• Korea Journal of Hospital Management
• /
• v.19 no.1
• /
• pp.1-20
• /
• 2014

In this study, we investigated the relationship between friendship level within a hospital organization and job satisfaction, organizational commitment and job stress. Focusing on the hierarchy and occupation of a hospital, different from previous introductory studies. As a study tool, structured questionnaire were devised and used. The subjects were nurses, administrators and medical technicians who worked at 17 tertiary hospitals in Seoul and Kyongin area. To analyze the data, we conducted frequency analysis, t-test, one-way ANOVA, two-way ANOVA and multiple regression analysis.The main results of our study can be summarized as followings:Firstly, seen from the viewpoint of social demographic characteristics, on the whole friendship level with fellows is the highest, and then that with subordinates and that with bosses the lowest. Secondly, the friendship level with bosses, subordinates and fellows had a significant relationship with job satisfaction, organizational commitment and job stress, though there were some differences among them. In case of junior managers, the friendship level with fellows had a significant relationship with job satisfaction and organizational commitment; in case of middle managers, the friendship level with fellows had significant relationship with job satisfaction. We found that the friendship level with the bosses had a deeper relationship with job satisfaction, organizational commitment and job stress as we went down the hierarchy. Thirdly, analyzing the differences between occupation, administrators and medical technicians had relatively higher significant relationship with the friendship level with bosses than nurses in job satisfaction, organizational commitment and job stress. High friendship level with the bosses influenced job satisfaction significantly for the nurse; yet, in case of administrators and medical technicians, the friendship level with bosses influenced all of job satisfaction, organizational commitment and job stress. Based on our study, we recommend facilitating friendly relationship between the bosses and the subordinates in order to enhance job satisfaction, organizational commitment and job related stress reduction.

• Clinical and Experimental Pediatrics
• /
• v.64 no.9
• /
• pp.480-488
• /
• 2021

Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study established the National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008) based on data from a nationwide population-based health screening program and data on healthcare utilization for children. Methods: The NICKs-2008 study consisted of the Korean National Health Insurance System (NHIS) and the National Health Screening Program for Infants and Children (NHSPIC) databases comprising children born in 2008 (n=469,248) and 2009 (n=448,459) in the Republic of Korea. The NHIS database contains data on age, sex, residential area, income, healthcare utilization (International Classification of Diseases10 codes, procedure codes, and drug classification codes), and healthcare providers. The NHSPIC consists of 7 screening rounds. These screening sessions comprised physical examination, developmental screening (rounds 2-7), a general health questionnaire, and age-specific anticipatory guidance. Results: During the 10-year follow-up, 2,718 children (0.3%) died, including more boys than girls (hazard ratio, 1.145; P<0.001). A total of 848,048 children participated in at least 1 of the 7 rounds of the NHSPIC, while 96,046 participated in all 7 screening programs. A total of 823 infants (0.1%) weighed less than 1,000 g, 3,177 (0.4%) weighed 1,000-1,499 g, 37,166 (4.4%) weighed 1,500-2,499 g, 773,081 (91.4%) weighed 2,500-4,000 g, and 32,016 (5.1%) weighed over 4,000 g. There were 23,404 premature babies (5.5%) in 2008 compared to 23,368 (5.6%) in 2009. The developmental screening test indicated appropriate development in 95%-98% of children, follow-up requirements for 1%-4% of children, and recommendations for further evaluation for 1% of children. Conclusion: The NICKs-2008, which integrates data from the NHIS and NHSPIC databases, can be used to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors.

• The Journal of Korean Medicine
• /
• v.40 no.3
• /
• pp.59-75
• /
• 2019

Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

• The Korean Journal of Health Service Management
• /
• v.6 no.3
• /
• pp.53-66
• /
• 2012

The main purpose of this research is to gain full understanding of how well people are aware and prepared for after retirement. To reach the goal to learn more about the upcoming aging society, professionals from variety of medical fields were employed as subjects to this research. In order to get a detailed result, and to provide an ideal suggestion, the research was conducted with 406 professional workers from 31 different medical institutions as its subjects. Obtained results were summarized as follows. First, in terms of government policies in the field, the idea of long term recuperation insurance gained more support than the belief that the public annuity is a sufficient economic countermeasure. Second, there is a causal relation between the economical preparation for retirement and the reason why people do not prepare for their after retirement. The more one feel short of money, the more one is obtuse towards the necessity of preparing for retirement, the more ignorant one is about preparing for retirement, the higher the chance that there will be no preparation done for his/her after retirement.

