• 보건의료기술평가
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• 제6권2호
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• pp.88-94
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• 2018

This review aims to provide implications for relevant domestic policies and researches from Patient-Centered Medical Home (PCMH), a reinforcement model for primary care and its evaluations in the United States. As chronic diseases became dominant, changes in the health care delivery system in which primary care is central was required. The United States initiated primary care-reinforcing policies based on the PCMH following the increased demand for evidence-based health care policies. The current activities of the United States such as sharing research tools used to evaluate primary care interventions and circulating evaluation findings provide examples to Korea. Systematic evaluations for primary care interventions are required and appropriate methods using various types of data to reflect the real-world settings should be prepared. It is necessary to conduct policy assessment studies of public interests considering regional context. Support for the researches to make and advance from the existing environment must be examined.

• 한국보건간호학회지
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• 제8권2호
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• pp.71-82
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• 1994

The article reviewed the elderly health care management problems in policy development issue of the nation. Policy of Korean government on elderly health care has still not yet developed. The main stream of policy which is effective on elderly welfare policy is 'Elderly care are responsible by their families'. Now only those aged whose family members are not able to take care of their parents are receive custodial care at the non-profit nursing homes. This article examined the main stream policy in pro and cons aspects in relation to social changes such as: demographic changes. family structure changes. attitude changes. health care delivery system. and political settlement view points in connection with medical insurance program. Finally. a model for the elderly health care management was proposed which will provide chronic care services at the community level. such as nursing homes. day care centers. day hospitals, respite care units, and special care institute for dementia.

• 의료법학
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• 제20권3호
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• pp.235-262
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• 2019

전통적으로 인류를 위협해 오던 감염성 질환이 줄어드는 반면, 심뇌혈관 질환을 포함하여 암, 당뇨와 같은 만성질환이 빠른 속도로 퍼져나가고 있다. 오랜 시간에 걸쳐 발병하며 증세가 장기간 지속되지만 치료가 어려운 만성질환의 특성을 반영, 그 위험요인의 관리와 이에 대응하는 건강증진정책의 마련은 세계 각국의 중요 관심사로 부상하게 되었다. 일차 의료 시스템이 점점 더 복잡한 형태로 변화하는 현대사회의 건강요구에 부합, 건강증진 및 질병 예방 정책, 지역사회에 대응 솔루션 등 이른바 환자 중심의 다 부문 접근방식을 제공하면서 변화된 의료 환경에서 일차 의료의 가치는 다시 한 번 부각 되고 있다. 기존의 의료전달체계로는 급속한 고령화 및 질병 패러다임의 변화, 삶의 질 향상을 향한 민중의 욕구를 감당하기 어려워지면서 유럽연합국가들은 지속적이며 포괄적이고 조정된 관리를 제공하는 일차 의료 시스템을 구축, 그 품질 향상을 위하여 다각적인 노력을 기울이고 있다. 본 논문은 우리나라 보건의료 전달체계의 현황 및 문제점 등을 검토하고, 일차 의료 강화와 관련된 유럽연합의 예를 중심으로 그 시사점을 도출, 환자 중심의 미래형 의료전달체계 구축 방안에 관하여 논의하고자 한다.

• 보건행정학회지
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• 제24권4호
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• pp.301-303
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• 2014

• 보건행정학회지
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• 제29권3호
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• pp.342-356
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• 2019

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

• 한국의료질향상학회지
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• 제30권1호
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• pp.165-168
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• 2024

Quality improvement activities are especially important in middle to small-sized hospitals as well as in large hospitals. Hospital accreditation would play a crucial role in the re-establishment of the healthcare delivery system, which is now nearly collapsed in Korea. To achieve all these goals, it is also important to educate prospective medical personnel at college on the concepts of quality improvement and patient safety.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제17권2호
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• pp.27-34
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• 2011

It is very important to justify the reasonable role of healthcare facilities in the law in order to provide considerable medical services to the patient. Defining the right role of healthcare facilities makes it possible to build adequate Health Care Delivery System which might be helpful for the patient. However, the information of healthcare facilities in Korean law is so unclear that people are able to hardly understand what sort of proper medical service is for them. Furthermore, there is not enough regulation to differentiate each type of hospitals in the law. The result of this study is summarized into three points. Firstly, the current medical law does not reflect differences of function which each medical facility has. Secondly, the method of classification of healthcare facilities in the law disagrees with the Health Care Delivery System. Finally, there is no information on the type of sickbed in the law. Therefore, this study intend to analyze cause of problems which the law contains in order to be used for the fundamental resource for the healthcare facility planning.

• 보건행정학회지
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• 제17권1호
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• pp.75-93
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• 2007

This research purposed to analyse the diversity of the long-term care system based on the dependency/independency of the aged. For this purpose, we divided the long-term care systems to three components; form of benefit, generosity of benefit and delivery system. Form of benefit is whether the benefit is cash or in-kind, and the generosity of benefit is related to the level and coverage of benefit. The last concerned to focus on provider and user selection. According to this, we tried to make an ideal type of long-term care in the perspective of citizenship and consumerism. As a result, we established four types of long-term care system; active citizen type, passive citizen type, latent citizen type, and family dependent type. And we investigated Austria, Sweden, Germany and Korea for each type empirically.

• 보건행정학회지
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• 제29권2호
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• pp.112-129
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• 2019

Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.

• 보건행정학회지
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• 제3권2호
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• pp.130-158
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• 1993

This study was written to discover the changes that may exist in the contents of medical services after introduction of health insurance system, and to identify the net-effect of health insurance system on medical services. Uncomplicated nornmal delivery and appendectomy patients were divided into 4 groups, the non-insured in pre-NHI periods(group A), the insured of health insurance for employees in pre-NHI periods(group B), the insured of regional health insurance for city residents in post-NHI periods(group C) and the insured of health insurance for employees in post-NHI periods(group D). The mehtod of matching was applied to control for major demographic differences among these 4 groups of each disease. In pre-NHI period, the medical services and the variation of medical services of the non-insured were compared with those of the insured. The difference between the change of medical services from group A to those of group C, and the change of medical services from group B to those group D is defined as the net-effect of health insurance. The results are as follows. First, in length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients, frequency of sitz bath in delivery patients, there was net-effect of health insurance in increasing direction. Second, length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients and frequency of sitz bath in delivery patients were significantly more in the insured than in the non-insured group in pre-NHI period. Third, the variation of medical services of post-NHI period was not less then those of pre-NHI period. Fourth, antenatal care on which the third party does not pay and the patient pays for all, was diffrerent by socioeconomic and educational level of patients.