• YAKHAK HOEJI
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• v.52 no.2
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• pp.160-164
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• 2008

This study investigated the current status and drug expenditure of the drug shortage prevention program in Korea. National health insurance claims data from 2001 to 2005 were analyzed for the drugs with inadequate supply, which were designated as shortage prevention drugs (SPDs). Drug use of SPDs have increased every year, but the average increase rate of drug expenditure for SPDs, 13.5% was lower than that for all the reimbursed drugs, 18.6%. Drugs with price increase based on production cost were more actively used than drugs with prescription incentives for doctors.

• Journal of Korean Public Health Nursing
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• v.31 no.3
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• pp.567-581
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• 2017

Purpose: The purpose of this study was to develop a Health Mileage Program (EHMP) to promote exercise amongst the elderly and assess the feasibility of the program. Methods: A literature review to identify the effects of exercise in the elderly was conducted. Relevant cases were investigated and in-depth interviews with exercise instructors were conducted, after which the EHMP was developed based on the assessment and tested in three regions. The outcome was evaluated using indicators such as attendance rate, number of participants, proportion of participants who received health education, and proportion of participants who measured their physical and mental status. Results: Based on assessment, we developed an EHMP composed of four steps. Following application of the EHMP in three regions, ${\geq}80%$ of the participants received incentives. Additionally, ${\geq}85%$ of participants underwent measurement of their physical and mental status. The proportion of participants who received health education differed among regions. Conclusion: The EHMP program increased participation and interest in exercise programs for the elderly. However, there is concern regarding availability due to regional differences in resources related to elderly exercise; therefore, it will be necessary to invest in infrastructure, including facilities, and knowledgeable instructors.

• Journal of the Korean Society of Safety
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• v.20 no.1 s.69
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• pp.143-147
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• 2005

Immediate responsibilities for occupational health and safety (OHS) management reside in business proprietors and supervisors whose voluntary participation in OHS educational programs, not legal sanctions, may thus lead to safe and pleasant work environments. This study investigates how to promote the effectiveness of OHS educational programs to draw voluntary participations in such programs in Korea To this end, drawbacks of current practices in OHS education are first analyzed, and then OHS related policies in advanced countries in the area of disaster prevention such as United States and Germany, are also scrutinized. Based on the preliminary investigations, the following propositions are made to lay out the foundation for promoting effective OHS educational programs in Korea: improvement of government regulations, revitalizing job training initiatives, on-site OHS education, compensation and incentive programs for OHS education. These propositions may also facilitate the deployment of disaster prevention activities across the organization and prevent various occupational disorders (for example, musculoskeletal disorders). This study emphasizes that monolithic OHS education systems led by regulatory agencies may not be efficient to ensure healthy and safe work environments. Globally competitive OHS educational systems may be established only when they are based on the health and safety requirements specified by proprietors and workers.

• Research in Community and Public Health Nursing
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• v.26 no.4
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• pp.405-414
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• 2015

Purpose: The purposes of this study were to examine the effects of home visit healthcare using a complex program on community-dwelling frail elders' physical strength, frailty, and depression and to compare the effects among three regions. Methods: This study was conducted as a quasi-experimental study using one-group pretest-posttest design. A total of 86 subjects were sampled from three regions (metropolis, small city, and rural area). The program was applied for 14 weeks. This program consisted of disease management by a visiting nurse, exercise with a visiting nurse, self exercise, telephone monitoring, health education, counseling, providing handbook, and incentive. Physical strength was measured by balance, upper-limb, and lower-limb muscle strength. Frailty was measured by the Korean Frail Scale and depression was measured by the Geriatric Depression Scale. Paired t-test and ANCOVA were used to analyze the effects. Results: Physical strength, frailty, and depression were significantly improved after applying the complex program. There were not differences among the regions. Conclusion: Home visit healthcare using a complex program was effective in improving frail elders' physical strength, frailty, and depression. There were not differences among the regions. Therefore, home visit healthcare using a complex program needs to be expanded to other regions.

