• Health Policy and Management
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• v.29 no.3
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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.

• Korea journal of population studies
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• v.4 no.1
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• pp.23-35
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• 1981

Health policy is directed to equity in the provision of primary care for rural people before the year of 2, 000. This study aimed to define and identify the need for physician's care by using empirical data, and suggested an alternative of the primary care delivery system in rural areas to the government. 1. Twenty percent of the study population wanted to obtain any form of medical care services. : 9.3 percent of the population was in need for physician's care; 15 percent of the need was met by physicians, while 85 percent remained unmet at the time of survey in 1979. 2. For meeting all the need for physician's primary care, 2.9 annual physician visits per capita are demanded. An alternative, which was devised in some favourable way at reasonable cost in rural settings, was suggested. It was to deploy the physician extender such as community health practitioner in the infrastructure of the health care delivery system, whose supervision is provided by physician, based on experience of the KHDI health demonstration project. 3. One physician, two community health practitioners and two community health aides should be assigned in distant locations for meeting all the estimated need for physician's primary care for 10, 000 rural underserved residents.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.589-599
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• 2001

The purpose of this study was to analyze the relation amongst health status, health care costs. health service utilization among the low income elderly who were 60 years of age or older, earning a half of the average Korean family income. The cross-sectional descriptive survey research we conducted used families randomly sampled nationwide. The data were collected from July 12 to August 7, 1999 and the total sample was 1.259 household members (421 households). These were the major findings. 1. As for the health status. 72.4% of respondents fell ill in the last 1 month; 54% of respondents had chronic disease. 2. As for the health care cost. the cost of hospitalization and the medical treatment were 1.069,000 won and 226.000won. respectively. 59.3% of respondents experienced a burden from the monthly health care expenses. 3. As for the health service utilization for the last 3months. 28.5% of respondents didn't utilize the health service. In addition, 22.2% of respondents gave up a medical treatment because of economic situation (88.8%). 4. The statistically significant determinants of health service utilization are old age, female, living with a spouse, unemployed state, medicare, and more days sick. 5. It is shown conclusively that equity and efficacy of the health care policy are to be considered for lower income older adult.

• Health Policy and Management
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• v.26 no.4
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• pp.265-270
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• 2016

Public health system for more prevention-oriented health promotion rather than hospital-based curative service, focusing population rather than individual, and comprehensive health management in the local community strongly needs to be constructed to solve major issues on efficiencies and equity problems which Korean healthcare system is facing nowadays. Public health promotes and protects the health of people and the communities where they live, learn, work, and play. Medical care tries to cure those who have diseases, but public health tries not to become ill and not to be injured. Debates on how we build or rebuild public health system, which is contrasted with medical care system, are needed in Korea, focusing how needs for healthy community and right to health are fulfilled. Public health specialists for practising population health at local community level should be systematically recruited, the function of public health centers should be strengthened, and new government organization should be established for place-based health management.

• 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.

• Health Policy and Management
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• v.28 no.4
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• pp.339-351
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• 2018

Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.

• Health Policy and Management
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• v.1 no.1
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• pp.95-108
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• 1991

The World Health Organization and its member states, in 1978, declared that primary health care is a key to attain the goal of Health for All by the goal of Health for All by the yeas 2000. As a member state of WHO, the Republic of Korea has participated in the declaration of ALMA-ATA and committed to put national efforts for devedoping and implementing primary health care approach with the spirit and content of this Declaration. Since 1978, to translate the spirit of the Declaration into realization, Korean goverment has developed a new category of health manpower such as Community Health Practitioners serving people living in remote rural areas and Village Health Workers serving voluntarily their own village, strengthened the function of Health Centers and Health Subcenters through their reorientation and improved the infrastructure by their new construction or renovation. While primary health care is viewed as an essential health care in Korea, there are some circles who follow a narrow definition in referring to the health care at the periphey of a health system, which is erroneous. Considering the PHC is accepted as the best alternative approach to health care to solve problems that modern health systems are facing, we propose the followings as desirable health policy directions that modern health systems are facing, we propose the followings as desirable health policy directions which might translate the persopective into action at the national level after reviewing past and current PHC approach in Korea : 1. To improve the equity through the reduction of gaps between those who have access to health care and those who have not. 2. To reinforce multisectoral approach and intersectoral coordination through the re- establishment of the National Health Council or establishment of equivalent organization at the central level. 3. To stengthen community participation through lacal people's empowerment by leadership training, changing planning process from the top-down approach to bottom-up and giving the priority to human resources rater than technology, 4. To reinforce the Ministries of Health and Social Affairs through upgrading its role and function to Coordinate Ministries which involve human welfare policies, and creating a Division which is in charge of PHC in the Ministry.

• East Asian Journal of Business Economics (EAJBE)
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• v.11 no.2
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• pp.71-80
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• 2023

Purpose - The pandemic has magnified and deepened existing socioeconomic disparities, including healthcare, education, income, gender, and housing. This study aims to examine the intersectionality of these disparities and their implications for promoting equity and justice. Research design, data, and methodology - This study is a comprehensive review of the literature on the impact of the COVID-19 pandemic on socioeconomic disparities. The review includes empirical studies, policy reports, and academic articles on healthcare, education, income, gender, and housing disparities. Result - The pandemic has exposed significant disparities in healthcare, education, income, gender, and housing. Healthcare disparities have been highlighted, and there is a need for more equitable access to care and addressing social determinants of health. Educational and income disparities are closely linked, perpetuating cycles of poverty and inequality. Gender disparities have been exacerbated, with women experiencing disproportionate impacts on their health, well-being, and economic security. The pandemic has highlighted the need for safe, stable, and affordable housing. Conclusion - The pandemic has brought to light numerous socioeconomic disparities that require systemic change to address. Promoting equity and justice requires a comprehensive, long-term approach that addresses systemic factors and promotes social and economic equity. By taking action to address these issues, we can create a more just and equitable society that promotes the health and well-being of all its members.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.435-445
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• 2017

This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.

• Korea Journal of Hospital Management
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• v.23 no.4
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• pp.53-64
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• 2018

Purposes: The hospitals needs to generate a minimum profit, in order to perform its own role such as providing high-quality medical services. The demand for hospital management is increasing, as the social demands are diversified and the financial transparency is emphasized. The purpose of this study is to compare hospitals management based on Dupont Identity, by various hospital classification. Methodology: This study is based on '2016 Statistics for Hospital Management' provided by the Korea Health Industry Development Institute. The hospitals were classified according to the scope of care, the type of establishment, the location, and the number of beds. We analyzed the general and financial characteristics of over 337 hospitals using the method of Dupont Identity. Findings: Net profit margin (PM) has the biggest impact on return of equity (ROE). By the number of beds, general hospital with 160-299 beds have the highest return on equity (ROE). By location, hospitals in local municipalities have higher return on equity than hospitals in urban municipalities. According to the type of establishment, public hospitals have lower business performance, and although they invest more than private hospitals. Practical Implications: This study can inspire interest and provide understanding in hospital management and financial structure, by analyzing through an intuitive indicator named Dupont identity. It is possible to provide basic data for hospital management methods for each financial elements, in order to increase the profitability of hospitals.