• 제목/요약/키워드: Health system reform

검색결과 121건 처리시간 0.03초

국외근로자 비과세제도 개선방안 연구 : 국제선항공승무원을 중심으로 (A Study on the Improvement Plan of the Tax-Free System for Overseas Laborers : Focusing on International Air Crew)

  • 이기일;김수련
    • 한국항공운항학회지
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    • 제23권3호
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    • pp.42-52
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    • 2015
  • Since the tax-free system for overseas laborers was implemented in 1974, the tax-free limits of international air crew, overseas construction workers and crewmen of deep-sea fishing ships and ocean-going ships had been identical by 2005, but there are big differences, currently. The Ministry of Strategy and Finance pointed out the poor working environments and international competitiveness of the industries to explain the reason for the differential tax-free limit. From this perspective, the fairness of the tax-free system for overseas laborers was analyzed. This is an empirical study, based on the objective fact. The study finding showed that international air crew were working in the structural flight work environments to threaten the right of health due to jet lag and excessive exposure to high-altitude cosmic radiation. Therefore, it was analyzed there should be a proper system reform to apply the tax-free limits to international air crew which are identical to those applied to overseas construction workers and crewmen of deep-sea fishing ships and ocean-going ships, for a fair taxation.

보편적 건강보장을 향한 노정 : 베트남 보건의료 부문의 역사·문화적 맥락을 중심으로 (The way to achieve Universal Health Coverage: Focusing on the Historical and Cultural Context of Health Care Sector in Vietnam)

  • 백용훈
    • 동남아시아연구
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    • 제28권1호
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    • pp.173-218
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    • 2018
  • 본 연구는 지속가능개발목표(Sustainable Development Goals) 하에 보편적 건강보장(Universal Health Coverage) 달성을 목표로 전 국민의 건강보험 가입을 추진하고 있는 베트남의 보건의료 부문에 주목하여 보건의료 체계와 건강보험법의 개혁 과정에서 나타난 특징을 역사 문화적 맥락을 통해 파악해보고 개발의 관점에서 그 함의를 살펴보고자 한다. UHC의 세 가지 차원, 즉 인구 집단에 대한 보장성 확대, 다양한 의료서비스 제공, 그리고 재정적 보호를 기준으로 베트남 보건의료 부문의 현황을 요약하면 다음과 같이 정리할 수 있다. 첫째, 2015년 발효된 개정 건강보험법에서 가구 단위의 의무 가입과 그에 따른 건강보험료 정산 방식이 새로운 제도로 시행되고 있다는 점이다. 둘째, 1차 의료시설, 즉 사($X{\tilde{a}}$, Commune)급 단위의 보건소를 중심으로 예방 및 건강관리 서비스를 제공할 수 있는 의료 네트워크가 구축되어 있다는 점이다. 셋째, 의료보험법 및 다양한 제도 시행 이후 공공 지출이 증가하고 민간 지출이 감소하고 있지만 여전히 본인부담 의료비 지출(Out-of-Pocket Expenditure)이 많은 비중을 차지하고 있다는 점이다. 베트남의 사회건강보험 개혁은 현재 과도기이다. 따라서 베트남은 보건의료 체계와 건강보험 제도를 어떻게 구축해 나갈 것인가에 대한 문제가 더욱 중요할 수밖에 없는 시기적 상황에 당면해 있다. 제도와 체계에 대한 개발은 효율성보다는 그것을 고스란히 감당해내야 하는 주체, 즉 해당 사회의 구성원들에게 적절하고 정당한 방식으로 설계되어야 한다. 본 연구는 제도와 문화, 즉 제도를 공유하는 사회적 가치, 가족 문화 그리고 비공식적인 제도 등과의 상호작용 등으로부터 그 함의를 이끌어내고자 하였다.

건강보험 청구 질병코드와 퇴원손상환자심층조사 질병코드 비교 연구 (A Comparative Study of the Disease Codes between Korean National Health Insurance Claims and Korean National Hospital Discharge In-Depth Injury Survey)