• Journal of Korean society of Dental Hygiene
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• v.15 no.3
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• pp.513-521
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• 2015

Objectives: The purpose of the study was to investigate the correlation between health behaviors and experiences of oral diseases in Korean adolescents. Methods: This study used the results of the seventh, eighth, and ninth adolescent health behavior online survey which was completed by a self-administered questionnaire targeting 222,264 middle school and high school students in September, 2011, June, 2012, and from June to July, 2013. The questionnaire consisted of four questions of socio-economic characteristics of the subjects, three questions of health behaviors, and four questions of eating habits. Data were analyzed by SPSS 18.0 program. Results: Oral health knowledge and behaviors were closely correlated to smoking, alcohol drinking, and toothbrushing after meal. Liking for fruit, soda, snack, and vegetable had a significant influence on oral diseases. Smoking and alcohol drinking had a significant relation to oral disease prevalence rate. Conclusions: In Korea, the prevalence rate of oral diseases is still high in the adolescents. Therefore, continuous dental health education program is very important to decrease the oral disease morbidity. The incentive program for the adolescents will improve the concern for the oral health.

• Health Policy and Management
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• v.23 no.4
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• pp.427-433
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• 2013

Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.127-136
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• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• Health Policy and Management
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• v.17 no.2
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• pp.68-90
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• 2007

Nurse staffing level is an important factor that influences the quality of health service and patient outcomes. This study was carried out to examine the current state of acute hospital nurse staffing and find out factors that affect the nurse staffing level. Nurse staffing of individual hospitals was measured using the number of registered nurses per 100 beds. Descriptive and multiple regression analyses were conducted using 592 acute care hospitals' data. Regression model included structure factors such as referral level, ownership, medical and general staffing, and financial outcome factors such as occupancy rate, inpatient and outpatient revenues. Market characteristics included strength of competition, supply of nurses, and income and health status level of consumers. The average number of nurses per 100 beds was 28 and showed a great variation according to the referral level. Regression model explained this variation as much as 76.87%. Hospital structure variables which affecting the hospital nurse staffing level positively were ICU bed ratio, the staffing level of specialist, training doctor and employees except doctor and nursing personnel, while the negative factor was nurse aid staffing level. General hospitals employed more nurses than hospitals. Among outcome characteristics, occupancy rate and the amount of health insurance inpatient revenue affected positively on the hospital nurse staffing level. The more supply of the new nurse and the higher consumer income and health status in the medical service markets, the more nurses were employed by the medical institutes. According to the study result, hospitals employed more nurses when they had more financial incentive by increasing nurses. This means appropriate hospital incentive policy and regulation policy, which hospital violate nurse staffing level have to pay penality, should be needed. Clarifying job description between nurses and nurse aids and the reentry program for unemployed experienced nurses will be helpful to increase nurse staffing level.

• Health Policy and Management
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• v.23 no.1
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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.

• Journal of Korean Public Health Nursing
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• v.34 no.2
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• pp.182-197
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• 2020

Purpose: This study undertook to qualitatively investigate the operation status, support requirements and improvement plans for establishing an appealing dementia rest area in Gyeongsankbuk-do. Methods: Data were collected from May 1 to June 20, 2019, using participation observation and in-depth interview of 8 health professionals, and were subjected to qualitative analysis. Results: Our analysis revealed 4 themes and encompassing 16sub-themes: 1) program operation status (hard to prepare and operate programs, difficulty adjusting the program level, various needs of program participants, lack of mutual understanding among program participants); 2) policy support needs (need for assistants staff and basic education, requirement of extensive training for the main operators, support program aid equipment, incentive payments and performance reflections); 3) project operation's improvement plan (improved the operation of doubles classes, improved of training materials for the main operators, improved program activities and workbooks, Increasing the number of dementia rest areas); 4) positive effects and changes (positive effects of specialized projects, changes in perceptions of dementia, strengthening community awareness through doubles classes, synergy effect on community health care post awareness) Conclusion: We believe the current study results can be applied as basic data for establishing a new model, and will positively impact the national dementia management project.