• Health Policy and Management
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• v.34 no.1
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• pp.68-77
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• 2024

Background: Depressive disorders can be categorized into daily depression and clinical depression. The experience of depressive disorder can increase health care utilization due to decreased treatment compliance and somatization. On the other hand, the clinical depression group may also experience social prejudice associated with the illness, which can limit their access to health care utilization. In terms of the significance of health care utilization as a factor in individual and social issues, this study aims to compare the health care utilization of the clinical depression group with that of the non-depressed group and the daily depression group. Methods: The analysis utilized the inverse probability of treatment weighting based on the generalized propensity score. Results: As a result of the analysis, clinical depression and daily depression were higher among women, low-income groups, individuals with low education levels, and so forth. The clinical depression group was also higher among individuals who were not economically active, did not have private health insurance, or had multiple chronic diseases. The number of outpatient department visits in the depression group was significantly higher than in the non-depressed group. In addition, the number of outpatient department visits for the clinical depression group was significantly higher than that for the daily depression group. Outpatient medical expenses were higher in the depression group than in the non-depressed group, and there was no significant difference between the clinical depression group and the daily depression group. Conclusion: Health care utilization was higher in the depression group than the non-depressed group, it was also higher in the clinical depression group than the daily depression group.

• Health Policy and Management
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• v.28 no.3
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• pp.263-271
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• 2018

Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.103-111
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• 2020

Objectives: The study recognizes the seriousness of depression in youth with atopic dermatitis, and tries to identify factors that affect depression. Methods: Data were obtained from the 2014 Korean Youth Health Behavior Risk Behavior On-line Survey. In this study, 17,232 people who were Atopic dermatitis without missing variables were included in the final analysis. It conducted frequency, chi-square and logistic regression analysis by SPSS 20.0. Results: An analysis of factors affecting depression showed that subjective health level, subjective happiness satisfaction, subjective sleep satisfaction, subjective stress level, smoking, and drinking had an effect. Conclusions: The factors affecting youth depression with atopic dermatitis revealed health status, life behavior. These results are thought to require attention and research on youth with atopic dermatitis, along with the development of practical treatment programs and systematic management by applying them to teenagers in an appropriate time and method.

• Health Policy and Management
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• v.31 no.1
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• pp.17-23
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• 2021

With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

• Health Policy and Management
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• v.34 no.1
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• pp.87-93
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• 2024

Background: In recent years, studies have shown conflicting results regarding the benefits of dietary supplements in reducing healthcare expenditures. This study aimed to address this inconsistency by examining the association between supplement consumption and health expenditures using nationally representative data from the Korea Health Panel Survey (2019-2020). Methods: A 1:1 matched case-control dataset was established using propensity score matching technique based on supplement consumption. Then, total annual healthcare expenditures were compared between the two groups. In addition, a multivariate regression analysis (Proc Surveyreg) was performed to determine the association between the supplement consumption and medical costs. Results: The supplement user group spent about 1.72 million Korean won, while the non-user group spent about 1.43 million Korean won on medical services (p=0.0186). The results of multivariate regression showed that the costs were approximately 26.15% higher in the user group than in the non-user group (p=0.0004). Conclusion: Contrary to the previous studies that have shown the benefits of supplement use in reducing healthcare costs, this study showed that those who consistently consumed supplements spent more on medical services. This can be interpreted in the same context as previous studies suggesting that dietary supplement intake is a healthy behavior for managing one's health. However, we caution against drawing firm conclusions due to data limitations. Further analysis using patient-level epidemiologic data is needed.

• Health Policy and Management
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• v.31 no.1
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• pp.24-34
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• 2021

Background: The purpose of this study is to identify factors that affect work dissatisfaction and turnover intention for dedicated nurses working in emergency departments of vulnerable areas of health care. The purpose of this study is to identify risk factors related to the working environment that influence job dissatisfaction and intention to turnover among dedicated nurses working in emergency rooms in areas of medical vulnerability. Methods: We conducted a survey of nurses working in emergency rooms in vulnerable areas of medical care, and the survey was conducted for two consecutive years. A logistic regression analysis was performed with the working environment variable as the independent variable and the work environment dissatisfaction and turnover intention as dependent variables, respectively. Results: The variables that significantly affected both dissatisfactions with the working environment and turnover intention at the current institution were age, overlapping work in other departments, and the total work experience of nurses. Annual salary, the average number of double-duty (continuous work) per month, type of work, and work experience of nurses at the current institution had a significant effect only on dissatisfaction with the working environment. Conclusion: The results of this study are thought to be of great help if the government takes reference when establishing medical policies in vulnerable areas in the future.

• Journal of Legislation Research
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• no.44
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• pp.387-433
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• 2013

Understanding the concepts of health and medical practice are significant because they are the basis of health and medical policy and law. How legislators, policy makers, and the public perceive those concepts defines the direction of legislation and policy making. This study aims to show the changes of the concepts by reviewing the history of major Statutes relating to health and medicine. Alongside medicalization of human conditions and daily activities, the concepts of health and medical practice also expanded. On the other hand, as technologies of health and medicine have specialized and segmented, the large portion of public services of the past is now provided by the private sector. We argue that the actual laws and decisions by the judiciary should be responsive to social and scientific changes, which may cause the changes of the perceptions of health and medical practice. By doing so, they not only can have actual legal force but also even initiate a movement for establishing new medical policy or law.

