• 보건행정학회지
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• 제18권4호
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• pp.185-206
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• 2008

The National Health Insurance (NHI) has been the main body of health care system in Korea for the last 30 years since the NHI was founded. However, the inefficient management and strong regulations of the NHI have hindered the development of health care industry. The establishment of the MB government, whose interest lies on economic growth rather than equity, is expected to help the health care services gain a momentum. The essential measures that can step up public health care services overall are the following: the introduction of competition within NHI, the activation of private health care insurance, and the allowance of for-profit hospital. The private-public mix with market mechanism would level up the health care service for the public.

• 보건행정학회지
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• 제19권4호
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• pp.78-97
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• 2009

This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

• 가정∙방문간호학회지
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• 제14권1호
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• pp.11-17
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• 2007

The purpose of this study was to describe the policy agenda and alternatives for the home health care system in Korea. The home health care system development was not fully integrated while the medical laws were established in 2000, community health law in 1995, and elderly long-term health insurance law in 2007. Because of the increasing population of people over the age of 65 and dramatically decreasing fertility rate, the burden of various health-care expenses has become a great obstacle for the Korean government. Under these circumstances, the home of home health care system in has taken on an important role under the mandate of the national health care system. The types of home health care system in Korean shows a greater contrast from those utilized in other more industrialized countries, such as, U.S. or Japan. In conclusion, the strategy in overcoming the obstacles to enhance home health care system under the national health system would be developing it as a comprehensive and exchangeable consumer-focused organization.

• 보건행정학회지
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• 제1권1호
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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.

• 가정∙방문간호학회지
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• 제14권2호
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• pp.98-105
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• 2007

Home health care system in Korea has been classified into three types of home care programs based on different laws and regulations; for example, home health care nursing(HHCN) is based on medical laws, visiting health care nursing (VHCN) is based on long-term health care insurance, and visiting health care(VHC) is based on the regional health care act. HHCN in Korea has taken on an important role under the mandate of the national health care system since 2000. VHCN will commence its role under the long term health care insurance system in 2008. The strengthening of VHC commanded health promotion and prevention for vulnerable families in the community in 2007. This is an important turning point for increasing quality management for home health care program; it suggests certain possibilities for building a foundation for further changes in the service delivery structure. Accordingly, the home health care policy makers in Korea have a major function and role that consists of developing an agenda and alternatives for policy making in a systematic manner and clearly presenting implementation strategies for elderly health care system.

• 대한예방한의학회지
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• 제9권1호
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• pp.77-89
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• 2005

Since 1990's, the Korean society, experiencing the low fertility and aging society, has been confronting with the threats in health care sector. The threats are the increases in the demand for health care, health care financial burden, and so on. In particular, the change of disease pattern and aging population result in the increases patients' demand for not only western medical services but also oriental medical services and complimentary medicine. Recently, the increases in availability of oriental medical services and the health care resources related to oriental medicine are raising some issues and conflicts in the Korean health sector. Theses circumstance required policy makers, central and local government, and public health sector to develop health policies related to oriental medicine and interface or integrate of traditional Korean medicine and Western medicine. For the near future, these issues will probably remain the focus of integration of traditional Korean medicine and Western medicine in public health sector. To cope with the threats in health care sector, one of the opportunities is to scale-up e public role of traditional Korean medical services. The main purpose of this study was to develop strategies to scale-up the Public role of traditional Korean medical services for the future society. The research questions are: what are the trends and problems in traditional Koran medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the cause?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? The results of this study are as follows. In order ta scale-up the public role of traditional medicine, this research offered health policy directions for traditional Korean medicine in response to a change environment of health care sector. There are four directions to be addressed: 1) the development of and investment in public oriental medicine infra-structure; 2) the development of public policy on oriental medicine; 3) modernization and globalisation of traditional Korean medicine; 4) the expansion of academic exchange between Western medicine and traditional Korean medicine. Finally, we discussed stakenholders' on traditional Korean medicine in the health care market. Then, public policy options for future society was suggested.

• 한국병원경영학회지
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• 제13권1호
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• pp.1-23
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• 2008

In the shortest period of time, we achieved both industrialization and democratization. We also achieved good performance in health care sector. Whole population are covered by health insurance since 1989 and health outcomes, such as infant mortality, life expectance show good level. However, health care system has several problems, rapidly increasing rate of health care expenditure, dissatisfaction of both consumers and suppliers. Current health care system does not reconcile with market competition principle. Causes of these problems originated from 1977 paradigm which was formed to expand health insurance to whole population within short period. Dominant assumption of 1977 paradigm is to assure equitable access of health care by government's command and control. We urgently demand to reform the 1977 paradigm to suitable in 21th century. Our economy entered into a road to advancement. We have concerns how President Lee's administration reform health care system to harmonize with economic development and to achieve advancement in health care sector.

• 보건행정학회지
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• 제11권4호
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• pp.129-151
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• 2001

This study was conducted to describe trends of health services research (HSR) in Korea since 1968 and analyse the relevance of HSR to changes in health policy. Research methods are as follows: firstly, HSR articles were selected from 4 HSR related journals implicitly. Secondly, classification system of HSR was developed and then applied to previously selected papers in order to describe research trends. Finally, the frequency rankings of articles in research areas were compared with rankings in order of the importance of research area rated by experts. As a resesult, HSR articles have increased with time and three main research areas are health programme, health care financing, and health care organization/management. And many articles have been related to the efficiency and quality of health care since 1990. It seems HSR articles had little relevance to changes in health policy and policy environment. Especially, the recently disputed policy topic, namely the separation of prescription from disposing, has not received little attention since 1990. These findings suggest there is an urgent need for the reflection on HSR direction in Korea.

• 보건행정학회지
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• 제30권1호
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• pp.131-138
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• 2020

The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

• 보건행정학회지
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• 제24권3호
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• pp.228-241
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• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.