• Quality Improvement in Health Care
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• v.25 no.2
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• pp.16-25
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• 2019

Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

• Health Policy and Management
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• v.4 no.1
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• pp.1-24
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• 1994

Recently, two main changes were observed in relation to activities of District Health Centers. One is the rapid increase in the quantity and variety of people's demands for health services due to improvement of income level and the other is an introduction of autonomy in local administration. Unitl recently, the District Health Services were mostly depended on the instructions and orders given by Central Governments, and it would be necessary to prepare for the future implementation of autonomous local administration. Especially, the urban health centers may need more attention than those in rural areas because of their complexity and it would be more difficult in choosing and implementing a most suitable health programs for urban communities. This study was made to find out a feasibl developmental model which could be applicable for the urban bealth centers in Kyeongnam- do area. The most studies relating to health centers activities in the past were made by saking questions to current health center workers, but this study has made an effort to find out the opinions of those who are representing the people in the community. For this study, therefore, the Members of Gity Parliament and Village Headmen from 10 cities is Kyeongnam- do were interviewed for the study and the results obtained were compared to those of health officers. It was found that both Parliament Members and Village Headmen were well aware of the need of health centers, however, they tend to put lower priority for health services in compare with other community activities, and pointed out poor quality of services and lack of public understanding as the problems to be overcome. As to the desirable body for policy decision and implementation of health programs, the Members of Local Parliament think the Local Parliament as ideal, where as Village Headmen prefer health experts, and health officenr prefer District Health Center respectively. The most urgent problems of the District health Centers are mentioned as lack of health manpower. As the results of his study, the followings are suggested for improvement of District Health Services; First : reinforcement of professional health workers, Second : establishment of Community Health Council, Third : strengthening of public health education and support, Fourth : flexibility in Local Autonomy and target system relating to health activities.

• Health Policy and Management
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• v.25 no.4
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• pp.295-306
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• 2015

This study aims to examine the performance of public municipal hospitals through the analysis of data envelopment analysis, efficiency, profitability, and publicness by using panel data during period from 2006 to 2010. The main findings of the study are as follows. First, as a result of efficiency analysis during the period from 2006 to 2010, it was revealed that the number of staff by each job category, labor cost ratio, the number of operating beds need to be decreased. Second, the performance data represented by the indicators of efficiency, profitability and publicness were complementary and showed a tendency of being increased or decreased in same direction. Third, from the result of panel analysis, the efficiency was mainly influenced by the structural factors, while the profitability was influenced by managerial factors, and the publicness by medical environment. In conclusion, in order to enhance the performance of public municipal hospitals in Korea, it is important to harmonize the effort for efficiency, financial and policy support by central and local government, and the continuous participation of community residents.

• Health Policy and Management
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• v.26 no.1
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• pp.12-23
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• 2016

Background: Many studies have explained regional disparities in health by socioeconomic status and healthcare resources, focusing on differences between urban and rural area. However some cities in Korea have the highest cardiovascular mortality, even though they have sufficient healthcare resources. So this study aims to confirm three hypotheses. (1) There are also regional health disparities between cities not only between urban and rural area. (2) It has different regional risk factors affecting cardiovascular mortality whether it is urban or rural area. (3) Besides socioeconomic and healthcare resources factors, there are remnant factors that affect regional cardiovascular mortality such as health behavior and physical environment. Methods: The subject of this study is 227 local authorities (si, gun, and gu). They were categorized into city (gu and si consisting of urban area) and non-city (gun consisting of rural area), and the city group was subdivided into 3 parts to reflect relative different city status: city 1 (Seoul, Gyeonggi cities), city 2 (Gwangyeoksi cities), and city 3 (other cities). We compared their mortalities among four groups by using analysis of variance analysis. And we explored what had contributed to it in whole authorities, city and non-city group by using multiple regression analysis. Results: Cardiovascular mortality is highest in city 2 group, lowest in city 1 group and middle in non-city group. Socioeconomic status and current smoking significantly increase mortality regardless of group. Other than those things, in city, there are some factors associated with cardiovascular mortality: walking practice(-), weight control attempt(-), deficiency of sports facilities(+), and high rate of factory lot(+). In non-city, there are other factors different from those of city: obesity prevalence(+), self-perceiving obesity(-), number of public health institutions(-), and road ratio(-). Conclusion: To reduce cardiovascular mortality and it's regional disparities, we need to consider differentiated approach, respecting regional character and different risk factors. Also, it is crucial to strengthen local government's capacity for practicing community health policy.

