• Health Policy and Management
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• v.27 no.4
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• pp.324-335
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• 2017

Background: The aim of this study is to analyze determinants of welfare attitudes toward healthcare services in South Korea, using three main theories: self-interest (positive welfare attitudes if the policy fulfills people's personal interests), symbolic attitudes (positive welfare attitudes if the person is politically progressive or egalitarian), and sociotropic perception (positive welfare attitudes if the person experienced positive aggregated collective experiences of societal events and trends regarding the policy). Although the definition of the welfare attitude is rather ambiguous in literatures, in this investigation, we operationalize the concept as the 'willingness to pay higher taxes to improve the level of health care services for all people in Korea' which shows individuals' actional propensity. Methods: We used the health module from the International Social Survey Program 2011 for the analysis (N= 1,391). Five logistic regression models were built successively using two variables for each theory to measure key concepts of self-interest, symbolic attitudes, and sociotropic perceptions as independent variables. Results: The result showed self-interest and symbolic attitudes factors to be strong determinants of welfare attitudes towards healthcare services in South Korea, whereas sociotropic perception factors have inconsistent effects. Conclusion: For a more politically elaborated healthcare reform in South Korea and elsewhere, there needs to be further research on various dimensions and determinants of welfare attitudes to understand popular basis of welfare expansion, especially in the era of inequality.

• Health Policy and Management
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• v.20 no.1
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• pp.137-154
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• 2010

This study empirically analyzed the effects of the Top Management Team (TMT) on organizational performance. We verified whether the age heterogeneity, job heterogeneity (core career, core function and major), and process (communication and integration) of the TMT affect organizational performance (management performance and healthcare service quality evaluation level). We collected data about 473 members of the 2006 TMT in 81 medical institutions. We also utilized statistics of organizational performance from the Ministry for Health, Welfare and Family Affairs and the Korean Institute of Hospital Management. Results of the study showed that the age heterogeneity of TMT exerted a negative effect on the healthcare service quality evaluation level, while the process exerted a positive effect. However, the age heterogeneity, job heterogeneity, and process had no influence on management performance. We discussed the implications of such outcome of the investigation in comparison with the former studies on TMT and organizational performance, and presented its restrictions and future plans.

• Health Policy and Management
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• v.33 no.2
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• pp.203-213
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• 2023

This study examined the trend of healthcare status and compared the status of South Korea and other member of the Organization for Economic Cooperation and Development (OECD) using the OECD health statistics 2022. We used the OECD health statistics from 2022 and a position value for relative comparison (PARC) index to compare the five elements of the healthcare system. The study also used a Mann-Kendall test to analyze the trend of the PARC values from 2000 to the present year. The findings of the study indicate that many South Korea's PARC values were higher than the OECD median. But practicing physician in supply part and medical cost were lower than OECD median but the trend significantly increased. Medical accessibility part and quality of care part except primary care, and mental health had a high relative position but the trend did not increased significantly. After outbreak of coronavirus disease 2019, there were changes in medical accessibility. Health screening and vaccinations showed an overall decline in 2020 compared to 2019. These results suggest that policymakers need to take necessary steps for a sustainable healthcare system in the country.

• Health Policy and Management
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• v.34 no.1
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• pp.4-16
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• 2024

Smart hospitals involve the use of recent ICT (information and communications technology) technologies to improve healthcare access, efficiency, and effectiveness. Standardization in smart hospital technologies is crucial for interoperability, scalability, policy formulation, quality control, and maintenance. This study reviewed relevant international standards for smart hospitals and the organizations that develop them. Specific attention was paid to robotics in smart hospitals and the potential for standardization in this area. The study used online resources and existing standards to analyze technologies, standards, and practices in smart hospitals. Key technologies of smart hospitals were identified. Relevant standards from ISO (International Organization for Standardization) and IEC (International Electrotechnical Commission) were mapped to each core technology. Korea's leadership in smart hospital technology were highlighted. Approaches for standardizing smart hospitals were proposed. Finally, potential new international standard items for robotics in smart hospitals were identified and categorized by function: sampling, remote operation, delivery, disinfection, and movement tracking/contact tracing. Standardization in smart hospital technologies is crucial for ensuring interoperability, scalability, ethical use of artificial intelligence, and quality control. Implementing international standards in smart hospitals is expected to benefit individuals, healthcare institutions, nations, and industry by improving healthcare access, quality, and competitiveness.

• Health Policy and Management
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• v.22 no.4
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• pp.696-702
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• 2012

The purpose of this study was to evaluate the improvement of disabled access to healthcare institution located in Jongno-gu, Seoul in 2011 compared to 2003 since disabled access has been mandatory in healthcare institutions located in new buildings by the amended law in 2004. We had investigated 10 assessment items for disabled access in 166 healthcare institutions located in Jongno-gu, Seoul and the results were compared with those of 2003 survey. On average, 74.1% of the healthcare organizations has equipped with items for disabled access. However the adequately equipped rate for those items was only 39.2%. Compared with the results of 2003 survey, these rates showed a little increase by 4.1% and 8.0%, respectively. There were only 10 healthcare institutions located in new buildings which were constructed after July, 2005. Their average equipped rate(84.4%) and adequately equipped rate(46.8%) were higher than those of the other organizations because the Korean government ruled that healthcare institutions in new buildings must have facilities for the disabled. In conclusion, we confirmed that the accessibility of the disabled to healthcare institution slightly increased. In particular, the healthcare institutions in newly constructed building showed the significant increase of accessibility of the disabled. However, it is founded that disabled access is still not enough for the disabled.