  • 배순옥;강길원
    • 보건행정학회지
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    • 제24권4호
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    • pp.322-329
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    • 2014
  • Background: As most of people in Korea are covered by National Health Insurance (NHI), the disease information collected in NHI provides high availability for health policy. Nevertheless, the validity of disease codes in NHI data has been controversial till now. So we tried to evaluate the validity of them by comparing the NHI claims data with Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) data. Methods: We compared the NHI patients sample data (2009) with the KNHDIIS data (2009). We selected the inpatient data of KNHDIIS and NHI patients sample. The weighted number of patients from NHI patients sample was 5,551,210 and the number of patients from KNHDIIS was 5,559,874. We classified the disease codes into principal diagnoses and other diagnoses, and we compared as one, two, three unit level. Also we calculated the agreement rate of each of them. Results: In the comparison of principal diagnoses, NHI claims data had more C code than KNHDIIS data did, whereas KNHDIIS data had more Z code than NHI claims data did. In the comparison of other diagnoses, NHI claims data had 2, 3 more codes than KNHDIIS data did. The overall agreement rate at three unit level was 76.5% in principal diagnoses and 46.8% in other diagnoses. Conclusion: Considering the large difference between the two data, the validity of disease codes in NHI Claims data seems to be low. To increase the validity of them, the definite detail coding indicator, the reinforcement of coding education, and the reform of system are needed.

Challenges and opportunities in integrating complementary and alternative medicine into mainstream of the Malaysian healthcare system

  • Tahir, Nurul Ain Mohd;Thomas, Paraidathathu;Li, Shu Chuen
    • 셀메드
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    • 제5권4호
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    • pp.23.1-23.6
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    • 2015
  • Complementary and alternative medicine (CAM) practice is still popular among the Malaysian population nowadays although western or allopathic medicine is the first line of treatment. Dissatisfaction with health services and therapeutic effects of western medicine or preference for holistic, integrative approach in treatment are common reasons favouring the increasing popularity of CAM practices. The efforts toward integration of CAM and western medicine in Malaysia were rather slow and in a piece-meal fashion. Strategic efforts in strengthening government and self-regulation among practitioners, formalizing education, promoting research, and cultivating national and international networks are necessary to achieve an integrative system. Regulations to restrict the practice and sale of CAM products to licensed practitioners, strict and mandatory registration of the practitioners, inclusion of CAM in essential medicines list, and pricing regulations must be comprehensively discussed. Development of curriculum, offers of scholarship and incentives, promotion of courses and seminars for professionals is necessary to increase the numbers of CAM experts. Malaysia should follow the efforts of other countries on the production and documentation of local CAM data, allocation of funding, and establishment of research centres to assess the efficacy of potentially useful local products. Local and international collaboration in research and continuous education is important for exchange of knowledge and skills. In conclusion more coordinated efforts in regulation of CAM practice and products, formalizing CAM training and education would significantly move the process forward and allow the public to enjoy more health benefits from CAM practice in Malaysia.

안경사 인력 수급 및 관리제도 개선방안 (The Improvement Proposal of Control System for Supply and Demand of Korean Optometrist)

  • 김상현;임용무
    • 한국안광학회지
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    • 제12권4호
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    • pp.9-14
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    • 2007
  • 본 논문에서는 매년 증가되는 안경광학과 입학정원 증가에 따른 문제점들을 연구하였다. 주된 문제는 안경사 인력의 과잉공급과 열악한 근무환경에 기인하며 이를 해결하기 위해서는 안경사 인력의 수적 불균형을 해소하겠다는 관계자 모두의 공통된 정책적 시각을 가져야 한다. 또 보건의료 인력의 수요와 공급을 예측하고 정확한 정책을 수립하기 위해서는 보건의료 인력개발을 담당할 상설기구와 중장기적인 계획이 필요하다. 안경사 인력의 질적 불균형의 해소를 위해서는 정확한 직무 영역을 설정하고 전문교육과정을 재편하며 국가고시 실기평가의 방법을 구체화하며 보수교육의 내용과 방법을 혁신해 가야 한다.

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보건의료인을 위한 약물감시교육의 해외 동향 및 국내 현황 (Educating Healthcare Professionals in Pharmacovigilance: Global Trends and Korea's Status)

  • 박소희;정규혁;박병주;강동윤;신주영
    • 의학교육논단
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    • 제22권1호
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    • pp.32-45
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    • 2020
  • This narrative review introduces global trends in pharmacovigilance (PV) education for healthcare professionals and the status of PV education in Korea. Proactive participation of healthcare professionals, including physicians, pharmacists, and nurses in reporting suspected adverse events is the main driving force for effective operation of the spontaneous adverse event reporting system database, which in turn facilitates early safety signal detection of otherwise unknown suspected adverse events. The World Health Organization recognizes PV education curriculum as a key aspect in promoting awareness of PV and adverse event reporting among healthcare professionals, and multiple studies have demonstrated that PV educational interventions for healthcare professionals have increased overall adverse event reporting. Considering the global trends in PV education, the curriculum in Korean universities still has room for improvement in promoting PV obligation among future healthcare professionals. Further research is needed to develop PV education curriculum. We suggest a three-step project for innovating PV education in Korea to meet the global PV educational standards: a survey to gauge current PV competencies among healthcare professionals, reform of current PV academic curriculum, and evaluation and fine-tuning of the reformed curriculum.

