• 보건행정학회지
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• 제30권2호
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• pp.151-163
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• 2020

This study reviewed primary care purchasing issues of the Indonesian single-insurer, BPJS-K, in the context of triangular power relations between the government, the insurer, and the providers, and considered its challenges of purchasing as the national single-insurer. Some literature reviews and interviews with Indonesian stakeholders and residents were used to describe the historical and social contexts of Indonesian healthcare and social health insurance systems especially focusing legal and institutional status of BPJS-K and primary care provision and delivery conditions in remote areas. Though BPJS-K directly belongs to the presidential office of Indonesia, it has limited power in terms of purchasing as a single insurer. Mainly it was due to the lack of primary care resources, Ministry of Health's strong power as the regulator and provider, and BPJS-K's powerlessness against monitoring and quality of care assessment. Ambiguous accountability was another issue among the insurer and the Ministry of Health. This created confusions in primary care provision. It is suggested that each agencies' accountability should be obvious in terms of legal, political, and social contexts.

• 한국학교ㆍ지역보건교육학회지
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• 제19권2호
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• pp.53-63
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• 2018

Objectives: This study was intended to provide resources for the development and operation of the elderly's oral health education programs by comparing the difference of oral health behavior, oral health care self-efficacy and oral health levels according to their oral health education experiences and by researching the correlation of oral Health Behavior, self-efficacy, subjective oral health level and oral health education experience. Methods: An interview survey using structured questionaries was done on 180 senior citizens older than 65 years old residing in some areas of Gyeonggi-do from April 19 to May 25, 2018. The data was analyzed with Chi-square, t-test, spearman correlation coefficient with the use of SPSS 20.0. Results: 1. Those who are older than 75 years old and have higher levels of education and finance have more experiences of oral health education. 2. Those who have experiences of oral health education brush their teeth more than three times a day, use more oral health care items and get more regular preventive treatments such as oral examination and scaling. 3. As they has experiences of oral health education, their oral health behaviors, oral health care self-efficacy(tooth care, dietary control, regular checkup) and subjective oral health levels are high. Conclusion: It is necessary to try to improve the elderly's oral health levels by motivating the importance of oral health care and changing their oral health behaviors positively with the implement of oral health education on the elderly. Especially, oral health education programs that are operated on the elderly should be planned with practical programs that can cause the change of their oral health behaviors and should be processed to reinforce oral health care self-efficacy. Furthermore, preventive treatments for the elderly such as oral health education, oral examination and scaling should be implemented systematically and continuously by policy.

• 보건행정학회지
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• 제7권2호
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• pp.147-176
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• 1997

This research identifies the most important domains in health care administration from now to the year 2005 and differentiates job skill, konwledge, and ability requirements necessary for successful management. Fellows of the Korean Hospital Association from about thirteen percents of the country responded to mail inquiry. Five of eleven domains, in order of ranked importance, were health care delivery concepts, leadership characteristics, quality management, cost/finance and human resources management. Results indicated that while a business orientation is needed for organizational survival, and equal emphasis on person-oriented skills, knowledge, and abilities is required.

• 가정∙방문간호학회지
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• 제26권2호
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• pp.166-179
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• 2019

Purpose: The purpose of this study was to identify the job performance and educational needs, and recognition of professionalism among care workers, and to organize educational programs according to the priorities of care workers. Methods: The participants were 119 care workers who were working in long-term care facilities. Data were collected from May 31 to June 7, 2019 using self-report questionnaires. Collected data were analyzed using t-tests, ANOVA, and Spearman's Correlation Coefficients. Results: The performance aspects of the job were as follows: care for safety and infection-related, communication and leisure support, and excretion. The most demanded educational needs were in first-aid. Care workers had more than average professional recognition. Job performance and educational needs, and recognition of professionalism differed significantly according to several general characteristics. Conclusions: The educational needs of the areas with low frequency of job performance were high. First-aid is low in frequency, but it is important to cope with emergencies, so it is necessary to continue education. Also, there is a difference in recognition of professionalism according to the career. It will be necessary to develop individualized education programs to meet the needs of care workers.

• 대한약침학회지
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• 제25권1호
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• pp.15-23
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• 2022

Objectives: This study aims to develop a community care model in traditional Korean medicine (TKM) by developing a community care participation model for the health of the elderly and deriving tasks to implement it. Methods: This study implemented a group interview with experts. A fact-finding survey was conducted targeting 16 local governments that are implementing a leading project to identify the status of TKM service provision and welfare service linkage in all regions. An expert group interview (FGI) targeted public and private sector experts for each job role, the former represented by those in charge of the central government's health care policy and administrative delivery system, and the latter by professors majoring in social welfare, professors majoring in health, and local TKM societies. After forming the expert groups, three expert group interviews were conducted. Results: Through collective interviews with experts, a model for providing TKM and welfare services in community integrated care was derived by dividing it into local and central government levels. The strategies and tasks for promoting TKM-oriented health welfare services were derived from 3 strategies, 8 tasks, and 20 detailed tasks. Conclusion: The core direction of the TKM health care model is the region-centered provision of TKM and welfare services. To this end, policy support for the use and linkage of health care service resources is required at the central government level, and linkage and provision of health welfare services centered on TKM are necessary through linkage and convergence between service subjects and between government health care projects.

