Comparative Research for the Healthcare Budget and Burden of Disease in Perspective Resource Allocation

Park, So-Youn; Yoon, Seok-Jun; Park, Hyesook; Jo, Min-Woo; Oh, In-Hwan

Because the MOHW plays a significant normative role in health policy formulation in Korea, we chose to zero in on MOHW funding. Health priorities that underpin the 2018 MOHW budget are shown in Fig. 1 . 9 In practice, several departments and agencies operate the R&D funds under a delegation of authority from the MOHW, the Korea Health Industry Development Institute (KHIDI), the National Rehabilitation Center, the Centers for Disease Control and Prevention, the National Cancer Center, and the hi-tech medical complex. Data for the R&D budget were taken from the 2018 MOHW R&D Project's integrated implementation plan. 10 We analyzed the contents of the plan to identify the appropriate group of diseases budget related. Table 1 shows how we aggregated budget lines from the implementation plan. This study used the disease classification systems from the KNBD study. For example, diseases are classified into three level 1 groups: group 1 comprises communicable, maternal, neonatal, and nutritional diseases; group 2 comprises non-communicable diseases; and group 3 is injuries and violence. Each level 1 disease group is further classified into additional level 2 disease groups, such as human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) and tuberculosis, diarrhea, lower respiratory infections, meningitis, other common infectious diseases, and so on. We identified budget lines for levels 1 and 2 diseases, which are communicable diseases including tuberculosis, HIV/AIDS, malaria, maternal, neonatal, and nutritional diseases; as well as non-communicable diseases such as neoplasm, chronic respiratory diseases, mental and behavioral disorders, diabetes, musculoskeletal disorders; and then finally for the injury and violence burden of disease clusters. 7 Every fund was classified in the most detailed manner. But some funds, such as the one for big data in healthcare, was assigned to the non-disease specific clusters. Similarly, wide budget lines that could not be classified in one level 2 disease group were also assigned to the non-disease specific group. We then categorized a wide range of disease clusters using the budget groups that could meet the burden of disease in terms of the numbers of DALYs. We also investigated whether the MOHW R&D budget allocations varied according to the economic burden of disease. Also, some budgets target risk factors rather than disease group. Therefore, the DALYs from risk factors in 2013 and the risk factors budget are also compared. 6 The USD is converted using the average exchange rate of 2017.