• Journal of Preventive Medicine and Public Health
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• 제51권2호
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• pp.83-91
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• 2018

Objectives: One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households' income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

• 한국병원경영학회지
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• 제19권3호
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• pp.53-64
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• 2014

This research is designed to analyze the professionalism of administrators working in Korean hospitals as a way to make them a better expertise in the industry. For this purpose, we conducted a survey of 105 administrative professionals working in hospitals nationwide and statistical analysis was performed with the SPSS Windows version 15.0. The survey questions were developed based on the Spencer & Spencer's results of research in expertise variables. The results showed that the current Korean hospital administrator do have short of expertise required for their job position. Therefore, the curriculum reform is required for healthcare management programs in college and the Korean College of Hospital Administrators (KCHA) is required to change the contents of license exam based on the results of the study.

• 보건행정학회지
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• 제27권3호
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• pp.267-271
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• 2017

This year marks the 40th anniversary of the introduction of National Health Insurance (NHI) which has contributed to improving public health and accessibility. This article aims to show the trends of main indicators during the last 40 years. NHI has achieved rapid expansion of target population (1977-1989). The percentage of population covered increased from 8.8% in 1977 to 94% in 1990. The average number of visit days per person was 0.75 in 1977 but significantly increased to 31.11 in 2015. In 2015, NHI revenues were 52.4 trillion won and expenditures were 48.2 trillion won which is 9.5 times and 9.6 times higher than in 1995. NHI achieved universal coverage in short period of time and has contributed to improving the healthcare status. However, there still remain problems including low-benefit coverage and high out of pocket money. Therefore, the effort to reform these problems is needed.

• 약학회지
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• 제47권4호
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• pp.252-259
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• 2003

Self-medication is a representative phenomenon in the domain of popular care, originated from perspective of medical pluralism and the pharmacy profession is said to be in the most appropriate position of health care professions to activate self-medication. As any healthcare reform impacts in a country, 2000 institutional separation between medicine and pharmacy implemented in Korea brought a lot of changes in behavior of drug use not only to physicians and pharmacists but also to consumers (patients). In this paper, the reality of self-medication since the institutional separation between medicine and pharmacy was analyzed, based on the empirical data which were collected by the Korea Institute for Health and Social Affairs in 2002. The major finding is that the domain of popular care including self-medication was significantly shrunk, while that of professional care was proportionally expanded. As a result, the following four points were strongly recommended for the purpose of promoting self-medication: i) upgrading the pharmacy education system from 4 year to 6 year level, ii) improvement of continuing education and introduction of GPP (Good Pharmacy Practice), iii) activating 'pharmacal encounter' (i.e., pharmacist-consumer relationship) and iv) promotion of socio-economic research activities and proactive participation in the international self-medication movement of pharmacists in Korea.

• 보건행정학회지
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• 제31권4호
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• pp.385-386
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• 2021

The 2022 Presidential election is approaching. Because health policies are intimately connected to other policies and involve multiple stakeholders, it is difficult to promote policy changes. Hence, the presidential election, during which policymakers are replaced, is a great timing for making policy improvements. Several important policies have been introduced and promoted throughout the presidential election process. However, these policies have been implemented without going through sufficient discussion among the experts but rather through the voices of minority groups with stronger political will. This eventually posed an obstacle to the balanced development of the entire health care system. The current medical system faces challenges that need to be addressed in the medium and long term. In particular, we should be wary of the populistic approach. We look forward to seeing more policy commitments, proposed through the evidence-based policy process and sufficient amount of discussion among the experts.

• 보건행정학회지
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• 제24권4호
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• pp.396-412
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• 2014

Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.

• 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.

• 보건교육건강증진학회지
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• 제31권4호
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제16권3호
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• pp.69-79
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• 2010

Canada is a democratic country, yet it keeps a social democratic system in which the government is in charge of welfare of its people. And this is one of the most significant features about the country. Her public and private pension system has been effective since the 1920s, securing its people's fundamental income. In particular, the public medical system applies to its every citizen and performs its role. This system is called the National Medical System as well as "MEDICARE" named after its related law. However, there has been a significant change in the national medical and welfare policy due to the budget deficit. In other words, the policy was mainly implemented to welfare facilities in the past, but the policy changed to a welfare policy for the elderly with a concentration on the support for self-reliance of senior citizens since the reform. The purpose of this study is to provide data and implications for Korea through the analysis of the current situation and distinct features of the housing welfare system in Canada. This study has researched the literature on the subject with an analytic focus on three aspects that are the fundamental frame of the system, essential content (support for self-reliance and facility composition), and distinct features of the housing for the elderly. In other words, they are, first, how the fundamental frame of the housing welfare system for the elderly is composed; second, how the service for self-reliance welfare and facility service are composed; and third, what their scale and distinct spatial features of general houses for the elderly with self-reliance are. A comparative study was conducted in detail on courses and characteristics of the housing welfare system for senior citizens in Canada and the USA of North America. In particular, it reveals the scale and distinct spatial features of public houses for the elderly with self-reliance in British Columbia (BC) which is one of the main provinces of Canada.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제15권1호
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• pp.13-22
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• 2009

The nursing home for the elderly has a weak point for evacuation from the fire because most of all the users are suffering from a dementia or paralysis. When it comes to night shift, it is much difficult to get them evacuated due to the lack of staffs. In addition to that, the nursing home for the elderly has such a strict control system for access that does not have a utility for escape opening. That is why they need the differentiated evacuation planning. This study is to consider the point at issues on the present conditions of law, system, and evacuation plans for the nursing home for the elderly that has some difficulties because of impaired functions of residences. This study dealt with the point at facilities and operations of the emergency evacuation system. First of all, for the point at the facilities, I found that it need to be considered on the characteristics of the elderly who has any difficulties of the self evacuation. And the established regulation did not reflect the characteristics of closed area of the nursing home for the elderly. The second, for the point at the operation of the institutions, it is pointed that there seems to be a lack of ways to manage to a emergency situation and educations on the operation staff. And the last, for the point at the operation, the requirement for the managers of fire prevention facilities are similar to that of a normal building. Furthermore there is a lack of corporation with the fire station.