• 보건행정학회지
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• 제23권1호
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• pp.3-18
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• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

• 보건의료산업학회지
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• 제4권1호
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• pp.1-10
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• 2010

The purpose of this study is to investigate the effects of provider and consumer characteristics, and patient trust on relational commitment among healthcare customers of an university hospital, and to suggest some implications for improving customer relation management of hospitals. Data were collected from 250 patients of an university hospital located in Ulsan using structured self-administered questionnaire. Major result of the analysis is as follows: First, study variables are significantly varied by age and income among socio-economic factors. Second, assurance, and empathy among provider characteristics and customer satisfaction and reputation among consumer characteristics are found to be significant affecting factors on patient trust. Third, trust affects significantly both on re-visit and recommendation among relationship commitment, while reputation affects on re-visit and customer satisfaction and reputation affect on recommendation. Above results imply that relationship management strategy for enhancing patient trust is crucial to improve competitiveness of hospitals in turbulent competition environment.

• 보건교육건강증진학회지
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• 제19권2호
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• pp.127-138
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• 2002

Objective: This prospective survey assessed factors associated with influenza vaccination behaviors among high-risk adults. Methods: 106 patients aged 65 or high risk for complications of influenza were interviewed to identify influencing factors to vaccination. Six potential consequences of Influenza infection and nine factors of vaccination were analysed between compliance and non-compliance groups. Results: Among the 106 patients, the vaccination rate was 62.3%. The rate of the group under the sixties was 37.0010, but the rate over the sixties was 88.5%. Factors in dependently associated with both influenza vaccination behaviors included older age, chronic disease, and especially, related to factors in older age were having positive attitudes toward immunization, perceived severity of infection and willingness to comply with the provider's recommendation. Conclusions: Emphasis on provider recommendations and the knowledge and attitudes of influenza infection and vaccination may enhance influenza vaccination rates in the organized vaccination programs.

• 동서간호학연구지
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• 제22권1호
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• pp.51-59
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• 2016

Purpose: This phenomenological study aimed to identify breast cancer patients' experience of unkindness of healthcare providers. Methods: Ten participants who were diagnosed with breast cancer were recruited to participate in the study and asked to share their experience related to healthcare providers. Data were analyzed using the phenomenological method of Colaizzi. In-depth interviews were conducted from November, 2014 to March, 2015. Results: Seven consistent categories and fourteen theme clusters emerged from collected data. The seven themes were 'being treated thoughtlessly', 'not giving special services for breast cancer patients', 'cold and authoritative manner', 'incomplete explanation', 'not accepting an appeal', 'being sorry for having short consultation hours', and 'unskilled and careless treatment'. Conclusions: It is needed to develop health care services in the view of beneficiaries. This may reduce the patients' experience of unkindness of the healthcare providers and improve the satisfaction of health care service.

• 대한예방한의학회지
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• 제9권2호
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• pp.17-41
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• 2005

Current Korean medical system is evaluated as inefficient and the government is planning a new medical development plan to provide guaranteed life-long medical service and more efficient medical system Korean medicine also needs to participate as the primary medical provider and strengthen public recognition. The needs for active participation are essential to prevent irrational medical policies and Korean medicine can exercise medical merits. When the doctors of Korean medicine are recognized as the primary medical provider, not only social rights are served but also provide medical service to less privileged sector of the society. This calls for the establishment of system for attending physician and public health doctor from Korean medicine. Another important issue is the establishment of public medical service at the government level. Doctors of Korean medicine should be posted at the national health center and other public hospitals. Revision of the current policies on Korean medicine must be made to yield concrete outcome of the public Korean medicine service as well as cooperation between the conventional allopathic medical community and the Korean medical community

• 보건행정학회지
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• 제19권3호
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• pp.109-124
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• 2009

