• 보건행정학회지
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• 제26권2호
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• pp.95-106
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• 2016

A new manual of System of Health Accounts (SHA) 2011, was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. This offers more complete coverage than the previous version, SHA 1.0, within the functional classification in areas such as prevention and a precise approach for tracking financing in the health care sector using the new classification of financing schemes. This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 1970-2014 constructed according to the SHA2011. Data sources for public financing include budget and settlement documents of the government, various statistics from the National Health Insurance, and others. In the case of private financing, an estimation of total revenue by provider groups is made from the Economic Census data and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. CHE was 105 trillion won in 2014, which accounts for 7.1% of Korea's gross domestic product. It was a big increase of 7.7 trillion won, 7.9%, from the previous year. Public share (government and compulsory schemes) accounting for 56.5% of the CHE in 2014 was still much lower than the OECD average of about 73%. With these estimates, it is possible to compare health expenditures of Korea and other countries better. Awareness and appreciation of the need and gains from applying SHA2011 for the health expenditure classification are expected to increase as OECD health expenditure figures get more frequently quoted among health policy makers.

• 사회복지연구
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• 제40권1호
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• pp.297-322
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• 2009

아동정책은 주로 보건복지부에서 요보호아동을 위한 사후적인 복지제도를 중심으로 집행된 반면 청소년정책은 국가청소년위원회에서 일반청소년을 위한 육성제도를 중심으로 실시되어 왔다. 하지만 아동청소년정책의 부처별 산발적 추진으로 인해 서비스 중복 현상이 나타나고 정책의 체계적 집행이 부족하였다. 따라서 일관성 있는 아동청소년정책의 추진을 위해 이명박 정부에서는 국가청소년위원회를 보건복지가족부로 흡수하면서 아동청소년정책의 통합작업을 진행하고 있다. 본 연구에서는 아동청소년정책에서 통합의 의미가 무엇인지, 이명박 정부의 전달체계 통합방안의 문제를 검토하고 이를 보완하기 위한 방안이 무엇인지를 제언하였다. 바람직한 통합정책을 추진하기 위해서는 부처통합에 따른 보건복지가족부내의 아동정책과 청소년정책의 단순 결합을 넘어서 국가 전체의 인적자원개발계획과 경제정책을 고려하여 통합적인 아동청소년정책이 수립되도록 전면적인 재설계가 필요하다. 또한 정책대상의 비효율적인 중복이 강조되기보다는 정책의 공공성과 적정예산의 확보를 위해 아동청소년정책예산의 획기적인 증가가 선결되어야 한다는 점이 강조되었다.

• 지역사회간호학회지
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• 제11권2호
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• pp.577-590
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• 2000

This study is basic research for developing health promotion programs in elementary school and is looking at the effect factor of School nurses perception and school health promotion. This study was conducted with the ACCESS model for school health promotion from WHO. The subjects of this study were 28 elementary school nurses located in the west side of Kung-Nam from the 7th of June to the 30th of June by direct interview. The results of this study are summarized as follows: 1. the score from obesity, dental caries, health counselling, scoliosis, hepatitis B, immunization BCG items are higher in the low grade but showed significant difference in visual disturbance items. 2. the average score of school health promotion perception is 5.04. The list of school health promotion is composed of school health policies(5.39), physical environments (5.38), school health services(5.34), social environments (5.22), personal health skills (4.92), and community relationships(4.64). 3. after an analysis of the perception of school health promotion from school nurses, the relationship between the school health budget and the school health policy and school health service was shown to be significant. 4. after analysis of the effect factor of perception of school health promotion from school nurses, school health policy, school social environment, personal health skills, and school health service were shown to be significant. 5. The factors in school health promotion are the number of classes and students, school budgets, school nurses' final education and age, health education classes per week, and teaching experience. Particularly the school health budget and school nurses of the classes per week are statistically significant. The suggestions of this study are as follows: 1, as a related factor of school health promotion. the generally characteristics of schools and school nurses should be considered for improving the perception of school health promotion. 2, the period of health education for effective school health management and health education should be an on-going program. 3. the scope of school health promotion and perception should be considered for developing health promotion programs. 4. elementary school health promotion programs should be developed and applied to research. 5. computer system programs should be developed for effective school health projects.

• 보건행정학회지
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• 제17권1호
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• pp.1-27
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• 2007

This study is designed to estimate an appropriate level of patient's cost-sharing for oriental medical services in the Korean National Health Insurance. The findings of this study can be summarized as follows: 1) The current co-payment system for oriental medical services does not reflect its cost structure in clinical practice due to inconsistency of cost-sharing plan in the NHI. 2) Both oriental medical institutions and their patients, as a result, are at a relative disadvantage in financial burden, compared with other services. 3) The substantial proportion of patients' cost-sharing depends on the amount of co-payment and the range of medical cost that a flat rate is applied to. 4) The extension of the range doesn't make any substantial decrease in patient's cost-sharing. 5) The fixed amount of co-payment is more sensitive than a range to total variations of patient's cost-sharing. Based on the above, the budget impacts of a new co-payment system were estimated for each co-insurance rate, according to given scenarios. The results range from -59 billion Won (-8.5%) to 16 billion Won(2.3%).

