• 보건행정학회지
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• 제28권3호
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• pp.226-232
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• 2018

The objectives of this study were to evaluate the current state of governance structure and management of the health system to achieve the goals of the health system in South Korea, and to propose reform plan. This study drew implications from the governance of United Kingdom, Germany, and Netherlands, based on the principle of health system proposed by World Health Organization. The presidency and the health ministry should make macroscopic decision-making. The government has to decentralize the enforcement by municipality to operate public health and national health insurance (NHI), and to distribute the centralized NHI fund by municipality. The front line health centers and community centers should provide integrated health and social services. The government has to establish diversified regulatory bodies to enhance both the patient-centered care and the efficiency and equity of health care, and to provide mechanisms for ensuring autonomy of providers. The governance of the health system should be composed of the centralization of macro decision-making, the decentralization of implementation by municipality, the integration of health and social services on the front line, and the well-balanced regulation and autonomy on both consumers and suppliers.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.661-671
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• 1993

In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.

• 근관절건강학회지
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• 제27권3호
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• pp.238-246
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• 2020

Purpose: This study aimed to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit among older people. Methods: The target participants were enrolled in 2007 and they were classified into 1 year, 2 years, 3 years, and 4 years according to their service provision period. We analyzed health insurance claims data and entitlement data from the National Health Insurance Service databases between 2006 and 2010. This study examined the participants' social-economic and health status factors related to total medical expense. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: Based on the use of home visiting service, the effect was reduced by 223,914 won. The cost for 952,109 people aged 65 or older was 39,891,462,882 won and the benefit was 213,190,534,626 won. The net benefit was 173,299,071,744 won and the benefit/cost ratio was 5.34 times, which was very economical. Conclusion: Home visiting health care should continue to expand as a means of economically effective health care for people aged 65 and older and to ensure health equity for vulnerable groups.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.173-174
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• 1995

• Journal of Preventive Medicine and Public Health
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• 제54권5호
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• pp.293-300
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• 2021

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.

• 보건교육건강증진학회지
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• 제16권2호
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• pp.205-233
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• 1999

This study is an effort to make policy suggestions by analysing the current health examination program as a benefit service provided by the national health insurance system, including health screening for the insured, screening of cancer and chronic diseases for their dependents. Analyses found some issues being gave attention to; 1) The insured under the community health insurance system do not get the health examination benefit. A program for them should be set to have equity in benefit services. 2) Low rates of using screen services compromise purpose and the efficiency the services have first intended to. An immediate attention should be made to increase low rate of use of screen test to detect chronic diseases in particular. 3) Selection of diseases and test items covered by health examination program does not reflect the need of the insured, but to reflect financial resources of the national health insurance system. 4) Lack of health screening facilities and their geographical maldistribution is observed, which with preference of a general hospital as a screening post by the insured may lead to unreliable test. 5) A follow-up system should have been developed for the suspected classified by test results of carrying chronic diseases. They should be cared for within the health examination program. Public health care systems incorporate such a system, along with caring for those who are in need of having a health counselling on preventive care. In conclusion, the national health insurance system should be a medical insurance of giving a higher priority on preventive care benefits, health examination program in particular. That could be done by making rearrangements of test items, screening methods and system, rationalizing current reimbursement system of service fee, increasing accessibility to and utilization of the services, and making an establishment of follow-up system.

• 대한예방한의학회지
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• 제6권1호
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• pp.1-14
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• 2002

The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.

• 문화기술의 융합
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• 제7권4호
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• pp.351-361
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• 2021

본 연구의 목적은 건강한 생활습관에 영향을 미치는 요인을 규명하여 개인 및 지역의 건강불평등을 해소하기 위한 기초자료를 제공하고, 건강형평성 접근과 국민의 건강권을 보호하는데 있다. 2019 지역사회건강조사자료를 사용하였고, SAS 9.4와 IBM SPSS를 이용하여 기술통계분석과 다변량 로지스틱 회귀분석을 수행하였다. 건강한 생활실천율은 전체의 33.8%로 지역별로 11~20%의 차이가 있었다. 개인요인으로는 성별, 연령, 직업, 수면시간, 주관적 건강상태, 주관적 스트레스 정도에서 건강한 생활습관이 유의한 차이를 보였다. 개인 간 관계 요인에서는 건강한 생활실천을 위한 사회활동에 차이가 있었고, 지역사회 요인에서는 지역의 물리적 환경에 대한 긍정적인 태도, 연간 의료불만족, 의료기관 이용에 유의한 차이가 있었다. 향후 지역별 건강한 삶의 실천을 확대하기 위해서 구체적인 전략과 함께 개인, 사회, 국가 차원에서 접근할 수 있는 종합적인 정책과 협력방안을 추진해야 할 것이다.

• 한국치위생학회지
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• 제9권4호
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• pp.644-658
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• 2009

Objectives : This study was to find out the status of job satisfaction and intent to leave the job for dental hygienists, and those factors affecting their intent to leave, so as to prevent dental hygienists from leaving their jobs in advance, and to strive for extending the life span of the job, contributing to improve dental care services provided by dental hygienists. Methods : The data were collected from 280 dental hygienists working in dental clinics or hospitals in Busan and Gyeongnam area by using a structured and self-administered questionnaire through mail, from February 1 to March 15, 2009, and were analyzed by using SPSS WIN 14.0 program. Results : First, It was the most prevalent for the dental hygienists surveyed to be between 100 to 149 thousand won in the level of monthly as 42.3%, and to be the assistance of dental examination and treatment for main duty as 62.5%. Leaving job was experience by 51.6% of the subjects, with work condition as the most common reason for 32.2%. Second, the degree of job satisfaction was 3.4 points overall in the score of 5 point Likert's scale on the average, showing affirmative level above the average, and significantly different according to certain characteristics such as age, education level, total years of work career, years of work career in the current job, monthly salary level, whether to provide monthly paid leave, and the number of patients treated per day. It also was significantly correlated with some structural factors and variables consisting attitude and value, including equity in pay(r=0.612), job perception as dental hygienist(r=0.573), work environment(r=0.552), self growth(r=0.531), affirmative attitude(r=0.421), and so on. Third, the mean score of intent to leave was 2.73 overall and lower than the average, showing significant relationship with some characteristics, such as age, marital status, education level, total years of work career, years of work career in the current job, monthly salary level, whether to provide monthly paid leave, and the number of patients treated per day. Intent to leave also showed the highest correlation with job satisfaction(r=-0.708), followed by equity in pay(r=-0.482), self growth (r=-0.453), job perception as dental hygienist(r=-0.392), work environment(r=-0.362), etc. Forth, job satisfaction was significantly influenced by some factors including equity in pay, followed by job perception as dental hygienist, relationship with fellow colleagues, affirmative attitude and work environment, and so on. Fifth, the intent to leave was significantly affected not only by job satisfaction but also by some structural factors including equity in pay, self growth and job perception as dental hygienist. Conclusions : The above results showed that the equity in pay was the most important factor for the intent to leave the job as well as job satisfaction among dental hygienists, thus suggesting that systematic measures should be provided to improve the job satisfaction to prevent economic loss due to leaving job frequently, and to provide pertinent reward system as a profession to enhance the motivation for accomplishment on job for dental hygienists.

• 한국병원경영학회지
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• 제27권1호
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• pp.1-10
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• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.