Background: This study aimed to examine whether cases of punishing false claimants threat general physicians to check their medical cost claims with care to avoid being suspected, and identify empirically general deterrence effects of the on-site investigation system in the Korean National Health Insurance. Methods: 800 clinics were selected among a total of 15,443 clinics that had no experience of on-site investigation until June 2007 using a stratified proportional systematic sampling method. We conducted logistic multiple regression to examine the association between factors related to provider's perception of on-site investigation and high level of perceived deterrence referring to fear of punishment after adjusting provider's service experiences and general characteristics. Results: The probability of high perceived deterrence was higher 1.7 times (CI: 1.13-2.56), 2.73 times (CI: 1.68-4.45) each among clinics exchanging the information once or more per year or once or more for 2-3 months than among clinics no exchanging the information about on-site investigation. Also, the probability of high perceived deterrence was higher 2.27 times (CI: 1.28-4.45) among clinics that knows more than 3 health care institutions having experienced an on-site investigation than among clinics knowing no case. Conclusion: A clinic knowing more punishment cases by onsite investigation and exchanging more frequently information about on-site investigation is likely to present high perceived deterrence. This result will provide important information to enlarge preventive effects of on-site investigation on fraud and abuse claims.

• 한국방재학회지
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• 제5권4호
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• pp.42-49
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• 2005

• 한국의사학회지
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• 제24권1호
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• pp.57-62
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• 2011

With the discovery of WooJam JabJeo, Jang-Taegyung[1809~1887] was highlighted as a noted doctor who won fame in the neighborhood of Gwangju, but with 'WoodJam Mango' seeing the light of day, this study was able to confirm the appearance of a literary man enjoying a reputation enough to sway literary circles with his writing of poems. It's possible to confirm his past related to medical service only until age of 42, which is because description in "WooJam JabJeo" came to a halt there. The situation is that the contents of 'WooJam Mango' started from age of 46 and were carried on even until after his death by his followers. Therefore, there exists a very intense impression that he might have put a focus on the life as a literary man ever after his mid-40s. and considering that he breathed his last at the age of 79, it's not difficult for us to estimate that his life was predominantly a series of literary activities rather than a health care provider. The place names appearing in "WooJam JabJeo" and "WooJam Mango" are limited to today's Jeonlanam-do, and this researcher would say that the through-composed poems, which sang of the beauty of Gwangju area scenery are the works, deserve to get a spotlight in local history even today. Through the above discussion, this study could prove that WooJam is a flawless figure enough to represent Gwangju and Jeonlanam-do as a health care provider and a literary person as well.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1999년도 제51차 추계 학술대회 연제집
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• pp.365-366
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• 1999

• Journal of Preventive Medicine and Public Health
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• 제36권3호
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• pp.239-247
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• 2003

Objectives : The objectives of this study were to examine the difference in attitude toward health-specific locus-of-control and medical care among western medical students, oriental Medical students, and non-medical school students. Methods : The subjects of this study were 667 students who agreed to respond the questionnaire :212 western medical school students, 190 oriental medical school students, and 205 non-medical school students. The health-specific locus of control was measured by the structured questionnaire developed by Lau and Ware. The attitude toward western and oriental medicine was also measured by the questionnaire. Results : Western medical students and non-medical school students were more likely than oriental medical students to place high value on 'the provider control over health' and 'the general threat to health' scales (F=20.47, F=19.98). But oriental medical school students ranked 'the self control of health' scale as more important than any other locus of control scale (F=19.34). The health specific locus of control was also different from the grade. When trte grade was increased, 'the provider control over health' scale was slowly decreased, especially in western medical students and non medical school students. However, the 'general threat to health' scale was increased in oriental medical students. Western medical school students expressed more positive attitude toward western medicine. Oriental medical school students put a higher score on oriental medicine. Nevertheless, as the grade was increased, the positive attitude toward oriental medicine slightly decreased in oriental medical school students. Conclusions : There is a difference in health-specific locus of control and attitude toward medicine among western medical students, oriental medical students, and non-medical students. The locus of control and attitude of medical students towards medicine may affect both how they behave towards patients and how they help shape future public policy. Therefore, interdisciplinary educational initiatives may be the best way to handle this issue.