• Health Policy and Management
• /
• v.31 no.4
• /
• pp.387-398
• /
• 2021

Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

• Journal of the Korea Convergence Society
• /
• v.11 no.11
• /
• pp.345-352
• /
• 2020

Under "Emergency Doctor Security Act of 2007", Japanese government focuses on relocating doctors in medically underserved areas and matching supply and demand of manpower in order to resolve the ubiquity of specific treatment departments. Particularly, there are two alternatives to secure the number of local physicians and avoid the regional shortage of doctors in the short term. Firstly, the government attracts existing physicians to the region. Secondly, the government increases the capability of regional clinical training system to prevent the influx of doctors to the larger cities. Also, it seeks solutions from various perspectives, such as cultivating manpower to work in vulnerable areas through the regional frame system and autonomous medical college. This study introduces the case of Japan as a benchmark and suggests that policymakers should focus on the recent conflict between the government and the medical consultation. More specifically, this study provides policy implications on the alternative measures for securing the manpower of regional doctors.

• Health Policy and Management
• /
• v.20 no.1
• /
• pp.1-18
• /
• 2010

This article examines social determinants of population health in OECD countries, where life years, infant mortality, and PYLL are used as proxy variables of health. The unit of analysis is a country which is the OECD affiliate. A panel regression estimation is chosen as a method, using OECD Health Data. The results are: the increasing national health expenditure affected positively to improve population health. Education was rather a significant determinant of health than income level. The government direct investment for public health did not contribute positively to enhance population health. The expansion of health care coverage was working positively for improving health, but with a time lag. The supply of doctors was a most influential determinant of health. In case of Korea, the coverage expansion of health care was the most important determinant of health. The supply of doctors was, however, not a positive factor for better health, which is different result with the case of OECD countries.

• Health Policy and Management
• /
• v.24 no.3
• /
• pp.205-218
• /
• 2014

Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.

• Korean Journal of Health Education and Promotion
• /
• v.18 no.2
• /
• pp.157-168
• /
• 2001

Currently the oriental medical care services in the health centers is getting popularity because of their unique aspects which western medicine can not cover. This study was conducted to speculate the current status of oriental medical care services in health centers and possibility of how to effectively provide the oriental medical care services(or traditional medical care services) in health centers. For the study, the survey questionnaires were distributed to all 269 health centers and 138(51.3%) of them were collected. Eight of the collected were inadequate for the analysis and 130 of 269 questionnaires were finally chosen for the study. The SPSS/PC WIN 8.0 was used for the statistical analysis. The results are as follows. First, 91 out of 130 sample health centers(70%) are providing oriental medical care services. The results show that the willingness of the directors and the public awareness in community are the most important factors to provide oriental medical care services in health centers. In contrast, the lack of cooperative efforts between western and oriental medical doctors and the lack of government supports are considered as factors that intervene the oriental medical care services in health centers. About 80% of the sample health centers respond that the government supports is needed for oriental medical care services in health centers. Second, it was asked to the directors of 39 health centers which do not provide oriental medical care services regarding their future plan to include the services. About 70% of health centers respond that no plan is available now. They acknowledge that the demand on the services is the most important factor to consider the oriental services as their future medical services. Third, 69.2% of the oriental medical doctors in health centers are public health doctor. 95.6% of the sample health centers have space for the oriental medical care services in their facilities and some health centers provide the services through the private clinics nearby facilities. Finally, the surveyors consider both budgetary constraints and difficulty in recruiting doctors as barriers for the effective oriental medical care services in health centers. Finally, t-test and LSD were employed to find out the difference among several groups. The analysis shows statistically significant difference among groups about their recognition on health care policy, health care system, and effectiveness of oriental medical care services. To be conclude, the study shows the necessity of oriental medical care services in health centers. To do so, the government supports, cooperative efforts between oriental and western medical doctors, and providing job security for doctors should proceed to provide effective oriental medical care services in health centers.

• Health Policy and Management
• /
• v.14 no.2
• /
• pp.99-116
• /
• 2004

This study estimates the determinants of national health expenditures of OECD countries using panel regression method. The data used are OECD Health Data(2003) covering 33 countries and from 1970 to 2001. This study shows several important different results compared to the previous studies. Further this study estimates the determinants of Korean case using data from 1m to 2000, and compare with the results of OECD panel. The main findings are as follows. The income elasticity of health expenditures is estimated below 1.0, but is shown above 1.0 when the different health systems of each country are controlled. The women's labor participation influences strongly positive effect on the health expenditures. The diffusion of new technologies is positively related with the increasing expense. The increasing government expenditures have a tendency not to contain health expenses, but to increase expenses. The expansion of public health insurance holders is containing the expenses, and the increasing number of doctors is pushing expenditures. This implies the health expenditures are influenced more by the induced demand of providers rather than the moral hazard of patients. However, the above result is opposite in Korean case. The existence of primary care doctors affects slightly up warding rather than containing expenditures. Finally the determinants are seriously depending upon which factors are included in the model and which statistical model is chosen. Therefore it must be cautious to interpret the results of statistical model.

