• 한국보건간호학회지
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• 제17권1호
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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.

• 한국농촌간호학회지
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• 제1권1호
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• pp.5-10
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• 2006

Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.

• 보건행정학회지
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• 제33권4호
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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.

• 보건행정학회지
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• 제28권3호
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• pp.197-201
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• 2018

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

• 보건행정학회지
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• 제2권2호
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• pp.1-32
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• 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.

• 보건의료산업학회지
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• 제6권3호
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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.

• 보건행정학회지
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• 제14권4호
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• pp.21-47
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• 2004

There is general agreement that the Korean health care delivery system has two basic structural problems. One is the limited capacity and role of public hospitals, and the other is the absence of functional differentiation and referral arrangement between the clinics and hospitals of various technological sophistication levels. This study is intended to make an empirical observation of the system's growth process from the viewpoint of the population ecology model of organizations so as to understand the background of these problems and to find out ways of approaching them. As predicted from the population ecology model of organizations, all the types of medical care facilities have expanded in response to the environmental changes for the past three decades or so, and the differences in the extent and pattern of expansion among the types are related to what have taken place in the environment. These findings suggest that the efforts for reforming the health care delivery system should be directed not only to medical care institutions but also to the environmental context under which they function. It is believed that the usefulness of the population ecology perspective on organizations for studying the health care delivery system has been demonstrated. Thus further studies along this line based upon more strict design would improve systematic understanding of the system that is needed for developing policy approaches needed to increase its effectiveness.

• 한국병원경영학회지
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• 제3권1호
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• pp.219-237
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• 1998

Economists have identified informed consumer choice as one element of a better-functioning health care market, and thus increased attention is directed to the role of information in the health care system. In this country, however, little work has been done for understanding consumers' search behavior in health care market. Based upon this observation, expectant mothers' information search for the choice of delivery care institution was investigated. In doing so, two hypotheses were proposed: 1) Those women who were more active in the search for information would make choice of a delivery care institution with more confidence and would feel greater subsequent satisfaction. 2) The activeness of expectant mothers in information search would depend upon their various personal characteristics, such as socio-economic status, obstetric conditions, and knowledge and attitudes in relation to delivery and health care. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using prepared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with 319. The results of analysis were generally consistent with the proposed hypotheses. Apparently, information increased expectant mothers' confidence in selecting a delivery care institution and subsequent satisfaction with the institution. Indication is that policy efforts should be strengthened to produce and disseminate relevant, comprehensible and credible information that can aid patient decision making. Also, attention should be directed to motivate patients to actively engage in information search from adequate sources.

• 한국학교ㆍ지역보건교육학회지
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• 제20권2호
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• pp.53-67
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• 2019

Objectives: The purpose of this study is to obtain the basic data for the development of maternal health care by analyzing the status and needs of service target persons in Timor-Leste. Methods: The subjects were selected through the non-probability sampling method applying the FGI. Researchers interviewed 3 maternal health service managers, 6 midwives at Gleno and Railaco Health Centers and 2 women between 15 and 45 years of age. Results: In the results of on-site visit of the delivery facility and the FGI, we found poor sanitation in delivery room, lack of medical equipment related to antenatal consultation and delivery. In the case of the health center manager, the public health center provides various maternity health services, but the lack of the staff has difficulty in providing the service and managing the subjects. Midwives asked for regular maintenance education. Women in child bearing age living in mountainous areas had poor access to delivery facilities and lack of awareness of delivery services. Conclusions: It is necessary to increase the maternity management rate through regular maternity and maternal health check service and application to maternal management database, to improve the sanitation of the maternity clinic in the public health center, to strengthen the midwife competency program.

• 보건행정학회지
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• 제8권2호
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• pp.1-24
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• 1998

There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.