미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰 (Nurse Practitioner Roles and Curriculums in the United States)

  • 이선옥
    • 한국간호교육학회지
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    • 제5권1호
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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토픽 모델링을 이용한 국내 포털사이트 방문간호 기사 내용 분석: 코비드-19 이전과 이후 비교를 중심으로 (Analysis of the Contents of Visiting Nursing Articles on Domestic Portal Sites Using Topic Modeling: Focusing on the Comparison Before and After Coronavirus Disease)

  • 임지영;이미진;김근면;이옥균
    • 가정∙방문간호학회지
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    • 제30권2호
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    • pp.141-154
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    • 2023
  • Purpose: This study aimed to explore the social perception of visiting nursing before and after coronavirus disease (COVID-19). Methods: This survey-based study used online big data for comparative analysis by classifying the keywords related to visiting nursing searched on domestic portal sites before and after COVID-19. Results: According to the results of analyzing the Intertopic Distance Map based on Latent Dirichlet Allocation in this study, four topics were extracted, two each before and after COVID-19. The first topic before the COVID-19 period was termed "the expansion of visiting nursing subjects and services visiting nursing," while the second was termed "visiting nursing," which is related to customized welfare. The first topic after the COVID-19 period was termed "the suspension and resumption of visiting nursing services," while the second was "the development of a non-face-to-face home visit healthcare system". Conclusion: The results of this study can be used as useful reference data to contribute to future medical service delivery system reform policies starting at the end of COVID-19 and the revitalization of community care for visiting nursing.

Delayed Presentation of Self-discovered Breast Cancer Symptoms in Iranian Women: A Qualitative Study

  • Khakbazan, Zohreh;Taghipour, Ali;Roudsari, Robab Latifnejad;Mohammadi, Eesa;Omranipour, Ramesh
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9427-9432
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    • 2014
  • Background: Delayed presentation of symptomatic breast cancer is a public health issue in Iran, making a major contribution to low survival. Despite the importance of this problem, current knowledge is insufficient to inform interventions to shorten patient delay. The aim of this study was to explore factors influencing patient delay in Iranian women with self-discovered breast cancer symptom. Materials and Methods: This qualitative study was conducted during 2012-2013. Purposeful sampling was used to recruit 20 Iranian women with self-discovered symptoms of breast cancer who attended the Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. Data were collected through semi-structured in-depth audiotaped interviews, which were transcribed and analyzed using conventional content analysis with MAXqda software version 10. Findings: Content analysis of the data revealed four main themes related to the delay in seeking medical help including: 1) attributing symptoms to the benign conditions; 2) conditional health behavior; 3) inhibiting emotional expression; and 4) barriers to access to health care systems. Conclusions: These results suggest that patient delay is influenced by complex and multiple factors. Effective intervention to reduce patient delay for breast cancer should be developed by focusing on improvement of women's medical knowledge, managing patients' emotional expression and reform of the referral system.

의료지리학: 개념적 역사와 역사적 전망 (Medical Geography: Its Conceptual History and Historical Vision)

  • 이종찬
    • 대한지리학회지
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    • 제48권2호
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    • pp.218-238
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    • 2013
  • 한국 지리학계에서 보건의료에 대한 지리학적 연구가 증가되고 있는 양상에 비추어 볼 때, 의료지리학이 개념적으로 어떻게 발달해왔는지에 대한 역사적인 인식이 요청된다. 이 글의 목적은 의료지리학의 개념적 역사를 탐구하고 향후 의료지리학의 역사적 전망을 제시하는 데 있다. 근대 의료지리학은 유럽이 열대 식민지를 통치하는 과정에서 필연적으로 직면하게 되었던 열대 질병을 통제하는 과정에서 의료지형학의 이름으로 형성되었다. 영국에서는 환경위생 개혁의 명분으로, 프랑스에서는 문명화 사명의 구호 아래, 독일에서는 지리의학의 개념으로 각각 발달해왔던 의료지리학은 20세기에 크게 질병 생태학과 의료체계의 두 가지 흐름으로 발달되었다. 본 논문은 질병의 지도에 함축된 권력의 의미를 강조하면서, 의료지리학, 보건지리학, 건강지리학의 공통 지점과 서로 다른 지향점을 제시하였다는 데 의의가 있다.

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