• 보건행정학회지
• /
• 제29권3호
• /
• pp.323-331
• /
• 2019

Background: The purpose of this study is to analyze the effect of impartiality in providing public health services on subjective health happiness and the mediated effects of public health service quality. Based on this, this study intends to present policy implications to improve public health services. Methods: The research method is multiple linear regression analysis. The analysis of the mediating effects is performed by Baron & Kenny's test, Sobel-Goodman's test, and Bootstrap. Results: The impartiality of public health services and the quality of public health services are shown to have a statistically significant effect on subjective health happiness. Quality of public health service appears to be mediating the relationship between impartiality in providing public health care and subjective health happiness. Conclusion: To promote people's subjective health happiness, it is necessary to secure impartiality in providing public health services in the first place and improve the quality of public health services.

• 보건행정학회지
• /
• 제33권1호
• /
• pp.40-54
• /
• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• 보건행정학회지
• /
• 제31권1호
• /
• pp.56-64
• /
• 2021

Background: Despite the high life expectancy, the subjective health status of the elderly people in Korea is reported to be the lowest as compared to other age groups. The purpose of the conducted study was to identify the factors related to the subjective health status of elderly people aged over 65 in Korea. Methods: This study used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2017) of the Korea Disease Control and Prevention Agency. The subjects of the study were selected to be 2,904 elderly people aged over 65. The factors that were selected related to subjective health status were socio-demographics, perceived diseases, health behaviors, and mental health. Results: As a result of the examination of the subjective health status according to the characteristics of the subjects of study, the subjective health status was high in males (β=0.144, p=0.011), urban dwellers (β=0.107, p=0.015), employed persons (β=0.139, p=0.001), college graduates (β=0.322, p<0.001), persons with high household income (β=0.226, p<0.001), persons without chronic disease, nonsmokers (β=0.146, p=0.009), drinkers (β=0.111, p=0.003), persons who practiced aerobic physical activity (β=0.150, p<0.001), persons without depression (β=0.286, p<0.001), and persons who rarely had stress (β=0.837, p<0.001). Conclusion: More attention should be paid to those with low subjective health to improve health for elderly people. Expanding policy supports are required for elderly people with low socioeconomic status, chronic disease or depression, or unhealthy behaviors (smoking or lack of physical activity).

• 보건행정학회지
• /
• 제33권1호
• /
• pp.55-64
• /
• 2023

Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.

• 보건행정학회지
• /
• 제33권4호
• /
• pp.421-431
• /
• 2023

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternal/newborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion: Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

• 한국병원경영학회지
• /
• 제25권4호
• /
• pp.94-102
• /
• 2020

Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

• 한국병원경영학회지
• /
• 제24권3호
• /
• pp.38-47
• /
• 2019

Purposes: Rapid aging and increase of high chronic diseases of the elderly are increasing the needs for expanding elderly care beyond the concept of treatment in medical institutions. This study is to discuss the core values, functions, and roles of municipal hospitals and suggest a suitable community care model. Methodology: The survey was collected twice derived from the domestic expert groups. This study analyzed experts' responses using Delphi method and Analytic Hierarchy Process, using Microsoft Excel 2016. Findings: Among the core values of the municipal hospitals, it was shown that community linkage had the highest priority. The publicity had the highest priority among the functions and roles of the municipal hospitals. In the community care models presented in this study, the model focused on 'Community Care Integration Center' showed highest relevance, suitability and applicability. Practical Implications: This study suggested three different community care models and derived the most suitable model for community care, which is focused on the municipal hospitals. It suggested effective application of the community care model to promote community care in each community.

• 보건행정학회지
• /
• 제2권1호
• /
• pp.147-166
• /
• 1992

The purpose of this study is to analyze the effects of the health center hospital on the health service utilization pattern of the rural population in a county. Two field studies had been conducted in Yonchon County, Kyunggi Province, on February 1989 and on August 1991 before and after the establishment of the Yonchon health center hospital. This study revealed that Yonchon health center hospital occupied 7.3% of total outpatient visits and 16.8% of hospitalization of the county population and the self-sufficient rate of the outpatient visit and hospitalization of Yonchon County between two field studies increased by 1.7% and 20.9% each. Yonchon health center hospital contributed to the growth of the public health sector but it weakened the role of health sub-centers. For the efficient health service utilization of the population in that County, more investment to health center hospital would be needed and the primary health activities of the health subcenter should be enforced.

• 보건행정학회지
• /
• 제27권1호
• /
• pp.3-17
• /
• 2017

In the traditional medical field, the patient was a person to receive protection from the doctor because there are vertical relationship between the patient and the doctor. But in modern medical field, patients change their role to health-care consumer to be guaranteed their rights more actively. This study compare patient's rights in doctor's vocational ethics and patient's rights in law, consumer rights. This study analyzes what is type of law-relationship between patients and doctor and how can they act health-care as health-care consumer.

• 보건행정학회지
• /
• 제2권2호
• /
• pp.1-32
• /
• 1992

The Canadian experience-universal government health insurance administeredby the ten provinces and two territories with some fiscal and policy variations-suggests the possibility of more effectve and efficient health care delivery system. The central purpose of the Canadian health in surance was to reduce and hopefully eliminate financial barriers to medical care. In this it succeeded. But it also produced varous kinds of unexpected side-effects on cost and quality. The Federal and Provincial Governments of Canada continue to exert theri efforts to ameliorate these problems. The lesson from Canada is that the health care revenue should be raised at the national level and managed at the regional level, and the regional healthcare financing organization has to take over the functions of the public health center. These alternatives is expected to make the Korean health care delivery system more efective and efficient, and to achieve health for all. This paper also discussed the policy agenda for implementing such alternatives in Korea.