Objectives: This job analysis of a staff in charge of quit-smoking policy at public health centers aims at providing fundamental information to establish strategies supporting various quit-smoking. Methods: The job analysis of a staff in charge of quit-smoking policy at public health centers was carried out through DACUM(Development of Curriculum) method from April through May 2006. Three experts had developed job description with staffs in charge of quit-smoking policy at public health centers through two workshops. The survey was practiced for staff in charge of quit-smoking policy at the other public health centers. The characteristics of the staffs such as age, years for working at public health center, years for charging with quit-smoking work, the proportion of responsibility for quit-smoking work, were surveyed. Results: The research has reached the conclusions below. 1. The job description have been developed considering input-process-outcome axis and plan-do-evaluation axis for quit-smoking policy at public health centers. The final job description is composed of 3 missions, 7 accountabilities, 20 sub-work items. 2. The quit-smoking activity mostly focused at direct education and counselling. But planing and evaluation activity for quit-smoking have been under-achieved. 3. The staffs for quit-smoking policy were feel it is easy to educate and counsel to comer to public health centers for quit-smoking. But having the high proportion of responsibility for quit-smoking policy have usually difficult to do that. So they want to education about counselling for smoker. 4. The staffs who worked over the 2 years for quit-smoking policy the public health center have responded that investigate the smoking rate of the jurisdiction community and the problem of the culture about smoking and smoking policy is important. Conclusions: The study helps reinforcing the initiatives of central government for quit-smoking policy at public health centers. Especially staffs want education in technology area for counselling smoker. And they want nationwide supporting for investigating smoking rate and related factors at the local level.
Performance of public hospitals is difficult to define and measure because not only their managerial or financial performance but also their role as a public entity is important. The purpose of this paper is to examine the internal and external factors that influence the performance of local government hospitals. A multiple regression was performed to analyze the effects of the environmental, organizational, operational, and cost-related factors on the return on total assets(ROA), operating margin(OM), and the ratio of Medicaid patients. Empirical results show that financial performance (ROA and OM) are more influenced by operational or cost-related factors, while the ratio of Medicaid patients is more affected by environmental or organizational characteristics. It is noteworthy that competition and the contract with private sector management have negative effects on the ratio of Medicaid patients that local government hospitals treat.
Park, Sun-Hee;Lee, Su-Jin;Soh, Un-Ki;Na, Baeg-Ju;Lee, Jin-Yong
Health Policy and Management
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v.21
no.3
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pp.349-364
/
2011
Objectives : The purpose of this study was to evaluate the relationship between new-building of rural public health centers and the outpatient medical utilization. Methods : The study subjects were 141 public health centers in rural area. The data were collected from 1995 to 2001, medical utilization and local population, healthcare resources, and economic characteristics were included. In order to evaluate new-building effects, we performed paired t-tests and multivariate regression analyses. Results : The following variables are significant affecting the medical utilization of rural public health centers: urban side location of public health centers(p<0.05), pre- and post-IMF economic crisis(p<0.001), number of medical aid recipients(p<0.01), number of private clinics(p<0.05), workers of public health centers(p<0.001), financial independent level of local governments(p<0.001). In contrast, the existence of new-building and number of the aged 65 and over were not significant variables. Conclusions : We could not find out the positive relationship between the existence of new-building and the volume of medical utilization in rural public health centers. In particular the medical utilization of rural public health centers is significantly affected by IMF economic recession and number of the poor strata, the economically depressed area.
Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.
On the stage of transition from highly centralized government to local self-government in Korea, administrating practice characteristics of the directors of Health Centers is essentially required to be found. This study was conducted in order to find the administration patte군 of the directors of Health Centers in Korea and their opinion on the environment of health administration including personnel management regime for them. The materials were collected from 149 directors of Health Centers with a structured questionaire by mailing. The major findings of this study were as follows. 1. About two-thirds of the directors(69.1%) make plan through the consensus between public service perosonnel in programme department and them in budgt control department. And 75.0% of the directors maintain the planed by the predecessor. 2. More than two-thirds of the directors (71.1%) take subordinates opinion into consideration in case of the programmes facing objections. 3. When the directors face obstacles in pursuing health programmes they usually consult other public service personnel than inhabitants. 4. Only 10.8% of the directors were satisfied with the support of the Ministry of Internal Affairs for health administration while more than half of them were satisfied with the support of health institution in higher level. 5. The directors evaluated the job attitude of the public service personnel in low level as more favorable than that of there higher level public service personnel who work for central government. 6. Only 18.1% of the idrectors were satisfied with their saley. And more than half of them expect the promotion of their position. On the ground of this result the administration attitude of the directors of Health Centers would be evaluated as improved and as more positive than that of other public service personnel in health authorities. However, they are required to consult the inhabitants more frequently for health administration. An the public service personnel in high level who work for central government are required to improve their job attitude.
Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.
