• Korea Journal of Hospital Management
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• v.13 no.1
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• pp.1-23
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• 2008

In the shortest period of time, we achieved both industrialization and democratization. We also achieved good performance in health care sector. Whole population are covered by health insurance since 1989 and health outcomes, such as infant mortality, life expectance show good level. However, health care system has several problems, rapidly increasing rate of health care expenditure, dissatisfaction of both consumers and suppliers. Current health care system does not reconcile with market competition principle. Causes of these problems originated from 1977 paradigm which was formed to expand health insurance to whole population within short period. Dominant assumption of 1977 paradigm is to assure equitable access of health care by government's command and control. We urgently demand to reform the 1977 paradigm to suitable in 21th century. Our economy entered into a road to advancement. We have concerns how President Lee's administration reform health care system to harmonize with economic development and to achieve advancement in health care sector.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.167-174
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• 2018

Objectives: The aim of this study was to analyze the accessibility of dental care services among individuals with precarious employment in South Korea. Methods: We used the $9^{th}$ wave of the Korean Health Panel data (2015) and included 7,736 wage and non-wage earners in our study. We determined precariousness in the labor market as a combination of employment relationship and job income, and categorized individuals based on this into the following four groups: Group A comprising those who report job and income security, Group B comprising those who experience job insecurity alone, Group C comprising those who report a stable job but low income, and Group D comprising those who experience both job and income insecurity. Accessibility to dental care services was determined by experience of unmet dental care needs and unmet dental care needs caused primarily by financial burden. Logistic regression analyses were used to assess the effect of precarious work on access to dental care services. Results: Individuals with job insecurity (Group B; OR=1.445; 95% CI=1.22-1.70) and both job and income insecurity (Group D; OR=1.899; 95% CI=1.61-2.24) were more likely to have unmet needs than the comparison group. Both groups B and D were also 2.048 (95% CI=1.57-2.66) times and 4.435 (95% CI =3.46-5.68) times more likely, respectively, to have unmet dental care needs caused by financial burden. Education status, health insurance, and health status were all also effective factors influencing unmet dental care needs. Conclusions: Unstable employment and low income resulted in diminished access to dental care services. Therefore, governments should consider health policy solutions to reduce barriers preventing individuals with employment and income instability from accessing adequate dental care.

• Journal of Periodontal and Implant Science
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• v.46 no.6
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• pp.405-414
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• 2016

Purpose: This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods: A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results: Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions: The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

• Health Policy and Management
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• v.9 no.2
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• pp.55-76
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• 1999

In order to understand the local council members' attitudes to the health policy, we conducted mail surveys using self-administered questionaire for 2 months(February and March. 1995). The study subjects were 2.312 local council members in Korea, but only about 11% among whom. 257 persons, responded to 2 times mail survey. This response rate revealed that the local council members was not interested in health care fields. The main results were as follows; The respondents thought that the economic and income development was most important among 15 regional policy agendas and the health care was the 5th or 7th important agenda. They. who had more health needs of and poor access to health care, tended to think that the health care was more important. They considered lobbying to and persuading the civil servants as the best method to tackle the local health care policy agenda. The respondents, who had poor access to health care facilities. tended to set the highest priority for the expansion of public and private health care resources. They expected that the election of local governor would activate the public health program more than thought that the program was implemented more actively than other region. The main opinion of respondents was that the central government had to take over planning and financing for the public health program, and the basic local government had to implment the program and budgeting. The majority of respondents agreed the private dominant medical care delivery system and nation-wide uniformed financing mechanism. Over 60% of them suggested that they were ready to suffer environmental pollution inducing health hazards for the purpose of regional economic and income development. About 75% of them favour the campaign for antismoking regardless of reducing local government's revenue from sale tax.