• KSII Transactions on Internet and Information Systems (TIIS)
• /
• v.10 no.8
• /
• pp.3852-3864
• /
• 2016

Patients' health data is very sensitive and the access to individual's health data should be strictly restricted. However, many data consumers may need to use the aggregated health data. For example, the insurance companies needs to use this data to setup the premium level for health insurances. Therefore, privacy-preserving data aggregation solutions for health data have both theoretical importance and application potentials. In this paper, we propose a privacy-preserving health data aggregation scheme using differential privacy. In our scheme, patients' health data are aggregated by the local healthcare center before it is used by data comsumers, and this prevents individual's data from being leaked. Moreover, compared with the existing schemes in the literature, our work enjoys two additional benefits: 1) it not only resists many well known attacks in the open wireless networks, but also achieves the resilience against the human-factor-aware differential aggregation attack; 2) no trusted third party is employed in our proposed scheme, hence it achieves the robustness property and it does not suffer the single point failure problem.

• Korean Journal of Clinical Pharmacy
• /
• v.23 no.2
• /
• pp.89-96
• /
• 2013

This article aimed to introduce 'risk sharing' schemes for pharmaceuticals between drug manufacturers and healthcare payer. Published literature review was undertaken to summarize risk sharing concepts and collect information on existing scheme examples in other countries focusing on new anticancer drugs. Risk sharing schemes could be categorized into health outcomes-based and non-outcomes (financial) based ones. Outcome-based schemes could be broken down into performance-linked reimbursement and conditional coverage. Performance-linked reimbursement can be further broken into outcomes guarantee and pattern or process of care and conditional coverage included coverage with evidence development and conditional treatment continuation schemes. Non-outcome based schemes included market share and price volume at population level, and utilization caps and manufacturer funded treatment initiation at patient level. We reviewed the fifteen examples for anticancer drugs that risk sharing agreements in response to the inherent uncertainties and increased costs of eleven anticancer drugs. Of them, eight cases were coverage with evidence development schemes. The anticancer drugs except bevacizumab and cetuximab were all listed on the national health insurance formulary in Korea, with reimbursement criteria defined on the basis of approved indications and administrations. Risk sharing approach may be a useful tool to ensure values for drug expenditure, but there are a number of concerns such as high administration costs, lack of transparency and conflicts of interest, especially for performance-based health outcomes reimbursement schemes.

• Journal of Korean Clinical Health Science
• /
• v.2 no.3
• /
• pp.158-166
• /
• 2014

Purpose. This study pursued the way for the effective application of the differentiated charge (Nursing grading system) by the nursing manpower which is performed for the nursing service quality improvement to the in-patients in Korea and the minimum employment problem solution of nurses. Methods. For this matter, the status of the nursing grade for 1,452 hospitals (44 high class general hospitals, 259 general hospitals, 265 hospitals, 59 oriental medicine hospitals and 825 recuperation hospitals) was identified which were registered in the Health Insurance Review and Assessment Service in March 2011 status quo. Results. In the most nursing grade by the kind of medical institutions, 70.5% of the nurses were third-graded in upper general hospitals, 38.1% were sixth graded in general hospitals, 62.7% were seventh-graded in oriental medicine hospitals and 40.4% were first-graded in recuperation hospitals. In the nursing grade by the scale of hospitals (in terms of the number of beds), there was a significant difference in general hospitals, but there was no significant difference between oriental medicine hospitals and recuperation hospitals. In the nursing grade by the location of hospitals and the foundation type of hospitals, there was a significant difference between general hospitals and recuperation hospitals. Conclusion. For the effectiveness of applying differentiated nursing fees by the number of nurses, it seems necessary to consider adjusting the present differentiated inpatient-charge system for the better so that small and medium-sized hospitals may induce more nurses.

• Health Policy and Management
• /
• v.30 no.3
• /
• pp.270-276
• /
• 2020

Entering the fourth industrial revolution era, health technology is rapidly developing and the people's needs for medical services are gradually increasing. Establishing a life cycle management of health technology has emerged as a new policy agenda to cope with these changes. However, the management of health technology have been conducted without continuity and with several problems pointed out. Therefore, we suggest the reform agendas by stages to establish system for a life cycle management of health technology in the fourth industrial revolution era as follows. In the stage of development, it is important not only to provide research funding, but also consulting by professional about whole cycle of health technologies. In the phase of market entry, there are needs for enhance the system that would expand the early adoption for innovative technology and increase its effectiveness. After the spread of health technology to clinical settings, a reassessment and post management system should be established that have an institutional framework with strong price adjustment and exit mechanism. Furthermore, we hope that discussions will be brisk in macro perspective on the balancing of development in healthcare industry, health of people and national health insurance finance.

• The Korean Journal of Health Service Management
• /
• v.10 no.2
• /
• pp.71-82
• /
• 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.

• Korea Journal of Hospital Management
• /
• v.9 no.3
• /
• pp.18-48
• /
• 2004

Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.