• Korea Journal of Hospital Management
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• v.17 no.1
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• pp.43-58
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• 2012

Gangwon province has been chosen as a health tourism site by one of the nation level projects from 2008. This study surveyed local governments in the province in 2009, in order to develop suitable approaches to health tourism for the province. From the result, all respondents supported the health tourism in their city. Furthermore, an appropriate type of health tourism for the province identified as health promotion whereby the natural environment rather than advanced medical care. To respond to this, cooperation between local governments and hospitals is important, thus Gangwon province should seek the strategies for this.

• Korean Journal of Health Education and Promotion
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• v.8 no.2
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• pp.6-23
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• 1991

The method of this study is as follows : First, the interview with the civil servants concerned. Second, the review of the pertinent public ledgers. Third, the review of the existing reference. The results of this study are as follows. 1) The health education system in Korea has only the head. But it does not have the trunk and the limbs that it can move with. 2) Health educator should have the essential work that is the planning and coordinating work of intersectoral health education programs. They should also have the trust works from other sectors. 3) The proposition in the health education policy is as follows: First, the department or section of health education should be made newly in the public health organization. Second, at the level of province(Do) and county(Gun), the health educator should be stationed. Third, most training courses of health care members should involve health education subjects. Fourth, the health center at the level of county(Gun) should have a minimum material and audio-visual equipment of health education. Fifth, regular health education should be put into practice through local broadcast or CATV etc.. Sixth, school health education should be consolidated. Seventh, village health worker(nurse) should be stationed at the level of health center, so that he(she) can work as health educator. 4) The ultimate model of health education system is that of Fig. 5. But it is impossible to change the system synoptically. At first health educator should be stationed at health center. And then the system should be gradually organized.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.73-92
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• 2014

Objectives: To provide basic data needed to develop national physical activity policy, this study was examined to identify the relationship among physical inactivity, physical activity, and chronic diseases. Methods: I have reviewed articles and research reports in relation to physical activity, health, and chronic disease published in national and international since 2005 through PubMed, RISS, and KISS. Results: physical activity should be the priority of public health for the prevention and management of chronic diseases as following reasons. 1) Prevalence of physical inactivity has been continuously increased. 2) There were strong evidences that sufficient physical activity could prevent and treat dozens of chronic diseases. Conclusions: Both central and local governments need to make the amount of physical activity to be increased by providing information and establishing a physical activity-friendly environment. Also, the local public health centers and the primary medical institutions are institutionally needed to counsel and prescribe every patient's exercise program at every visit.

• Journal of agricultural medicine and community health
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• v.22 no.2
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• pp.225-237
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• 1997

This study was conducted to the cognition and attitude for internal and external organizational behavior of health centers staff. An analytical model employed in this study was developed by modifying 'organizational behavior model'. Data was collected a mail survey 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 : Among directors of the health centers 47% of them stated that legislators and chief executive officer(CEO) of local governments are highly concerned about the public health program. However only 15.2% of health center directors reported that legislators and CEO put public health high priority. For leadership type of directors 39.0% of them was classified as controller, 30.3% as participant, 22.7% entertaining and 7.6% comprehending. Regarding sociopsychological characteristics of the health center staffs, about a quarter of them had high degree of group cohesion, while 10.7% had low degree. Those staffs who are older, high educational level, or working in the rural health centers showed higher degree of cohesion than those who are young, low educational level, or working in urban health center. A third of them were less likely to be satisfied by what they are doing at the health centers. The higher educational level, the likely to be satisfied by what they are doing at the health centers. The higher educational level, the more satisfied with their job. Considering these results, policy implication was discussed and suggested. It is 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.

• Health Policy and Management
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• v.23 no.1
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• pp.52-58
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• 2013

This study was conducted to investigate the responsiveness and its related factors of public health center for novel influenza A (H1N1) epidemic. The data was collected through a web-based survey conducted during February to April 2011. The 182 respondents were team leaders or persons who were responsible for H1N1-related work at public health centers during the H1N1 prevalence. The related factors affecting the responsiveness were different by urban or rural area. In the level of gu (urban) area, cooperation with the public organizations, preparing its own response plan were the significant factors. But, in the level of si or gun (rural) area, cooperation with private organizations (clinic or pharmacy), physical (facilities, equipments, and medicines), and human infrastructures (public health professions, education and knowledge, and motivation) were more important factors. Therefore, how to cope with H1N1 prevalence in the future should be different by local characteristics. As a result, there are several challenges that public health centers should prepare for the further emerging infectious diseases. First, it is needed to make standard manuals which could strengthen education and training in order to respond appropriately, as well as to prepare enough physical infrastructures for the crisis. Next, the public health center should prepare correct media response and cooperation system with public and private organizations.

• Health Policy and Management
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• v.34 no.2
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• pp.211-221
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• 2024

Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.