• Health Policy and Management
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• v.33 no.4
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• pp.479-488
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• 2023

Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion: In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

• Health Policy and Management
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• v.24 no.4
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• pp.304-311
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• 2014

This manuscript treats a new paradigm for the Korean health care system. We give an account of innovative health care delivery and payment models widely discussed in the contemporary US accountable care organization and coordinated care organization. In doing so, we explore a new health care model amenable to foreseeable changes to the health care system. We propose creating an integrated health care system in which the network of health care providers delivers coordinated and comprehensive care for enrolled patients residing within the geographic boundaries served by the provider network; providers may participate voluntarily in one or more networks and assume shared responsibility for patient care and cost; provider networks compete with each other based on cost and quality; and consumers are allowed to choose a network. We expect that the new paradigm will create a financially-sustainable system that assures quality of care and improves patient experience, minimizing the existing system-wide inefficiency through cross-network competition and within-network care coordination.

• The Journal of the Korea Contents Association
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• v.11 no.2
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• pp.367-375
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• 2011

This study conducts analysis on integrated care cases in Korea and other nations regarding health, medical, and welfare services that are segmented and fragmented in order to provide foundational data to establish an integrated care system appropriate for the situation of Korea. According to the result of the cases, integrated care provides various services in common through cooperation with organizations, collaborative participation of various professionals, provision of intervention and individualized protection, and experts for taking care of the cases. Based on those cases, this paper provides suggestions to establish an integrated care system of Korea. In fact, it is necessary to build integrated care general support centers, arrange service providing places in common, establish a care management system, develop resources and expand manpower, develop an integrated care case management system, and develop integrated care computer network.

• Journal of Community Nutrition
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• v.2 no.1
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• pp.12-26
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• 2000

In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.

• Health Policy and Management
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• v.8 no.1
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• pp.203-230
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• 1998

This purposes of this study is to develope policies on the facilities for the elderly care in Korea. Methodology of this study adopts comparative analysis on the facilities for the elderly care in 6 countries which have experienced various problems on the elderly. These 6 countries are Japan, Sweden, America, Australian, England and Germany. Major issues for comparative analysis are the standard of care facilities, residence condition, finance of facilities establishment and expense, operating system, management, and the law and administrative structure about the facilities for the elderly care. The elderly people need various kinds of welfare services such as medical care facilities, nursing home facilities, home care facilities etc.. Thus the public policies for the aging population nations are compose of income maintenance program, health and medical care services and social welfare services. The policies of facilities for elderly care are very important since these policies include the characteristics of income maintenance, me\ulcorner미 care program and welfare program. This study willsupply basic data for the development of facilities for the elderly care in Korea, especially conceming the system and institutional device of the facilities.

• The Journal of Korean Academic Society of Nursing Education
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• v.10 no.1
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• pp.64-74
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• 2004

This study was conducted to investigate what contents nurses want in the intensive major course of junior nursing college. Data were collected for four months from October 2002 to February 2003 by structured questionnaires. Subjects were 240 registered nurses in working at five hospitals and four public health centers and elementary or middle schools in the capital and its suburbs and country. The collected data were analyzed using SPSS 8.0 program. The results of this study were summarized as follows : 1. Nurses working at hospitals want the programs which involve the contents as follows : emergency nursing/CPR, infection control, critical care, caner pt. care, pain control, hospice, pulmonary disease pt. care, analysis of lab. exam, heart disease pt. care, chronic disease pt. care, DM pt. care, digestive-system disease pt. care, nervous-system disease pt. care, elderly pt. care, immune-system disease pt. care, endocrine-system disease pt. care. 2. Nurses working at public health centers want the programs which involve the contents as follows : home nursing, family nursing, management of DM, HT, degenerative disease, and chronic liver disease, elderly pt. care, health education, maternity nursing, rehabilitation nursing. 3. Nurses working at elementary or middle schools want the programs which involve the contents as follows : prevention of drug abuse or misuse, sex education and consultation, health education, consultation technique, emergency care, prevention of child obesity, prevention and management of adult disease in children, teaching method, method of school health room 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.3 no.2
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• pp.27-80
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• 1993

