title: Determinants of health care expenditures and the contribution of associated factors: 16 cities and provinces in Korea, 2003-2010.
abstract: OBJECTIVE
  The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review.
  
  
  METHODS
  The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients (R(2)) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost.
  
  
  RESULTS
  Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%).
  
  
  CONCLUSIONS
  As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kimyoung
authors.initials: K
authors.lastname: Han
authors.affiliation: Graduate School of Public Health, Ajou University, Suwon, Korea.
authors.forename: Minho
authors.initials: M
authors.lastname: Cho
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea. ; Graduate School of Public Health, Ajou University, Suwon, Korea.
authors.forename: Kihong
authors.initials: K
authors.lastname: Chun
mesh_terms: D002947:Cities; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D012044:Regression Analysis; D056910:Republic of Korea
keywords: Health care costs; Health resources; Medical care costs; Public policy