ongoing health care needs across multiple health services while helping them undertake actions by helping patients’ manage their conditions before they are admitted in the hospital.
The goal is to support the expansion of successful models of care, and higher remuneration for cost-effective patient services such as patient counseling and lifestyle modification. Further reforms have included improvements in pharmaceutical distribution, efforts to contain costs, and development of programs to care for older adults. A stronger primary care sector will also require a larger, dedicated workforce of primary care professionals. There is also considerable scope for targeted and high-impact initiatives that will deliver improvements in the quality of care today. The most pressing is to develop better systems to monitor individual physician’s performance, which can identify breaches in patient safety and provide a means for patients feedback on the quality of care they experienced, and to be complemented with greater efforts to encourage medial personnel to keep their skills up-to-date through continuing education. The Korean health system is a mix public and private financing: the mandatory health insurance contributions and out of pocket payments by patients. The government is responsible for health care services; it subsidizes a substantial portion of health care funding.
National Health Insurance provides universal coverage, which is predominantly funded through contributions by employees, employers and the self-employed (including contributions by the state as an employer of civil servants). About 36% of funding is private, mainly in the form of direct payments and cost sharing by patients, and in the form of premiums to private health insurance schemes (Kim J, 2008).
It is apparent that South Korea had adopted Japan’s health insurance system as a model. The overall impact of the Japanese model of industrialization on the socioeconomic development of Korea, it is not surprising that the Japanese health insurance system became a prototype for Korean NHI. The fact is that American medicine had a dominant influence on the development of Korean medicine after 1945. However, the American model was not an ideal model for the Korean health insurance system because the United States had failed to achieve compulsory, universal health insurance. It took Republic of Korea only 26 year since Health Insurance Law was passed and only 12 year since the start of the National Health Insurance program to achieve universal coverage.
Current Demographics
One of the most densely populated countries in the planet is South Korea, for every square kilometer it has 400 people. Almost seventy percent of South Korea’s land is uninhabitable since it is very mountainous with the population forming in the lowland areas. Seoul Korea is a very homogeneous community having their own customs, culture and language. There are some minorities of expatriated that live in Seoul which are Japanese and Chinese. Seoul Korea is the largest metropolis and capitol of the Republic of Korea. Statistic show that the Seoul Capital area is the second largest metropolitan in the world in addition to more than 25.6 million people and 10.44 million populate in Seoul alone. The largest metropolitan cities in the Republic of Korea are cities, Busan. (3.5 million inhabitants) is currently the second largest city in South Korea, with Seoul being first, Daegu (2.5 million), Daejeon (1.5 million), Gwangju (1.4 million), Incheon (2.9 million) Seoul (10.44 million) and Ulsan (1.1 million). The largest religions in the Republic of Korea is Buddhism and Christianity, however there are other that are practice in Seoul is Confucianism. Adding to their major religions, shamanisn also plays a very important part in their day to day life of the Korean community, it allows them to connect with the spiritual world and helps them make predictions about their future. The main language that is spoken in South Korea is Korean. English extensively taught in both middle and high school since it is used for educational purposes. Foreign languages such as Japanese, Mandarin, French, Spanish, Russian, German and Arabic are also taught in both middle and high school. Demographics Transition can be defined as the changes in the fertility and in the mortality of a specific society, meaning that the process of the change from an agrarian state to an industrialized and urbanized state, creating the reduction to fertility and mortality. The rapid process of demographic transition in Korea was facilitated by the interaction of rapid socioeconomic development and the full scale adoption of the family planning (Kim), since South Korea experienced a new era of baby boom that peaked in 1959 since then, the fertility level started to decline. The Korean was also had a great impact on the population with the war casualties that were estimated to be 1.6 million. (Lee) The crude birth rate declined sharply from 42 per thousand to 32 per thousand, with the reduction of birth rate, the fertility level began to steadily decline without any interruption. Between the death rate and the birth rate the growth rate of South Korea population started to see a decline. With the declining of the birth rate and the fertility rate the aging population began to increase. Statistics show that the aging population from the age of 60 and over had increased from 1.5 million in 1960 to 3.3 