It is widely known that patients' utilization pattern for medical care facilities and the patientflow are influenced by multi-factors, such as demographic characteristics, structural characteristics of society, socio-psychological characteristics(value, attitude, norms, culture, health behavior, etc.), economic characteristics(income, medical price, relative price, physician induced demand, etc.), geographical accessibility, systematic characteristics(health care delivery system, payment methods for physician fees, form of health care security, etc.), and characteristics of medical facilities(reliability, quality of medical care, convenience, kindness, tec.). This study was conducted to research the mechanism of patient-flow according to changes of health care system(implementation of national health insurance, health care referral system and regionalization of health care utilization, etc.) and characteristics of medical facilities(ownership of hospital, characteristics of medical services, non-medical characteristics, etc.). In this study, the fact could be ascertained that the patient-flow had been influenced by changes of health care system and characteristics of medical facilities.

• The Korean Journal of Health Service Management
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• v.6 no.3
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• pp.95-106
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• 2012

This study was described and analyzed health care system in Lao Cai, Vietnam. We analyze organization and delivery of health care system, health care resources, heath care facilities, heath care finances, and health index in Lao Cai, Vietnam. Lao Cai Province is a mountainous region located on the Chinese border in North-West Vietnam, with numerous ethnic minority groups. Health care organization and delivery system in Lao Cai Province is well formed Province-District-Commune level with Vietnam Government's Socialism. However, health care personnels are concentrated in the major city and is lacking in commune level. Lao Cai province has only two general hospital and is lacking number of beds. Lao Cai province's health care sector is insufficient financial support because the primary goal of the Vietnam government is economic development. Ethnic minority groups in Lao Cai have a dual burden of disease and health. To solve this problem, it is dispatched health care personnel to the commune level taking advantage of the well health care organization and delivery system in Lao Cai. It is also necessary to modernize hospital and improve number of bed. In conclusion, it will be improved the quality of life of residents and be able to achieve fairness among district through the enhancement of the health care system in Lao Cai province.

• Journal of Korean Public Health Nursing
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• v.17 no.1
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• pp.5-16
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• 2003

This policy alternatives for establishment of rehabilitation health care delivery system for the disabled in the community were developed based on the data of current health status and situations of health care management for disabled persons in Korea. This research was conducted with secondary data analysis for identifying health status and current situations of managing health of disabled persons, and discussed current issues for establishing rehabilitation health care delivery systems in the community. Observing the health status and current situations of managing health of disabled persons, scope and target population of disabled person extended. so prevalence rates increased. and the severity of disability intensified and specified. The summary of issues of health management for disabled persons included; 1) absence of comprehensive and systematic policy in rehabilitation health care systems. 2) absence of consumer based rehabilitation health care facilities and delivery systems that are considered as the characteristics of disabled persons 3) fixed form of projects based on the provider and lack of variety in the programs. Hereafter. to overcome these problems. policy alternatives should 1) establish a comprehensive rehabilitation health care policy for disabled persons. 2) establish comprehensive and specific community based rehabilitation health care delivery systems that can promote preventing disability. providing medical care for disabled persons, establishing rehabilitation management for disabled persons and health care when returning to society. 3) provide training and secure manpower for rehabilitation, but the training case managers who will take the roles as an expert rehabilitation nurse mediators for multidisciplinary team work are needed immediately. and 4) include efficient connection and provision of independent services for welfare rehabilitation service and health care. Conclusively. a community based rehabilitation health care delivery system should be comprehensive policy vision of the government on rehabilitation health care delivery System rehabilitation service has to be constructed systematically under suitable facilities con consumer characteristics and rehabilitation health care policy. By doing this, consumer comprehensive community rehabilitation health care delivery system could be constructed disabled person.