Since 1990's, the Korean society, experiencing the low fertility and aging society, has been confronting with the threats in health care sector. The threats are the increases in the demand for health care, health care financial burden, and so on. In particular, the change of disease pattern and aging population result in the increases patients' demand for not only western medical services but also oriental medical services and complimentary medicine. Recently, the increases in availability of oriental medical services and the health care resources related to oriental medicine are raising some issues and conflicts in the Korean health sector. Theses circumstance required policy makers, central and local government, and public health sector to develop health policies related to oriental medicine and interface or integrate of traditional Korean medicine and Western medicine. For the near future, these issues will probably remain the focus of integration of traditional Korean medicine and Western medicine in public health sector. To cope with the threats in health care sector, one of the opportunities is to scale-up e public role of traditional Korean medical services. The main purpose of this study was to develop strategies to scale-up the Public role of traditional Korean medical services for the future society. The research questions are: what are the trends and problems in traditional Koran medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the cause?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? The results of this study are as follows. In order ta scale-up the public role of traditional medicine, this research offered health policy directions for traditional Korean medicine in response to a change environment of health care sector. There are four directions to be addressed: 1) the development of and investment in public oriental medicine infra-structure; 2) the development of public policy on oriental medicine; 3) modernization and globalisation of traditional Korean medicine; 4) the expansion of academic exchange between Western medicine and traditional Korean medicine. Finally, we discussed stakenholders' on traditional Korean medicine in the health care market. Then, public policy options for future society was suggested.
This study was intended to provide basic data for increasing the interest in health projects for the public servants and local residents in the period ahead by examining the difference in the degree of interest in health projects among the public servants at resident centers and the residents. For that, 46 public servants at resident centers and 107 local residents were sampled, and their degree of interest in specific health projects was analyzed based on Chi-Square and independent sample t-test. Based on comprehensive consideration of the results of analysis, public servants at resident centers were found to have lower interest in health projects than local residents. The results of this study showed that the public servants at resident centers had lower interest in health projects than local residents. That arises from the consideration that specialization is important for implementation of special works. Thus, this study needs to focus on expanding the role of public servants to ensure that resident centers can take on integrated role related to public health. Therefore, the results of this study can provide basic data for expanding the role of public servants at resident centers. Moreover, the results of this study suggested that various ways need to be explored to increase the interest in health projects for local residents.
Kim, Sooyeon;Kim, Ji Man;Park, Chong Yon;Lee, Chang-Woo;Lee, Sang Gyu;Shin, Euichul
Health Policy and Management
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v.28
no.1
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pp.15-22
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2018
Background: Health is affected by various local factors. This study aims to investigate the age-standardized mortality variation of Seoul as well as the characteristics of the factors related to the mortality variation. Methods: The Korea Community Health Survey data, Seoul Survey data, Seoul statistics, and e-regional indicators of the National Statistical Office were used. To investigate the basic boroughs standardized mortality variation in Seoul, external quotient, coefficient of variation (CV), and systematic component of variation (SCV) values were suggested; correlation analysis and multiple regression analysis were conducted to investigate the characteristics related to standardized mortality rate. Results: The highest and the lowest standardized mortality rate of Seoul by boroughs had as much as 1.4 times difference; a low level of variation was shown in CV by 8.2; and was shown in SCV by 79. As a result of the multiple regression analysis of the factors that affect standardized mortality variation, the higher the rate of householders with college or higher, the lower the standardized mortality rate, and the higher the high-risk drinking rate, the higher the standardized mortality rate. Of the two, the rate of householder with a degree equivalent or higher than college was shown to have the biggest impact, followed by high-risk drinking rate. Conclusion: We found a variation in age-standardized mortality rate of boroughs in Seoul. The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.
This study was conducted to identify the factors that affect the output of health conters. An analystical model employed in this study was developed by modifying 'input-output model' and 'organizational behavior model'. Data were collected form two source; the 1995 report of thealth center which was submitted to the Ministry of Health and Welfare and a mail survey questionary of officers at health center, including 66 directors and 1,768 staffs of the health centers in southern region. The major findings are as follows: That analysis has identified the factors associated with dependent variables: medical services provided by the health center and health program performance(HPP). The number of primary medical facilities was negatively associated with health center performance while the number of staffs, job satisfaction, and professional background of health center directors were positively associated. These independent variables accounted for 40.1% of the variance of dependent variables. The variance of HPP was significantly explained by the number of health subcenter and primary health post, priority level of public health program by hief executive officers(CEOs) and legislator. A significant relationship was found between leadership types of health center directors and the performance of maternal and child health program. Considering these results, the authors suggested that the role in medical care service of health center in the should be rearranged at local level because medical care service of the health center is competing with primary medical facilities in the same region. It is also suggested that educational efforts be made to improve leadership of the health center directors and concern with public health program by the CEOs and legislators of local governments.
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