• 의학교육논단
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• 제24권1호
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• pp.35-45
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• 2022

Needs for public healthcare have recently increased. This paper proposes education topics for competency development in public healthcare in line with the needs of the times. In Korea, various lifelong education providers have already provided public health-related education. For example, the Research Institute for Health Policy (RIHP) under the Korean Medical Association provided an "executive course for physicians' public health care competencies" in 2019 and 2020. At the end of the course, the RIHP published a comprehensive report, entitled "Curricular development and evaluation for doctors' public healthcare competencies." This article is based on a summary of that report. To develop a curriculum for public healthcare, the RIHP adopted the following methodologies for a needs analysis; reviewing already-existing education subjects, evaluating end-of-course reports, and conducting in-depth focused group interviews and questionnaire surveys with doctors at public healthcare-related institutions. The results from the needs analysis can be categorized into two domains of education topics for public healthcare. The first domain includes education subjects related to the theory and practice of public healthcare, as follows: a general overview, community or population health, organizational administration, planning and evaluation, budget and finance, responses to disasters such as infectious diseases, health policy, and the legal system. The second domain contained education topics related to general professional competencies: leadership, communication, cooperation, teamwork, and professionalism. In conclusion, the curricular content for public healthcare will be an appropriate combination of competencies specific to public healthcare and core competencies for health professionals.

• 보건행정학회지
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• 제5권2호
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• pp.202-229
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• 1995

In Korea, Resource-Based Relative Value Scale(RBRVS) is suggesting to the alternative of Korean Medical Fee Schedule. This study developed to methodology of RBRVS applicable to Korean situation and applied to services of internal medicine and general surgery. Our methodology of RBRVS is basically same to Hsiao's. But there are some differences between our method and H냐매's because Korean medical situation differs to American. The first difference is method of measurement of work. The Unit of work in our study is total work including intra-servic work and pre-/post-service work. Secondly, in extrapolation, we use primary data gathered to small group of physician. Tertially, in measurement of practice cost, we directly survey to budget data of hosptials and analyse practice costs by service. Some results are presented in a companion article.

• 보건행정학회지
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• 제25권3호
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• pp.149-151
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• 2015

United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (${\leq}70years$) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.

• 보건행정학회지
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• 제31권4호
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• pp.387-398
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• 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.

• 보건행정학회지
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• 제25권4호
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• pp.285-294
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• 2015

Background: Suicide is one of important health problems in Korea. Previous studies showed factors associated with suicide in individual levels. However, suicide was influenced by society that individuals belong to, so it was required to analyze suicide in local levels. The purpose of this study was to analyze the regional disparities of suicide mortality by gender and the association between local characteristics and suicide mortality. Methods: This study included 229 city county district administrative districts in Korea. Age- and sex-standardized suicide mortality and age-standardized suicide mortality (male/female) were used as dependent variables. City county district types, socio-demographics (number of divorces per 1,000 population, number of marriages per 1,000 population, and single households), financial variable (financial independence), welfare variable (welfare budget), and health behavior/status (perceived health status scores and EuroQol-5 dimension [EQ-5D]) were used to represent the local characteristics. We used hot-spot analysis to identify the spatial patterns of suicide mortality and negative binomial regression analysis to examine factors affecting suicide mortality. Results: There were differences in distribution of suicide mortality and hot-spot regions of suicide mortality by gender. Negative binomial regression analysis provided that city county district types (city), number of divorces per 1,000 population, financial independence, and EQ-5D had significant influences on the age- and sex-standardized suicide mortality per 100,000. Factor influencing suicide mortality was the number of divorces per 1,000 population in both male and female. Conclusion: Study results provided evidences that suicide mortality among regions was differed by gender. Health policy makers will need to consider gender and local characteristics when making policies for suicides.

• 대한물리의학회지
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• 제16권1호
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• pp.123-141
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• 2021

PURPOSE: Focusing on the factors that influence the infectious disease emergency response policy (approached by dividing the factors into health policy management and economic policies), both SARS and MERS cases were based on the legal system, manpower, and budget, but there has not been enough learning from the epidemic. This study focused on infectious disease emergency governance, which various studies have neglected despite its social and academic importance. METHODS: The research is based on an analysis of SARS, MERS, and COVID-19 and compares global policies. In this study, infectious disease emergency governance was divided into health policy management and economic factors. This study focused on planning and leadership before and after the outbreak of infectious diseases and how cooperation was achieved to monitor and respond to infectious diseases successfully. RESULTS and CONCLUSION: The limit of this study was that COVID-19 is a currently ongoing infectious disease with high uncertainty. Because it is an ongoing problem, only some data and statistics are reflected, and many limitations prevent a proper comparison under the same criteria as other infectious diseases. In addition, because continuous changes are expected, there is also room for infectious diseases to develop in a completely different pattern from the current situation, and continuous research must be accompanied in the future.