• Health Policy and Management
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• v.34 no.2
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• pp.163-177
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• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

• Research in Community and Public Health Nursing
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• v.1 no.1
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• pp.174-175
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• 1989

본 연구는 보건진료원의 업무를 분석하기 위하여 충북에서 활동하고 있는 보건진료원 136 명을 대상으로, 설문지를 흥해 자료수집을 하였으며 백분률, 평균값, 표준편차로 자료처리를 하였다. 조사기간은 1968 년 8월 1일부터 11월 20일까지 했으며 그 결과를 요약하면 다음과 같다. 1. 보건진료원의 일반적 특성과 업무에 관련 된 배경을 살펴보면 다음과 같다. 보건진료원의 일반적 특성으로 연령 분포는 30 - 34세가 30.1 %로 가장 많았고 결혼 상태는 기혼자가 61.8 % 였다. 종교는 기독교가 42.6% 로 많았고 학력은 3 년제 간호전문대학 과정졸업 자가 78.9 %로 많았다. 현 가족과 동거상태에서 배우자와 자녀가 함께 사는 경우가 76.5% 였고, 보건진료원의 경력은 1 년 마만이 41.2 %로 가장 많았다. 보건진료원의 업무에 관련된 배경을 살펴보면, 근무지역조건은 갑지가 65.3 % 였고, 현 거주지는 보건진료소내 숙소가 대다수 였다. 보건진료소는 신축된 건물이 대다수였고, 보건진료소 시설은 '그저 그렇다'고 대답한 수가 가장 많았다. 보건진료소 운영협의회 수당은 월 $5\sim7$만원인 경우가 85.6 % 였다. 2. 보건진료원의 보건의료제공 실태는 다음과 같다. 보건진료원이 현재 담당하는 주민수는 $501\sim1,000$ 명이 35.3 % 이고, 1,500 명 이상의 주민을 담당하는 경우도 32% 였다. 보건진료소를 이용한 주만은 연평균 1,956 명이고, 보건진료소 평균 이용건수는 1,812건이다. 보건진료원의 직업만족도는 만족한다가 40.6%로 대체로 긍정적으로 나타났다. 3. 보건진료원과 보건의료 관련기관과의 관계는 다음과 같다. 지역주민의 보건의료자원 이용 정도는 보건소 진료소가 1 위로 가장 많았고, 약국, 약방, 의원, 보건지소의 순위로 나타났다. 보건의료 관련기관과의 협조가 잘 되고 있지 않다고 응답한 경우도 있는데, 보건소(19.7 %), 보건지소( 20.2%) 민간보건 의료기관(22.4 %)이며, 그 이유를 알아서 협조가 잘 이루어지도록 노력해야겠다. 원하는 감독체계는 보건소장(47.3 %), 보건간호 전문가(37.2 %)로 나타났으나 이는 현재있는 감독체제내에서 생각한 것이며 간호전문가에 의한 새로운 감독체제를 원하고 있었다. 많이 이용하는 의뢰 기관은 병원(52 %), 의원(24.4 %), 보건소(10.2 %) 순이었다. 4. 보건진료원의 업무 영역별 수행정도를 살펴보면 다음과 같다. 보건진료원의 업무 영역을 7개 영역으로 구분하여 수행평균 평점을 보면통상질환 관리가 3.70점, 사업운영 관리 및 지도가 3.44 점, 사업계획 수립이 3.19 점, 지역사회 조직 및 개발이 3.17 점, 모자보건 및 가족계획이 3.14 점, 지역사회 보건관리가 3.09 점, 보건 정보체계 개발이 3.02 점으로 나타났다. 위의 결과에서 지역사회 보건관리가 3.09점으로 통상질환 관리 3.70 점 보다 낮게 나타났는데 이는 일차보건의료 사업 정착의 과도기적인 현상으로 생각하며, 이 부분을 더 많이 수행해야 할 것으로 사려된다. 5. 보건진료원의 업무 영역별 수행 소요시간의 평균은 다음과 같다. 지역사회 조직 및 개발 3.48 시간, 사업계획 수립 3.55 시간, 지역사회보건 관리 6.74 시간, 모자보건 및 가족계획 5.55 시간, 통상잘환 관리 15.94시간, 사업운영 관리 및 지도 4.39시간, 보건정보체계 3.62 시간으로 나타났다. 보건진료원이 통상질환 관리와 더불어 예방활동을 효율적으로 할 수 있도록 적절한 행정적, 교육적 지원이 있어야 한다고 생각한다.

• Health Policy and Management
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• v.34 no.1
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• pp.1-3
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• 2024

Currently, the issue of poor accessibility to essential medical services has been brought to light as a social discontent. In order to strengthen the essential medical service system, the government has announced the "the policy package related to essential medical service" as a comprehensive solution and has vowed to invest more than 10 trillion won by 2028. As it contains crucial elements for changing the framework of the healthcare system, I would like to present several points to consider in policy implementation. Given that this package contains important elements for changing the framework of the healthcare system, there are a few issues to consider in policy implementation. First, a mechanism to prevent politicization should be established when designing the physician training system. Second, changing from a hospital centered on residents to one centered on specialists means that the society bears the cost of training residents, while paying a high price for specialist services. The willingness of society to pay for the costs incurred by such a change should be carefully considered, and an appropriate budget must be prepared. Third, as the operation of shared human resources and inter-organizational networking, among other detailed policy measures, are still at a level of conceptual discussion, various issues should be solidly reviewed and considered for in the mid to long term to suit the conditions of the domestic healthcare system.