• 보건교육건강증진학회지
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• 제16권1호
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• pp.101-126
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• 1999

As the WTO system launches through the agreement of Uruguay Round, the Government has to revise the office regulations or reform the system. Also, Integrating and Coordinating the like affair in health care (i. e., children's home, industry health, school health, health manpower, the administration of health center, the administration on food hygiene, health environmental education, and so on.) which is now scattered into some government departments like the Ministry of Labor, the Ministry of Education, the Ministry of Home Affairs, the Ministry of Agriculture, and the Ministry of Environment, the Government has to prevent unspecialty, inefficiency, inconsistency, and uneconomy. The Government has to review and adopt above suggested the Proposal 1),2),3),4) of the Health Centers on the basis of the local autonomy law and it will help the successive settlement of the local autonomy system in Korea. According to the suggested proposal, the Central Government mainly takes charge of the Macro affairs as hardware, and transfer the Micro affairs as software into the Local Governments to attempt the appropriate functional allocation. To achieve it successfully, the Central Government also has to do the financial support, manpower training and technical support, allocation of health care resources, direction and control, research and development and the health care plan on the macro level. Local Governments which divided into the wide local government and basic local government also have to do their best for health improvement of the community societies like plan of health care program, implementation of health care service program, taking charge of the affairs of health insurance, activation of community residents' participation and security of health care resources etc. To achieve this goal, the Government have to be more active and reformative, the related social and health agencies and educational agencies have to cooperate and support for the goals, and especially, the community residents have to participate actively and voluntarily, When all these conditions promote, local health care administration will be developed, and health level of community residents will be secured. And going one step forward, the country and people will be more healthy

• 보건교육건강증진학회지
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• 제24권4호
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• pp.201-217
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• 2007

This study reviews the amount and expenditures in national health promotion fund from 1997 to 2006, to analyse the problems and provide the future direction of health promotion fund programs. This study suggested the guide for future plans and the scope and contents of health promotion fund programs, priority and fund budgetary allocation, and operation organization. It is needed to revise health promotion law and enforcement decree of the health promotion act. The fund should be used in limited 9 areas related to healthy life activities: (1)Anti-smoking actions, (2)To support activities leading to a healthy life, (3)Public health education and development of materials, (4)Investigation and research regarding community health matters, (5)Public nutrition management activities, (6)Oral health management activities, (7)Physical exercises for health promotion, (8)Foundation related to supporting healthy life style practice society, (9)Expenses necessary for the management and operation of the fund. And also, in order to improve the performance of health promotion, it is considered to reform the operation system including organization.

• 디지털융복합연구
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• 제13권5호
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• pp.227-235
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• 2015

세계적으로 정부 재정에 상당한 영향을 주고 있는 보건의료 비용 문제를 해결하기 위해 m-Health가 등장하였다. 그러나 최근 저조한 m-Health의 결과물들은 m-Health 서비스 개혁의 필요성으로 이어졌다. 따라서 본 논문의 목적은 이와 같은 일환으로 m-Health 환경에서 효율적인 생체 데이터 전송 및 보관을 위한 방안을 제시하는 것이다. 연구방법으로는 생체 데이터를 효율적으로 전송 및 보관할 수 있는 시스템 및 알고리즘을 개발하였다. 분석 결과로 제시하는 솔루션의 효율성을 평가하기 위하여 전송되는 데이터의 압축률을 비교 평가하였다. 그 결과 본 논문의 압축률은 30.4배였다. 본 연구가 제시하는 시스템은 향후 m-Health에서 생체 정보를 모니터링 하는 시스템을 구축하도록 기여할 것으로 전망된다.

• 보건행정학회지
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• 제21권1호
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• pp.132-157
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• 2011

The purpose of this article is to examine the cause of policy non-compliance in the case of pharmaceutical rebates from the perspective of rational choice institutionalism. In Korea, there have been rebates practices between pharmaceutical companies and hospitals since the introduction of the Actual Remuneration System for insured medicine in 1999. The government has chosen the policy means of punishment to eliminate pharmaceutical rebates but the illegal practices are still widespread. Institution in rational choice institutionalism usually reflects the incentives and preferences of actors, and the Actual Remuneration System has resulted in a the lack of procedures to ensure savings on drug expenditures. Pharmaceutical rebates are the product of the institutions which reflect their incentives: the Actual Remuneration System, the current pricing policy for generic drugs, the drug distribution system, and so on. In the end, the problem of the rebates is the consequence of policy non-compliance as actors' rational choice because their incentives lead to opportunistic behaviors. We should therefore understand the incentive structure of policy stakeholders, which is derived from the view of new institutionalism; also, the newly designed Korean drug pricing policy reform must be compatible with the incentive structure.

• 한국의료질향상학회지
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• 제19권2호
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• 한국직업건강간호학회지
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• 제16권2호
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• pp.222-231
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• 2007

Purpose: This study aims to suggest political alternatives for nursing care costs for PCAs to provide qualitative medical benefit for patients with occupational disease by investigating present situation and problems of the nursing care cost system of Korea's Industrial Accident Compensation Insurance. Methods: Data was collected from 6 workers' accident medical corporation and 275 nurses affiliated with Korea labor welfare corporation using self reported questionnaire. Result: Research results were as follows; Character of nursing care cost of the Korea's Industrial accident Compensation Insurance changed as if it aims to support for living expenses for the family; As possible problems which could be caused under current system, administrative problems, decrease of service quality were made as objects of criticism. Some patients did not make every effort in rehabilitation to be beneficiaries continuously. Some patients were supplied with whole one PCA or all-night PCA even though they did not need as much caring as such. Conclusion: The research suggested that PCAs payment system improvement is necessary, and the presented nurses' opinion for the improvement method could be applied for policy making.

