• Health Policy and Management
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• v.28 no.4
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• pp.369-377
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• 2018

Background: Catastrophic health expenditure (CHE) occurs when medical expenditure of a household passes over a certain ratio of household income. This research studied the effect of gender on CHE based on Korea Health Panel data. Methods: This study implemented binary logistic regression model to figure out whether gender affects CHE and how different gender groups show pattern of CHE process. With gender, age, marital status, income level, economic activity, membership of private insurance, existence of chronic disease, and self-rated health were included in the model. Results: Results showed that females faced CHE 1.5 times more than males (odds ratio, 1.241). Also, main determinants of CHE in female groups were marital status, while age and economic activity status were significant in male groups. Subgroup analysis displayed that married female under 35 years old are located in intersectionality of CHE including pregnancy and delivery, multiple health risk behaviors, mental stress, and relatively vulnerable social status due to lower income. Meanwhile, both gender above 50 years old faced remarkably high chance of CHE, which seems to be caused by complex health risk behaviors and chronic diseases. Conclusion: Such results implied not only that gender is an important determinant of CHE, but also other determinants of CHE differ according to gender, which suggests a necessity of gender-based CHE support and rescue policy.

• Health Policy and Management
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• v.31 no.3
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• pp.280-291
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• 2021

Background: Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications. Methods: Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present. Results: As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders' perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens' use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized. Conclusion: While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.

• The Journal of the Korea Contents Association
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• v.21 no.6
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• pp.404-414
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• 2021

This study was to investigate the differences of functional health status and medical service experience and needs between general and vulnerable older people in community. This study is a cross-sectional descriptive research. The data obtained through direct visit surveys from November to December 2016. The target population of the study was older people over 65 years old, the final study subjects were 444 older people residing in one district of Seoul. The chi-square test was conducted to confirm the difference in their functional health areas and medical service experiences, and the necessity of medical service utilization in accordance to the social class. In the experience of abnormality in functional health, the vulnerable older people had higher experience in cognitive function, nutrition, hydration, pain, and falling than the general older people. The rate of experience of using medical service to solve the cognitive function problem for general older people was 31.9%, higher than that of the vulnerable older people. In contrast, the medical service utilization needs of the vulnerable older people in the pain management category was significantly higher than that of the general older people. In setting policy of public medical service programs for general and vulnerable older people in community may be differentially developed based on this study. In order to improve the medical accessibility of the vulnerable older people, public medical institutions should be actively supported to overcome obstacles to medical use due to economic barriers.

• Journal of Korea Entertainment Industry Association
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• v.13 no.6
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• pp.319-328
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• 2019

One of the most important things for hospital managements is understanding the patients' needs. The aim of this study is to analyse the priorities of the factors influencing patients' choice for hospital with analytic hierarchy process (AHP), which can derive the relative importances of factors. With understanding the factors that influencing patients' choice for hospital, the proper methods to improve hospital reputation and health care quality could be determined. Among 12 factors, speciality of hospital, number of departments, staff kindness, doctor-patient communication, and patients' visit time were relatively more important and higher priority. Whereas, public transport accessibilities, hospital equipments, and parking lots were relatively less important and lower priority. These results could be used to improve hospital reputation and health care quality effectively. Therefore, the hospitals in Gwangju should consider the factors that influencing patients' choice and improve policies for hospital marketing strategies for better hospital reputations and health care quality.

• Health Policy and Management
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• v.34 no.1
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• pp.59-67
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• 2024

Background: Korea's recent suicide problem has been the most serious in the world. This study was conducted to identify factors related to suicidal ideation of Korean adults and to identify the association with socioeconomic deprivation. Methods: The 17th Korea Welfare Panel Study (2022) raw data was used, and 10,065 adults aged 20 years or older who responded to all major questions were selected as subjects for the study. SAS ver. 9.4 program (SAS Institute Inc., USA) was used for data analysis. Multiple logistic regression analysis was performed to identify the association between socioeconomic deprivation and suicidal ideation. Stratified analysis was performed to confirm the difference by subjective health status and gender. Results: For every 1 unit increased in socioeconomic deprivation, suicidal ideation increased 1.5 times (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.37-1.61). People with good subjective health status showed 1.3 times higher suicidal ideation (OR, 1.30; 95% CI, 1.12-1.52) for each unit increased in socioeconomic deprivation, and those with poor subjective health status showed 1.6 times higher (OR, 1.58; 95% CI, 1.43-1.75). Conclusion: As socioeconomic deprivation increased, suicidal ideation increased. Therefore, policy measures should be prepared to improve the level of more multidimensional deprivation and subjective health status in order to lower the suicide rate of Korean adults.

• Journal of Convergence for Information Technology
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• v.11 no.10
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• pp.239-249
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• 2021

The purpose of this study is to verify the mediating effects of psychological flexibility on the relationship between emotional dissonance and mental health(depression, anxiety, somatic symptoms) in university administration staff. For this study, a sample of 191 university administration staff completed the questionnaires. The data was analyzed using the SPSS program and Sobel Test. The results of the analysis are as follows: 1. Most of the university administration staff had difficulties with emotional dissonance(52.36%), depression(47.12%), anxiety(58.12%), and somatic symptoms(62.83%). 2. The risk group of emotional dissonance had a significantly higher level of depression, anxiety and somatic symptoms compared with the normal group. 3. Emotional dissonance and psychological flexibility had a significant effect on depression, anxiety and somatic symptoms. 4. The mediating effects of psychological flexibility on the relationship between emotional dissonance and mental health(depression, anxiety, somatic symptoms) was verified. Finally, We suggested the need to intervene in emotional labor and mental health in university administration staff and psychological flexibility as an intervention and prevention method.