million in 1990 and has been forecasted to increase to 9.9 million by the year 2020. The numbers show that the elderly population aged 60 and over have doubled in the past 30 years and are expected to increase in the years to come. Korea has already experiencing the enormous decline in fertility and mortality and has a vast motion for further population aging. With Koreans low birth rate of 1.9 children per woman, the population could shrink due to the social and economic barriers. Studies have showed that the have one child in which they invest in heavily in the child’s human capitol. Korean parents would rather have one successful offspring versus a number of low achieving offspring’s. Korean woman also evaluate the cost and the benefits it would have in having children. They compare children to alternative options such as obtaining higher degree of education; securing a prominent job and spending more time at the job or indulge themselves in their own hobbies. Urbanization Seoul was selected to be the capitol in 1394 by the Chosun Dynasty, and did not become a central city for political, economic, social and cultural purposes until the end of late 14th century. The city of Seoul as the capitol and central city of the Republic of Korea didn’t grow much during the Chosun Dynasty (1392-1910). The population of Seoul increased due to the economic development on the late 1960’s, is when the rapid urbanization and the changes in the infrastructure occurred. With the transformation of urbanization in Seoul, it created countless infrastructure problems that affected everyday living for the citizens of Seoul. The Korean government developed and implemented numerous decentralization policies and plans within the last 20 years. The government’s strategy was to better the environment for their citizens of Seoul and to strive a better balanced for development. When Seoul began to experience the modernization that began in the 19th century the spatial structure of the land began to change in the first half of the 20th century. Between the disruption of the Japanese occupation from 1910 to 1945 and the Korean War 1950 through 1953, these two events disrupted the traditional society and it destroyed the infrastructure of Seoul and the spatial arrangement. With the freedom from Japan the people returned to Korea in large numbers and made Seoul their hometown, which led to a rapid growth in Seoul. With the spreading and migration from the rural areas to the urban areas in The Republic of Korea, it changed by influencing the population of Seoul. The population in Seoul now stands at 10.44 Million becoming a colossal metropolis population, which created a socio-economic change in the city. Seoul has consistently maintained a single core structure since its foundation, but the structural transformation of urban activities has tended to accelerate the appearance of an emerging multi-centered city since 1980, as a spatial analysis of population distribution, employment structure, land values and commuting patterns demonstrate. (Lee). Seoul has become a global city and has gone through a great transformation since the 19th century.
The infant mortality rate in 2014 the estimate was 3.93 deaths/1,000 live births male: 4.13 deaths/1,000 live births: female: 3.73 deaths/1,000 live births. Research shows that the main causes of death in children that are under five years of age is diarrheal diseases and in addition to acute respiratory infections (ARIs), which is combined with malnutrition as in many other developing countries. It was reported that infant deaths due to diseases of the circulatory system was a combine total of 25 in which 11 were infant males and 14 were infant females. Congenital malformations, deformation and chromosomal abnormalities is the highest with the overall total of 271, with a total of 136 male .06 deaths/ 1,000 live births and 136 infant female’s .06 deaths/1,000 live birth. There is little known causes of death that begins in the perinatal and neonatal period.
Cancer is the leading cause of death Korea. In 1983, 11.3 % accounted for total number of cancer death in the Republic of Korea. Statistics have shown that there has been a steady increase of death due to cancer that have now accounted for 27.6% of deaths in 2012. The projection of cancer incidences are expected to increase from 218,017 in 2011 to 270, 809 in 2015, this is a 24.2% increase that was monitored over a four-year period. This increase is due to the countries aging population and their changing lifestyles.
According to the National Statistical Office, stomach cancer occurred most frequently in males that have accounted for 19.4% which is 85.1 per 100,000 in all cases, which was followed by colon and rectum cancer of 15.6 % which accounted for 68.4 per 100,000, lung cancer was at 13.8 % accounted for 60.5 per 100,000, while liver cancer was at 11.1% and that accounted for 48.6 per 100,000. Whereas in females, thyroid cancer had occurred the most frequently that accounted for 31.1 % the incidence rate was 134.1 per 100,000 of all cases followed by breast cancer at 14.8% accounting for 63.7 per 100,000, colon and rectum cancer at 10.2% which accounted for 43.8 per 100,000, cancer of the stomach at 9.5 % which accounted for 41.1 per 100,000, and at 6.1% was lung cancer at 26.3 per 100,000. These numbers may be alarming, but is it lower than the cancer death rate of the United States for both male and females.