• Journal of Urban Science
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• v.8 no.1
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• pp.51-58
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• 2019

This study examines the determinants of emergency care utilization and equity of access to care in elderly Koreans. Based on the data from the 2014 Korea Health Panel Survey, descriptive and logistic regression analysis was performed. The sample for this study was 1,313 individuals who participated in interviews. Predisposing factors such as age, sex, and education were significant determinants of emergency care utilization. Differences in need do not fully account for the original differences observed between subgroups of older Koreans. Health status was important determinant of older Koreans using emergency care services. Spending medical expense did not ameliorate the subgroup differences in the use of emergency care services. Nonetheless, spending medical expense remains a particularly important predictor of emergency care utilization. Health care reforms in Korea should continue to concentrate on insuring effective universal emergency care, implying that all older Koreans with need receive effective coverage. Future study is also needed to understand the access barriers that may exist for the selected demographic subgroups, i.e., those over 75, women, less educated persons, and those with higher medical expense.

• Korean Journal of Health Education and Promotion
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• v.28 no.1
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• pp.115-130
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• 2011

Objective: This study aimed to introduce Health Impact Assessment using the case of a HIA on 2008 Dream Start Project in Cheongju. Methods: We followed the typical procedure of HIA recommended by the Merseyside Guidelines on HIA. In scoping, the steering committee decided 5 key domains of child health to be assessed: prenatal care, vaccination, nutrition, access to health care, and child abuse and also the methods of collecting the evidence. The HIA appraisal team collected information from various sources including literature, community survey, and focus group interviews. The HIA appraisal team also synthesized the collected information in terms of the nature of health impacts and equity and made recommendations accordingly. Results: Positive impacts were expected in prenatal care, vaccination, and nutrition, while negative impacts were expected in access to health care. The impact of Dream Start on child abuse was uncertain. Several recommendations were made and submitted to the Dream Start team for their consideration. About 2 years later, we found many of them were implemented in 2009 Dream Start project. Conclusion: HIA was found to be applicable and effective to make decision makers in the welfare sector consider health in their work.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7757-7759
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• 2013

Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management.

• Health Policy and Management
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• v.9 no.2
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• pp.139-156
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• 1999

Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.

• Health Policy and Management
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• v.17 no.3
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• pp.106-128
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• 2007

The Korean health care system is under great controversy. Over the last 30 years, main goal of health policies was to pursue equal access of health care services. However, another goal of health policies laid on efficiency and Quality of care, it had lower priorities. Superficially, controversy stems from priority setting among goals of health care system, equity, efficiency and quality. At a deeper level, arguments arise from disagreement and confusion about the values of Korean health care system. One of the value spectrums believes that health care is the basic right of human beings, therefore it should be produced and distributed on need approach, and needs are known to be decided by professionals. If we accept need approach, health care is a pubic good. Another value of spectrums considers that health care should be distributed on demand approach. Demand approach means that health care is a consumption good on the positive economics, while normative judgement believes that health care is a public good. In equity aspect, health care is considered as a public good. Over the last several years, some of scholars proposed health care reform based on the principle of competition which is based on demand approach. Others argue that the competition principle based on demand approach is not appropriate for the reform proposal, because health care has to be approached on need base. If we do not make explicit values we should adopt, consensus building for reform is nearly impossible. From this perspective, this article will review an ideology and reality in health policies in Korea.

• The Journal of Industrial Distribution & Business
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• v.12 no.12
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• pp.11-24
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• 2021

Purpose: The purpose of this study was to provide comprehensive measures for the development of public health care through a survey on consumers' awareness of health care use from the point of view of local residents. Research design, data and methodology: For about one week from January 07 to January 14, 2021, questionnaires were distributed to 800 local residents and analyzed. For statistical analysis of collected data, frequency analysis and cross-analysis were performed. Results: Regarding public health service, 'providing medical services that can be used by all citizens and protect and promote health' had the highest response rate of 95.2% of total respondents. Regarding health care system satisfaction, 'Accessibility to general treatment' had the highest score with an average of 3.31 points. Regarding comprehensive measures for the development of public health care, 'Establishment of an infection and patient safety system' had the highest score with an average of 3.91 points. Conclusions: The direction of public health care and services should include management of infectious diseases during national disasters, reduction of gaps in medical use by region and class, improvement of access to emergency medical care, and quality improvement of specialized medical care.