• 치위생과학회지
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• 제23권2호
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• pp.154-168
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• 2023

Background: Legal regulations and fees have been established in Korea to provide visiting oral health care services to individuals with long-term care insurance (LTCI). However, beneficiaries of this service are very limited. Therefore, to improve the Korean system we propose a comparative analysis with the Japanese system. Methods: This study is a descriptive analysis based on secondary data, such as statistics, laws, and service record forms from Korea and Japan. The most recent institutional documents were obtained through a Google search. The variables investigated were financial resources of LTCI, co-payment structure, monthly limit of LTCI benefits, care levels of LTCI, service providers, service costs, contents of service, and the number of cases of service. Results: In both Korea and Japan, LTCI is financed through a combination of taxes and insurance premiums. However, the monthly limit for receiving LTCI services in Japan is about 2.4 times higher than in Korea. Visiting medical and dental treatment is also possible in Japan. Furthermore, nursing staff can provide daily oral health care services according to dental hygienists' instruction unlike Korea. Oral health care services in Korea are focused on oral hygiene and prevention of oral diseases, while Japan additionally provides oral function screening, patient education for oral health management, and training for nursing staff to enhance oral function, eating, and swallowing of the patients. Conclusion: We concluded that the possibility of visiting dental treatment, differences in monthly limit of LTCI benefits, oral function assessment and guidance, as well as collaboration with other healthcare professionals contributed to the difference in the frequency of utilization of visiting oral health care services between Korea and Japan.

• 보건의료산업학회지
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• 제10권2호
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• pp.71-82
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• 2016

Objectives : This study purposed to analyze the productivity trends of regional health care resource uses in South Korea. Methods : Data was provided from the regional health care statistics by the National Health Insurance Service(NHIS) and collected from 2011 to 2014 at the 226 administrative regions such as Si(city in Korean), Gun(county in Korean), Gu(district in Korean). Productivity trend was analyzed with Malmquist Productivity Index(MPI). Input variables were the number of medical personnels, facilities, and major medical equipments. Output variables were the number of inpatient and outpatients in model A, and the amount of inpatient and outpatient reimbursements in model B. Results : In model A, the productivity of 62 regions were increased but it was decreased in 164 regions. In model B, the productivity of 123 regions were increased but it was decreased in 123 regions. Conclusions : If these trends were continued, there will be problems with the efficiency of national regional healthcare resource utilization. Health policy makers will require to focus in solving this phenomenon.

• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• 부모자녀건강학회지
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• 제5권1호
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• pp.90-100
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• 2002

Web sites on the internet are excellent information resources for the consumers to gain health care knowledge. Especially web sites related to child-care more increase recently. But a concern has emerged for the quality of contents contained on the child-care web sites. Lack of evaluation criteria have led to inaccurate and misleading child-care related publications on the Internet. For evaluating the quality and reliability of child-care related information on the Web, rating tool should be provided and developed. So, this article reviewed and investigated the elements to evaluate child-care sites on the internet. On the basis of the review of articles and the validity test about the contents, 16 preliminary items including purpose, contents, authority, feedback, design developed. Through the pilot study that apply the preliminary evaluating criteria to 20 evaluating criteria for child-care web sites developed. This evaluating criteria have 24 items and that were categorized to purpose(2 items), detail of contents(16 items), authority(2 items), feedback(2 items), design(4 items). The result of this study suggest that the evaluation criteria for child-care web sites may be useful for evaluating the quality of child-care web sites.

• 대한치과기공학회지
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• 제33권4호
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• pp.413-425
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• 2011

Purpose: This study conducted a survey on the elderly with physical debilities, who are in a medically vulnerable social class, to examine closely their demo-sociological characteristics, unmet needs, dental states, and living qualities and satisfaction levels relating to oral health and social supports to them, and also to prepare the basis for effective public medical policies and health improvement programs aimed at improving the quality of life for the elderly with physical debilities. Methods: Twenty-two elderly care facilities within Jeju Special Self-Government Province participated in the survey. Between 11 January and 5 March 2010, a total of 250 elderly persons(65 and over) with physical debilities were interviewed and their dental health was checked. Results: The results of the survey are as follows. The need for social support for dental care of the elderly with physical debilities was high in the medical institution-supported service (49.6%). The unmet needs for physical care were high in bathing (49.6%) and using public transportation (71.6%). More than half of these surveyed had ten or fewer teeth. The survey found that 31.6% of the participants experienced problems eating, due to poor dental health. Concerning quality of life, 30.5% of those surveyed experienced physical pain. Conclusion: In summary, the ages of the survey participants directly relates to the degree of behavioral debility experienced. The more debility a participant exhibits, the greater is the need for social support and dental care. The dental health of a participant directly relates to a higher quality of life. Good dental health of a participant translate to better quality of life. In light of the fact that the elderly with physical debilities suffer from a lack of accessibility to medical care and worse oral health than do other elderly persons, it is essential to increase accessibility to medical institutions that can provide such services as door to door dental care. Current insurance policies, funding for denture insurance, and free denture and denture-upgrade programs desperately need to be expanded. Therefore, to improve effectively the quality of life for the elderly with physical debilities civil dental medical resources should be encouraged to provide inclusive and prevention-focused medical care. In the public domain, door to door dental care services and cooperation with civil dental care resources need to be improved to increase impartial accessibility to dental medical institutions.