• Health Policy and Management
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• v.34 no.3
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• pp.334-346
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• 2024

Background: Research on the link between subjective health and unmet healthcare needs is limited. This study examines whether experiences of subjective healthcare needs and unmet needs are related to subjective health in South Korea, where the rate of poor subjective health is notably high. Methods: This analysis utilized data from the Korea Health Panel (2014-2018), incorporating 68,930 observations from 16,535 adults aged 19 or older. The dependent variable, subjective health, was dichotomized into poor (bad or very bad) and non-poor (fair, good, or very good) categories. The primary variables of interest were the experiences of subjective healthcare needs and unmet needs, while control variables included 14 socio-demographic, health, and functional characteristics. The study employed population proportion analysis and multivariable two-level binary logistic regression analysis for each gender, accounting for the complex sampling design. Results: In 2018, the rate of reporting poor health was 8.7% (95% confidence interval [CI], 8.0%-9.5%) for men and 14.7% (95% CI, 13.8%-15.6%) for women. For both genders, compared to individuals whose healthcare needs were met, those without healthcare needs were less likely to report poor subjective health (adjusted odds ratio [AOR], 0.58; 95% CI, 0.39-0.86 for men; AOR, 0.59; 95% CI, 0.37-0.93 for women). Conversely, individuals whose healthcare needs were not met were more likely to report poor subjective health (AOR, 2.31; 95% CI, 2.01-2.65 for men; AOR, 2.19; 95% CI, 1.98-2.43 for women). A policy simulation indicated that reducing the experience of subjective healthcare needs would be approximately 5 times more effective in reducing poor subjective health than a policy focused on reducing the experience of unmet needs. Conclusion: South Korea must make significant efforts to reduce the deterioration of subjective health and promote appropriate healthcare utilization. To achieve this, a set of policies is recommended to address subjective healthcare needs. These policies should include (1) prompting individuals to proactively manage their own health, (2) providing primary healthcare similar to that in advanced countries, (3) ensuring the healthcare delivery system operates effectively, (4) decentralizing the healthcare management system, and (5) reducing the likelihood of people being misled into thinking they have a healthcare need.

• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• Journal of The Korea Institute of Healthcare Architecture
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• v.23 no.3
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• pp.57-69
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• 2017

Purpose: This study aims to emphasize interrelation between healthcare policies, design standards and hospital architecture of the United States since 1950s; to examine spatial characteristics of inpatient care facilities through case studies; and to consider the social implication of these spatial changes. Methods: In this study, reviewing the overall healthcare system, design standards and inpatient care facilities of the United States since 1950s, a total of five inpatient care facilities, one for each period, were selected in order to analyze the spatial characteristics. The spatial maps of Space Syntax were employed for analyzing five case studies. Results: The distance between the nursing station, the support service, and inpatient room were getting closer. The spatial structure of inpatient care facilities is transformed from tree structures to annular tree structures. This result shows that the efficiency between patient, staff and support service is higher and the depth of the spaces is getting deeper, which indicates that efficiency for improving healthcare quality affect the spatial structure of inpatient care facilities. Implications: In the future, if Korea's health policy is changed to a demand-oriented health care policy, this conclusion predicts medical planning of hospital will be focused on the efficiency.

• Health Policy and Management
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• v.31 no.4
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• pp.491-507
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• 2021

Background: This study aims to measure regional healthcare differences in Korea, and define relatively underserved areas. Methods: We employed position value for relative comparison index (PARC) to measure the healthcare status of 250 areas using 137 indicators in five following domains: healthcare demand, supply, accessibility, service utilization, and outcome. We performed a sensitivity analysis using t-SNE (t-distributed stochastic neighboring embedding). Results: Based on PARC values, 83 areas were defined as relatively underserved areas, 49 of which were categorized as moderate and 34 as severe. The provincial regions with the most underserved areas were Gyeongbuk (16 areas), Gangwon (13), Jeonnam (13), and Gyeongnam (12). Conclusion: This study suggests a relative comparison approach to define relatively underserved areas in healthcare. Further studies incorporating various perspectives and methods are required for policy implications.

• Health Policy and Management
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• v.31 no.1
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• pp.56-64
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• 2021

Background: Despite the high life expectancy, the subjective health status of the elderly people in Korea is reported to be the lowest as compared to other age groups. The purpose of the conducted study was to identify the factors related to the subjective health status of elderly people aged over 65 in Korea. Methods: This study used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2017) of the Korea Disease Control and Prevention Agency. The subjects of the study were selected to be 2,904 elderly people aged over 65. The factors that were selected related to subjective health status were socio-demographics, perceived diseases, health behaviors, and mental health. Results: As a result of the examination of the subjective health status according to the characteristics of the subjects of study, the subjective health status was high in males (β=0.144, p=0.011), urban dwellers (β=0.107, p=0.015), employed persons (β=0.139, p=0.001), college graduates (β=0.322, p<0.001), persons with high household income (β=0.226, p<0.001), persons without chronic disease, nonsmokers (β=0.146, p=0.009), drinkers (β=0.111, p=0.003), persons who practiced aerobic physical activity (β=0.150, p<0.001), persons without depression (β=0.286, p<0.001), and persons who rarely had stress (β=0.837, p<0.001). Conclusion: More attention should be paid to those with low subjective health to improve health for elderly people. Expanding policy supports are required for elderly people with low socioeconomic status, chronic disease or depression, or unhealthy behaviors (smoking or lack of physical activity).