• Journal of Convergence for Information Technology
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• v.11 no.4
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• pp.203-210
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• 2021

This study analyzed the financing ratio by operation fund financing method and their impact on management performance according to the establishment operation management entity of the medical institution. For the analysis method, ANOVA, logistic regression, and regression analysis were conducted using financial information registered with HASPA.The results of the study, The ratio of gross revenue to operating funds differed significantly depending on the establishment operation management entity. In addition, it was found that the financing ratio of each operation fund financing method was significantly related to the management results(deficit, surplus), and the impact of the operation fund financing method on management performance differed according to the establishment operation management entity. As a result, the management of operating funds of medical institutions is deemed appropriate to apply cost management first considering the ratio of revenue to operating funds, and then to utilize internal operating funds.

• Health Policy and Management
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• v.21 no.3
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• pp.457-492
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• 2011

The primary goal of our study was to investigate the vast transformations of the healthcare sector in Korea during the past half century. Official data reported in the Korean statistical yearbooks and secondary data suggested by previous studies were used for institutional analysis of healthcare environment. Information on hospital released by the Korean Hospital Association was also used for ecological analysis. Institutional analysis: We identified three distinctive eras based primarily on changes in institutional logics, institutional actors, and governance structures : 'professional dominance (1952-1976)', 'government involvement (1977-1999)', and 'coexistence of competing institutional logics (2000-present)'. During the first era, physician association supported by Korean government comprised the primary governance regime. During the second era, the government became a major actor as a regulator and purchaser in health care sector, introducing of the 'mandatory national health insurance'. During the third era, making healthcare system sustainable and providing health care efficiently was overarching goals although it was hard to find a single central logic dominating this period. Ecological analysis: Evidence from the analysis of hospital population suggested that the expansion of the bed capacity was made from different processes, shifting from the ecological process in 1980s to the adaptive process in 1990s. And Korean hospitals had changed following both 'directional process' and 'stabilizing process' over time. Based on our results, we concluded that more studies to compare more organizational populations other than hospitals and to empirically test the effects of institutional changes on organizational changes and vice-versa, need to be conducted.

• Health Policy and Management
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• v.5 no.2
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• pp.104-126
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• 1995

This study was carried out to assess the utilization of urban health center and its related factors among the urban residents. The survey was carried out for 2,394 households in Taegu and Kyongju by the structured questionnaire from 28 March to 4 April and from 2 July to 9 July, 1994. Well trained interviewers visited 2,630 households in Taegu and Kyongju, and interviewed with housewives. Of the target households, 91.0%(2,394 households) were responded through three-time visiting. The major results were summarized as follows : The fourth and fifth decad utilized the health center more frequently than any other age groups.. The lower income group showed higher rate of health center utilization than those in higher income group in Taegu City. The mean length of residence among residents of Kyongju City is longer than those of Taegu City, and the longer length of residence, the higher rate of the health center utilization. Those who are living together with neonate and infant or elderly people showed higher rate of health center utilization than those who are living without neonate and infant or elderly people in both Taegu and Kyongju. The most common reason for visiting the health center was 'low cost'. The major reasons for not visiting the health center were 'not regular customer', 'poor health center facility', and 'low quality of care'. Vaccination, communicable disease control, outpatient care, public hygiene, maternal and child health program were well recognized as health center activities. In logistic regression for the utilization of health center, the significant independent variables were length of residence and recognize the site of health center in both Taegu and Kyongju. The improvement of quality of health service, physical environment of health center and public relations on health center's activities shoulod be considered for reactivation and reingorcement of health center functions.

• Health Policy and Management
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• v.23 no.1
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• pp.59-65
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• 2013

Background: The purpose of this study was to analyze the related factors which decide the percentage of health care expenditure of the total fiscal expenditure of local governments and to provide the basic data to contribute for the efficient allotment of healthcare budget. Methods: This study was conducted by the percentage of health care expenditure for 3 years by classifying a total of 230 local governments into the metropolitan cities (gu, 69), the counties (si, 75), and the boroughs (gun, 86) all over the country. With the collected data, the general characteristics of independent variables and the dependent variable were analysed using SPSS ver. 18.0, The correlation analysis and multivariate regression analysis were conducted for the characteristics of variables according to regions by year. Results: In correlation between health care expenditure by year and other variables, there was a significant positive correlation with unemployment rate, metropolitan cities (gu) and other regions, the percentage of health center personnel, health care expenditure in last year as a independent factors. On the other hand there was no correlation with social assistance recipients and the percentage of aging population, financial self-reliance, industrialization rate, suicide rate, cardiac disease mortality, cerebrovascular mortality on health care expenditure. Conclusion: The study clearly shows that health care expenditure of local governance was not correlated with health care need factors comparing social welfare expenditure.