• The Korea Journal of Herbology
• /
• v.27 no.2
• /
• pp.1-16
• /
• 2012

Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

• The Korean Journal of Health Service Management
• /
• v.12 no.3
• /
• pp.13-26
• /
• 2018

Objectives: This study investigated how Korean daily newspapers frame the present government's health insurance coverage expansion policy, Moon Jae-in Care. Methods: A contents analysis was conducted to construct news frames represented in the four Korean daily newspapers' editorials and columns on Moon Jae-in Care during from April 2017 to April 2018. News text was classified into three different layers of frames: expressive element, narrative structure, and implied values. Results: The analysis revealed that the frequency of narrative frames was as follows: health system improvement (20.8%), public burden (14.6%), opposition by doctors (14.6%), and populism (12.5%). The financial sustainability accounted for 41.7% of the value frame, followed by procedural legitimation (18.8%), and coverage expansion (16.7%). The results also revealed that reported frames were different among newspapers: Chosun Ilbo tended to report in a negative tone, while Hankyoreh shinmun and Kyunghyang shinmun used a positive tone. Conclusions: This finding suggests that there are salient framings in reports on Moon Jae-in Care. Based on the results, the government needs to present a detailed financing plan on Moon Jae-in Care in detail. I discussed another implication of media frames results.

• Journal of Society of Preventive Korean Medicine
• /
• v.17 no.2
• /
• pp.105-127
• /
• 2013

Objectives : We examined the use of the moxibustion through survey on Korean Medicine Doctors (KMDs) on preparation of universal moxa product standard by fully reflecting opinions of practitioners and the industry. Methods : The questionnaire is composed of 25 questions including use of indirect moxa, side effects, complaints and improvements, general characteristics and so on, and were responded by 1,588 KMDs. For statistics, frequency analysis, chi-square analysis, T-test and ANOVA were conducted using SPSS 12.0 for windows, and the significance level was 0.05. Results : In this research, 91% of the responded KMDs was using moxibustion, and the proportion of using mediate moxibustion was shown as 63.2%. They used mediate moxibustion for side effects of direct moxa method such as risk of burn, ease of use, control of stimulation and so on. And it was mostly being conducted to women and 40 ages. Most respondents gave moxibustion treatments for the purpose of thermal stimulation on acupoint to musculoskeletal diseases. Most respondents were treating 1~2 pieces of moxibustion to patients by moxibustion points to those of 1~2 regions every time within 10 minutes. Regarding the frequency of side effects of mediate moxibustion, within 3% of respondents had experienced side effects, and the types were burn, flare and itchiness, odor and smoke. The dissatisfaction of mediate moxibustion products was moderate(2.00 out of 5 point scale), and went up public health doctors, the younger ages and the shorter clinical experience. Complaints on mediate moxibustion products were serious odor, poor attachment, risk of burn etc. Regarding ways to improve mediate moxibustion, the expansion of moxibustion's insurance cost carne out highest, followed by preparation of manual on efficacy, strengthening of training, acquiring evidence on efficacy, diversification of specifications, safety improvement, quality improvement of mediate moxibustion products. Conclusions: Many KMDs use for ease of use and give moxibustion treatments for thermal stimulation but they complain about safety, efficacy and quality of mediate moxibustion. After this it is considered that we have to elevate therapeutic effect through the improvement of mediate moxibustion products.

• Journal of Science and Technology Studies
• /
• v.13 no.2
• /
• pp.71-110
• /
• 2013

As a patient has recently been recognized as not a passive object but a subject of medical services, various attempts are being made to strengthen the status of a patient. Medical communication which has been led by a doctor so far is being made with a focus on a patient due to sovereignty of a consumer and activation of medical information. The purpose of this paper is to investigate the process to strengthen the status of a patient as a consumer of health care service through a patient association and consumer movement as medical information becomes public. As the patient centered medical service is creating a variety of health care service market using IT technologies, it has contributed to the improvement on asymmetry of medical information. As the expansion of IT fusion health care market is bringing the fundamental change into the traditional relationship between a doctor and a patient, the medical service market is being re-organized. A patient centered medical service such as expansion of mobile health care model led by a patient is being accelerated.