• 보건행정학회지
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• 제16권4호
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• pp.86-111
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• 2006

Either ways of understanding health care as a commodity or public work are at opposite ends of health care spectrum. These two rival conceptions reflected by viewpoint(ideology) would lead to different directions in policy-making for health care reform. The purpose of this study is to access the value differences of experts' policy views about health care issues by analyzing the extent of consensus among experts in the field of health care. Using primary data obtained through a mail survey of 558 experts in the field of health care, we analyzed the differences of experts' opinions about characteristics of health care market, policy issues and values Gdeology). The study represents from 50-50 split analysis, entropy index, and factor analysis that the wide spread disagreements over health policy, which is a major barriers to effective policy-making, could be caused by the ideological perception differences among experts. This implies that, if values play an important role in policy-making, we should identify the differences in value and seek ways to balance among the diverse values such as efficiency, equity, freedom, and security. For this, the policy issues debated on differences in values should be reconciled for narrowing gaps of experts' perceptions through various ways.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.298-308
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• 2014

Objectives: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. Methods: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. Results: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. Conclusions: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.

• 보건행정학회지
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• 제17권1호
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• pp.94-124
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• 2007

This paper critically reviews three decades of research on geographic variations. in health services utilization in the United States, thereby drawing policy and research implications for Korea. The recent renewed interest in variations research in the United States, precipitated by studies on regional variations in Medicare expenditures, stems mainly from the policy implication that a substantial amount of Medicare expenditures could be saved without compromising quality and access. From the research perspective, this policy implication was made tenable by integrating micro- and macro-level analysis of variations in health services utilization. Still, theoretical limitations inherent in the research pose great challenges to developing effective strategies at the health system level. Variations research in the United States can serve as a case study as to how health services research has responded to efficiency and quality issues in an ever expanding health system Considering the current health policy and research environment in Korea, the following implications can be drawn. Variations research will help formulate a national policy agenda for health care quality and also advance the framework of approaches to health policy issues. For such purposes, both relevant descriptive and hypothesis-testing studies are needed. Further advancement in variations research will require interdisciplinary explorations and methodological sophistication. To the extent that Korean health policies will strive to achieve complex goals, variations research will increasingly prove to be useful.

• 한국학교보건학회지
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• 제28권3호
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• pp.139-149
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• 2015

Purpose: This study aims to analyze the factors affecting the agenda-setting process and the formation process of school-based mental health policies by applying a policy stream model. Methods: For this purpose, Kingdon's policy stream model was used as the analytical framework. Results: First, when establishing a school-based mental health policy, the agenda was set going through unpredictable and nonlinear changes. Second, for the school-based mental health policy to be selected onto the agenda and to be developed and implemented as an actual policy, the role of policy makers was considered most important in the process. Third, the policy window for school-based mental health policy was closed around the year 2013. Finally, an analysis of the school-based mental health policy stream identified two key features. One is that the school-based mental health policy first emerged when school violence prevention policy expanded its scope into relevant neighboring policies. The other is that the school-based mental health policy has taken shape through a linear decision-making process (being put on the government's agenda, searching for an alternative, selection, and implementation) during the policy implementation period after it has been selected as an alternative policy. Conclusion: Conclusions can be summed up as follows. The school-based mental health policy needs continuous development and improvement in case the window for the policy may open in the coming future. The government's support is needed to draw policy makers' interest and participation who play the biggest role in establishing policies.

• 보건행정학회지
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• 제31권3호
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• pp.312-327
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• 2021

Background: Infection prevention and control (IPC) to manage healthcare-associated infection (HCAI) has emerged as one of the most significant public health issues in Korea. The purpose of this study is to draw implications in IPC policies by analyzing the context, process, and major actors in policy development and comparatively analyzing IPC policy contents of Korea with three other countries. Additionally, IPC policies were analyzed in the context of coronavirus disease 2019 (COVID-19) to provide implications for future pandemics and HCAI events. Methods: This study incorporates a qualitative approach based on document and content analysis, applying codes and thematic categorization. IPC policy contents are comparatively analyzed by adopting the concept model, developed by the World Health Organization, which consists of core components of IPC structure at the national and facility level. Results: National IPC policies were developed within a complex social and political context, through the involvement of various stakeholders. IPC policies in Korea place a high emphasis on establishing IPC programs and built environments in healthcare facilities, whereas there were potentials for improvement in policies involving patients and promoting a safety culture. IPC policies, which currently focus on general hospitals and certain functions of hospitals, should further be expanded to target all healthcare facilities and functions, to ensure more efficient and sustainable IPC responses in the current and future disease outbreaks. Conclusion: IPC is a complex policy arena and lessons learned from the analysis of existing policies in the context of COVID-19 should provide valuable strategic implications for future policies.

• 보건행정학회지
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• 제27권2호
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

• 보건행정학회지
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• 제18권2호
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• pp.86-106
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• 2008

This research analyzed. knowledge structure and its effect factor by analysis of co-author and keyword network in Korea's health policy and administration sector. The data was extracted from 339 articles listed in the Korean Journal of Health Policy and Administration, and was transformed into a co-author and keyword matrix. In this matrix the existence of a link was defined by impact factors which were calculated by the weight value of what the role was and the rate of how many authors contributed. We demonstrated that the research achievement was dependent on the author's status and network index. Analysis methods were neighborhood degree, correspondence analysis, multiple regression and the difference of weight distribution by research fields. Co-author networks were developed as closeness centrality as well as degree centrality by a few high productivity researchers. In particular, power law distribution was discovered in impact factor and research productivity. The effect of the author's role was significant in both the impact factor calculated by the participatory rate and the number of listed articles. Especially, this journal shared its major researchers who had a licensed physician with the Journal of Preventive Medicine and Public Health. Therefore, social scientists were likely to be small co-author network differently from natural scientists. It was so called 'two cultures' phenomenon. This study showed how can we verified academic research structure existed in the unit of journal like as citation networks. The co-author networks in the field of health policy and administration had more differentiated and clustered than preventive medicine and epidemiology fields.

• Safety and Health at Work
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• 제10권1호
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• pp.21-29
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• 2019

Background: Promoting healthy lifestyles at work should complement workplace safety programs. This study systematically investigates current states of occupational health and safety (OHS) policy as well as practice in the European Union (EU). Methods: OHS policies of EU member states were categorized as either prevention or health promotion provisions using a manifest content analysis. Policy rankings were then created for each prevention and promotion. Rankings compared eight indicators from the European Survey of Enterprises on New and Emerging Risks-2 data on prevention and promotion practices for each member state using Chi-square and probit regression analyses. Results: Overall, 73.1% of EU establishments take preventive measures against direct physical harm, and about 35.4% take measures to prevent psychosocial risks. Merely 29.5% have measures to promote health. Weak and inconsistent links between OHS policy and practice indicators were identified. Conclusion: National OHS policies evidently concentrate on prevention while compliance with health and safety practices is relatively low. Psychosocial risks are often addressed in national policy but not implemented by institutions. Current risk assessment methods are outdated and often lack psychosocial indicators. Health promotion at work is rare in policy and practice, and its interpretation remains preventive. Member states need to adopt policies that actively improve health and well-being at the workplace.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.167-168
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• 1995