The tendency in the occurrence of major risk factors for cardiovascular disease would include smoking, obesity, hypertension, diabetes, and hypercholesterolemia. Cardiovascular Disease covers a range if diseases that are related to the circulatory system, this would include ischemic heart disease or heart attack and cerebrovascular disease or stroke. Cardiovascular disease is also a major worldwide public health problem. It is become the number one cause of death in industrialized countries.
The number of deaths from cerebrovascular diseases has dropped from 10 years ago. However, the incidence and prevalence rates for the diseases jumped from 1.60 and 6.2 per 1000 in 1998 to 2.3 and 10, respectively, in 2003. The hike indicates an increase in disabilities related to stroke, adding to the burden of disease. Cardiovascular diseases are not as prevalent in the Republic of Korea as in many Western countries, but have been showing an upward trend. The number of deaths from ischemic heart disease more than doubled between 1996 and 2006, from 13.0 to 29.2 per 100 000. (ROK).
Both diabetes and hypertension is a very common disease in the Republic of Korea. It was report that an average of 8.0 % of Koreans had diabetes in 2007 and about 28% of Koreans had hypertension and prevalence of these two diseases are increasing. Studies show that the combined dependent of hypertension and diabetes have shown a substantial amount of comorbidity, mostly in diabetes, there is more than 50% of people that have been diagnosed with diabetes also have hypertension and on the contrary it is shown that only 20% of the Korean people with hypertension also have diabetes. Comorbidity is a vital concern since the Korean people that have both diseases also have a mortality rate that is two to three times higher than those patients with just diabetes alone. In Min’s study with limitation it was shown that a person with a higher level of education and a higher income was less likely to have these diseases in all four models. In addition, a person who had a higher level of education but with a lower income was less likely to have hypertension alone and either one, not both diseases and diabetes alone. In addition, a person who had a higher income but had a lower level of education was less likely to have both diseases alone, but this relationship was not significant with other models. Education and income in Republic of Korea did compensate each other to avoid having these two diseases. (Min).
The Occupational Composition of the Republic of Korea has undergone a major change in its occupational and class structure. The most important change that was significant in the Republic of Korea was the decline the agricultural population. The agricultural population was maintained in the last forty years with the process of the rural –urban migration. With the industrialization the Koreans saw a reduction in the agricultural labor force as it significantly expanded to the urban labor work force in order to satisfy the rising manufacturing industry. With Korea’s rapid rural- urban migration and the expansion to the urban capitalist was a shift in the occupational and class structure in which there was an increase in the new middle and working class population. Small traditional family businesses were replaced by the highly organized and the large scale modern day businesses that employed salaried workers, thus creating a decrease in the farming occupations has necessarily led to a quantitative expansion of the so called “urban” occupations, and farm laborers, as well as independent farmers, have been incorporated into the ranks of blue collar workers and white collar workers. However, there has been a minor increase over time in the upper class occupations of professionals, managers and administrators in the Republic of Korea (Hong).
Republic of Korea economy has gradually strengthened in its specialization in machinery, electronics, telecommunications and transport equipment. It seems that textiles, apparel, leather and footwear are far more important for the Republic of Korea’s industry than for the other countries in our benchmark. No significant changes within these long-term trends have emerged in the last decade (UNIDO).
Since the end of the Korean War, the Koreans endured the rapid economic growth with the industrialization and the urbanization of the Korean society. One notable changes was the rise of the new middle class, which consist of the civil servants, and the salaried white collar workers who work in the large private companies along with the professionals that have specialized training and education, such as those who are in the field as engineers, university professors, health care professionals journalist and architects. Remarkably there was an increase in numbers for those who worked in the factories.
A sociologist at Seoul National University, Kim Kyong-Dong had provided figures that showed that the population could now be labeled as the new middle class. The middle class grew from 6.6 percent to 17.7 percent by between 1960 through 1980, while the industrial workers expanded from 8.9 percent to 22.6 percent of the labor force during the same period. On the other hand, while the industrial workers expanded the rural lower class and the farmers declined in percentage, which accounted for sixty four percent of the population in 1960 but only 31.3 percent in 1980.With the great amount of recent arrivals from the rural parts of the country was the urban lower class in which they lived in the squatter areas of the region which was an estimate of 6.6 percent of the population in 1960 and 5.9 percent in 1980.