• 의학교육논단
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• 제24권1호
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• pp.10-17
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• 2022

South Korea is not a wasteland of publicly funded health care-instead, it has a good medical social security system known as the national health insurance (NHI). The NHI of Korea has three unique features; (1) low premiums, low insurance fees, and low coverage; (2) obligatory designation of medical institutions; (3) and allowance of non-benefit services. These features have made hospitals and doctors interested in profit-seeking. However, the commercialization of medical institutions has taken place in both private- and public-established sectors. A basic problem of commercialization is the co-existence of the obligatory designation of medical institutions and non-benefit services. The problem became worse in the Kim Dae-Jung government because it officially permitted non-benefit services. Since 2000, the Korean government has consistently pursued benefit extension policies, but the coverage rates of the NHI have stagnated. In addition, premiums and current medical expenses have markedly increased because policy-makers have emphasized accessibility to the NHI, while ignoring important principles of medical social security such as a needs-based approach and patient-referral system. In order to resolve the commercialization problem, the obligatory designation of medical institutions to the NHI should be changed to a contract system, and non-benefit services should be prohibited at NHI institutions. We must re-establish the patient-referral system via a needs-based approach. We also need to build a primary healthcare system and public health policies. We should make a long-term plan for healthcare reform.

• 간호행정학회지
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• 제17권2호
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• pp.147-157
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• 2011

Purpose: This study was done to investigate factors affecting perceived financial burden of medical expenditures. Method: The participants were 2,024 inpatients who were enrolled in a survey on the benefit coverage rate of the National Health Insurance in 2006. The collected data were analyzed using t-test, ANOVA-test, Mann-Whitney-test, Kruskal-Wallis-test, Chi-square test and logistic regression. Results: The crucial factors for perceived financial burden were age, job, equivalence scale, ratio of annual family income vs medical expenditure, and private health insurance. Perceived financial burden was higher for people who were older, who were unemployed, whose medical expenditures were high compared to annual family income, whose index of family equalization was low and for those who had no private health insurance. Conclusion: The results of the study indicate a demand for system reform that will enable management of no-pay hospital bills in the National Health Insurance to decrease the medical expense of people in the low-income bracket.

• 지역사회간호학회지
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• 제33권2호
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• pp.175-187
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• 2022

Purpose: This study was conducted with a focus group interview that drew out experiences, limitations, and difficulties in the workplace according to the employment conditions of visiting nurses in the public health centers. Methods: A total of 12 visiting nurses are those working in the public sector in Seoul and Gyeonggi province who were willing to participate in the interview. Analysis categories and coding were divided into three categories: compensation system, occupational status, and opinions to improve their treatment. Using the content analysis method, the current working status and compensation system of visiting nurses were described. Results: The main themes derived from the significant statements of visiting nurses were 'Ten years of frozen salary system', 'Full-time workers of their own league', 'Excluded from performance benefits', 'Every visiting nurses are virtually precarious', 'Experience of exclusion and discrimination', and 'Reasons and barriers to be a full-time worker'. All of the visiting nurses working in the community insisted on having equal treatment for work of equal value. Visiting nurses in the public health sector wanted to be set to the same payment system and the fair allowance system as well. It is necessary to continuously seek solutions to the problems left in insisting on the civil service of visiting nurses. Conclusion: Visiting nurses who were working in a precarious job position felt job insecurity, and experienced discrimination, alienation, and exclusion. Legal and institutional reform is needed to improve the treatment of visiting nurses.

• 대한간호학회지
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• 제24권2호
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• pp.313-318
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• 1994

To build a suitable National Health Care System for the coming 21s1 century, Nursing must also be renewed. The future Korea will be united and the majority of its population will raidly consist of the aged. Economically standing on the same level with developed countries the growth of scientific technologies will foster communications, firing astounding changes in the medical field. While the overall life style pattern of Koereans not to mention the structure of diseases undergo change, the possibility that the reckless induction of high-tech health care may only cause medical fees to eascafate. It can전so be expected that the health care system will evolve towards the consumers. Nursing in the 21s1 century will be of two scenarios according to WHO, which presents the role of the nurse. The first scenario is that "a gen-eric health care work force" namely a "care giver" will replace all other health professions. If Nursing does not become the compatent profession fitting to this purpose it will eventually dei out. The second scenario is that nurses who are educated in a well grounded and extensive general background and have command of a specialized area will undertake services varying from health pro-motion to treatment and rehabilitation both direct and indirectly, while supervising other personnel. The nurse here would become the "care giver". To become the necessary health care profession in the 21s1 century, nurses should be provided with more educational opportunities, variating in its con-tents, course, and system, enabling them to grow. Clair Faign points out that the minimal educational entry for the nursing profession is a 4 year undergraduate education in this aspect, now in the time to set the future of Nursing into the course of the first scenario. A new educational system stipulating a baccalaureate nursing degree is in urgent need, and aside from govermental actions nurse themseives should formaily officiallze this process, striving for quality assurance. While considering 6 years nursing education programs, multifarious degree courses for existing 3 years educated nurse should be provided Junior nursing schools must devise measures to grow into baccalaucate institutions, also. Among the existing courses, the Self Study Degree Program should be converted into RN, BSN courese provided by universities, and clinical training for the University on the Air must be supplimented, The possibility of establishing nursing courses into commercial high school programs only jeopardizes the development of the nursing profession.