• 한국병원경영학회지
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• 제10권4호
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• pp.1-22
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• 2005

Quality of care and patient safety have become today's agenda for healthcare industry in worldwide. This paper describes experiences to improve quality of care and patient safety in USA and identifies some future tasks for better implementation of quality improvement efforts. The paper concludes with a discussion of the implications for Korean healthcare system.

• 한국보건간호학회지
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• 제32권2호
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• pp.235-248
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• 2018

Purpose: This qualitative study examined the participation in ICT-based management from the perspectives of patients with chronic diseases. This study was conducted as one of several studies evaluating the effectiveness of chronic disease management in the Ministry of Health and Welfare. Methods: Focus group interviews were used as its guiding methodology. Group interviews with 16 patients were carried out using semi-structured interview questions developed from a literature review and discussion with researchers. Content analysis was used to analyze the data. Results: A total of 11 sub-themes were extracted through a comparison of the concepts and semantic analysis, and finally, four themes were derived: "Satisfied with systematic management of health care", "Leading in health care", "Understanding the pattern of blood pressure and blood sugar change" and "Adherence to existing health care habits". Conclusion: This study is meaningful in that it used qualitative analysis through FGI to evaluate the effects of an ICT-based chronic disease management project. Based on this study, a mixed-method design study and an intervention study among patients with metabolic syndrome is proposed.

• 보건의료기술평가
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• 제6권2호
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• pp.81-87
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• 2018

With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

• Safety and Health at Work
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• 제4권2호
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• pp.77-83
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• 2013

There is still a considerable burden of occupational diseases and injuries in the world. It is not well known which interventions can effectively reduce the exposures at work that cause this burden. The objective of this article is to summarize evidence from systematic reviews of interventions to prevent occupational diseases and injuries. We included systematic reviews of interventions to reduce the incidence of work-related cancer, dust-related diseases, occupational asthma, chronic obstructive pulmonary disease, noise induced hearing loss, back pain, and occupational injuries. We searched Medline and Embase with predefined search strategies to locate systematic reviews of these interventions. We found 23 systematic reviews of which the results are also applicable to low- and middle income countries. Effective measures to reduce exposure leading to work-related cancer, dust-related diseases, asthma, chronic obstructive pulmonary disease, noise, and injuries are available. However, better implementation of these measures is needed. Regulation, enforcement of regulation, and incentives for employers are effective interventions to achieve this goal. There is evidence that feedback and rewards for workers help in reducing occupational injuries. There is no evidence in many studies that back pain can be prevented. Personal protective equipment technically has the potential to reduce exposure but this is difficult to put into effect. There is no evidence in the studies regarding the effectiveness of education and training, preventive drugs, or health examinations. There is evidence that the implementation of technical measures enforced by regulation can prevent occupational diseases and injuries. For other interventions such as education or health examinations, there is no evidence that supports their effectiveness. More systematic reviews are needed in the area of injury prevention.

• 정보화정책
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• 제27권4호
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• pp.47-66
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• 2020

머신러닝과 딥러닝 등 인공지능 기술의 급속한 발전은 행정-정책 분야에도 영향을 확대하고 있다. 이 논문은 데이터분석과 알고리즘의 발전으로 자동화된 구성과 운용을 설계하는 인공지능 시대의 정책의사결정에 관한 탐색적 연구이다. 이 연구의 의의는 정책의사결정에서의 주요 연구 중 하나인 정책 문제의 문제구조화를 기반으로 하여, 문제정의가 잘 구조화된 정도에 따른 유형으로 이론적 틀을 구성하여 성공과 실패 사례를 구분하고 분석해서 시사점을 도출하였다. 즉 문제구조화가 어려운 유형일수록 인공지능을 활용한 의사결정의 실패 혹은 부작용의 우려가 크다는 것이다. 또한 알고리즘의 중립성여부에 대한 우려도 제시하였다. 정책적 제언으로는 우리나라 인공지능 추진체계구축 시 기술적 측면과 사회적 측면의 전문가들이 전문적으로 역할을 하는 소위원회를 병렬적으로 두고 이 소위원회들이 종합적, 융합적으로도 작동할 수 있는 운영의 묘를 발휘하는 거버넌스 추진체계 구축이 필요함을 제시하고 있다.

• 보건행정학회지
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• 제20권2호
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• pp.17-39
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• 2010

This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers' behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions' the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.

• 보건행정학회지
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• 제14권2호
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• pp.138-162
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• 2004

This study was performed to investigate small area variation in rates of three common surgeries in general surgery department across 156 small areas. Three surgery rates were analyzed; Anal and/or stomal procedures, inguinal and/or femoral hernia procedures, appendectomy. Methods: We used health insurance claims data and the number of patients were 13,845, 2,154 and 7,151 persons respectively. Surgery rates were directly standardized with age and sex and logistic regression was used to analyze surgery rates. Results: Mapping of the surgery rates, there was small area variation in anal and/or stomal procedures. The clinic which was located in more competitive market and chose DRG payment system tends to do more anal and/or stomal procedures. There was no factor except DRG bed rates had effect on rate of inguinal and/or femoral hernia procedures. Conclusions: Findings of this study will contribute to developing investigation method on small area variation and policy to reduce the variation such as developing evidence based medical practice guideline.

• 보건행정학회지
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• 제19권4호
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• pp.33-52
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• 2009

Health promotion policies have needed to assess in detailed and evidence-based work to set a policy goal and clear future directions of health promotion in Korea. To identify the major factors related with health promotion, we assessed the associations between public health outcome (potential years of life loss, PYLL) and national health determinants. For this purpose, we used a pooled cross sectional time-series regression analysis with corrected fixed effect models involving sixteen member countries of the Organisation for Economic Cooperation and Development during the period 1970 to 2001. The PYLL was positively associated with tobacco and alcohol consumption (model 1 and 2) and calories intake (model 2 and 3) while the PYLL was negatively associated with GDP, fruit and vegetable intake (model 2), number of doctors (model 3), coverage rates of health care security, and elderly population rates (model 4). In conclusion, health behaviors related with tobacco, alcohol, and nutrition were significant health determinants for health outcome. Overall analysis results of this study will provide a guidance toward improved macro- and micro-policy development for future health promotion policy in Korea.

• 보건행정학회지
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• 제30권2호
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• pp.142-150
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• 2020

The purpose of this study is to analyze the long-term plans of the central and local governments in order to plan policy and implementing programs. Through this, the governments is find out to reduce administrative burden. Based on the national health plan, evidence and related laws were collected and analyzed. As a quantitative methodology analyzed the contents of related laws in the overall plan. The qualitative methodologies analyzed and categorized the planning status of cities and provinces in the plan and were collated. There are a total of 39 plans for long-term plans by laws. The role of the central and local governments in the public health sector, there are a total of four plans (10.3%) that need to establish long-term and annual plans for the central and local (cities, provinces) government. A total of seven plans (17.9%) were required to establish a plan by the only local government. In terms of the public health sector on the local governments, 20 plans (51.3%) by cities and 12 plans (30.8%) by provinces were established by law. And in the health sector should be established 9 plans (40.9%) by cities and 7 plans (31.8%) by provinces. The plan needs to be reformed and merged between plans so that governments can focus on the program through planning central government policies, reducing local government administration.

• 보건행정학회지
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• 제29권3호
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• pp.342-356
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• 2019

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.