Today, education is the most important factor that is affecting the social mobility in Korea with one exception with the military, in which the ranks were educated in the Korean Military Academy. The only characteristics that the college graduate civilians shared with the military were that they graduated from the most prestigious universities. Seoul has a well-defined school such as the National University followed by Yonse University and the Korea University, followed by the top institution for women Ehwa Woman’s University. The social importance of education is one of the major continuities between traditional and contemporary Korea.
The farming system in the Republic of Korea is found in moist sub humid and humid agro ecological zones, such as the well-watered mostly flat landscapes. The farming system is primarily rice based which is the most important crop in Korea and with the cropping intensity, it is dependent on rainfall distribution. The length of the rice-growing season depends on the availability of its supplementary of water irrigation. Korea’s subsidiary crops also include red hot pepper, oilseeds, barley, maize, root crops, soybeans, sugarcane, cotton, red bean, green bean, sweet potato, maize, millet and sorghum, vegetables and fruits in all areas such as pears, grapes, mandarin oranges, apples, peaches, Welsh onions. Both livestock and off-farm income contribute to household livelihoods. Regional food security depends upon the production from this system. Poor prospects on the farm depleted farm villages as the young left and the old died. Parents sent their children to the towns and cities for a better education. Young farmers who could not find wives also left for the cities.
Cultured species in the Republic of Korea is Mari culture production of seaweed, which makes the highest contribution of aquaculture production. The species of Cultured seaweed would include kelp, sea mustard, green laver, codium and fusiform. The second most important group of marine aquaculture products and the primary species produced is mollusks; this would include Korean mussel, oysters, the sea squid, red oyas, abalone, Yesso scallop, carpet shell and ark shells. Another dominance in cultured species is in the marine finfish culture; this would include the bastard halibut, Korean rockfish, mullet, sea bass, yellowtail, red sea bream, black sea bream, brown croaker and puffers.
The Koreans also culture crustacean, which they are primarily concerned with only two species of shrimp and some crabs. They consist of kuruma prawn and fleshy prawn is there the prime species of shrimp. Being farmed with the former raised mostly in farms along the west of the peninsula and the latter in farms in the southern region of Korea. Crustacean and mollusks are of much less importance in freshwater culture in the country. The most important species in freshwater aquaculture is the Finfish species, which include Japanese eel, trout, mudfish, tilapia, common carp, loach, colored carp.
In comparison with the United States versus Republic of Korea, the United States has an employment rate of 7.30 percent as to the Republic of Korea a rate of 3.20 percent on unemployment. The South Korean employed person works on an average of 2071 hours each year whereas the average United State employed person works on an average 1788 hours each year. GDP per capita in the Republic of Korea is about $33, 200, while the United States is at $52,800; therefor The ROK makes 37.12 % less money. On health care in the Republic of Korea, they send 80.86 % less money on healthcare per capita for both public and private health combined is $1,702. 60 in USD, as to the United States spends $8,895,10 on insurance per capita. The GINI index measures the degree in inequality in the distribution of family income ROK is 31.10 as the United States is 45.00. This index measures the degree of inequality in the distribution of family income in a country. The index is calculated from the Lorenz curve, in which cumulative family income is plotted against the number of families arranged from the poorest to the richest. The index is the ratio of (a) the area between a country's Lorenz curve and the 45-degree helping line to (b) the entire triangular area under the 45-degree line. The more nearly equal a country's income distribution, the closer its Lorenz curve to the 45 degree line and the lower its Gini index, e.g., a Scandinavian country with an index of 25. The more unequal a country's income distribution, the farther its Lorenz curve from the 45 degree line and the higher its Gini index, e.g., a Sub-Saharan country with an index of 50. If income were distributed with perfect equality, the Lorenz curve would coincide with the 45 degree line and the index would be zero; if income were distributed with perfect inequality, the Lorenz curve would coincide with the horizontal axis and the right vertical axis and the index would be 100. (CIA). The Koreans also use 24.78 % less electricity at 9,165 kWh per capita, as to the United States at 12,185kWh per capita. The United States consumption of oil per day and per capita is at 2.4822, while Korea is at 1.9698. South Korea also has a low rate in HIV/AIDS at 0.10% with 500 deaths each year as to the United States at 0.60 % and an estimated death rate at 17,000 each year. The Korean government’s strategy is to better the environment for their citizens of Seoul and to strive a better balanced for development. If the United States followed the Korean’s government strategy, it would better our environment here in the United States.

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