• 보건의료산업학회지
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• 제12권3호
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• pp.13-26
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• 2018

Objectives: This study investigated how Korean daily newspapers frame the present government's health insurance coverage expansion policy, Moon Jae-in Care. Methods: A contents analysis was conducted to construct news frames represented in the four Korean daily newspapers' editorials and columns on Moon Jae-in Care during from April 2017 to April 2018. News text was classified into three different layers of frames: expressive element, narrative structure, and implied values. Results: The analysis revealed that the frequency of narrative frames was as follows: health system improvement (20.8%), public burden (14.6%), opposition by doctors (14.6%), and populism (12.5%). The financial sustainability accounted for 41.7% of the value frame, followed by procedural legitimation (18.8%), and coverage expansion (16.7%). The results also revealed that reported frames were different among newspapers: Chosun Ilbo tended to report in a negative tone, while Hankyoreh shinmun and Kyunghyang shinmun used a positive tone. Conclusions: This finding suggests that there are salient framings in reports on Moon Jae-in Care. Based on the results, the government needs to present a detailed financing plan on Moon Jae-in Care in detail. I discussed another implication of media frames results.

• 보건행정학회지
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• 제31권4호
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• pp.387-398
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• 2021

Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

• 대한영상의학회지
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• 제81권5호
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• pp.1024-1037
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• 2020

상대가치란 소모된 자원의 양을 기준으로 의료행위의 가치를 상대적으로 비교한 점수로 의사업무량, 진료비용, 위험도로 구성된다. 2차 상대가치 개정 당시 영상검사 수가는 높은 원가 보존율을 이유로 인하되었다. 영상검사 수가는 상대가치 체계에서 진료비용이 대부분을 차지하고 있으며, 의사업무량은 상대적으로 저평가되어 있다. 문재인케어라고 불리는 새로운 건강보험 보장성 강화 대책은 비급여의 급여화, 본인부담금 상한제 확대, 재난적 의료비 지원을 골자로 국민의 의료비 부담을 줄이는 것이 목표이며 향후 건강보험 재정에 부담이 늘어날 것으로 우려된다. MRI와 초음파 검사 급여 확대는 문재인케어에서 큰 비중을 차지하고 있으며 영상의학과는 문재인케어 적용 과정에서 저평가된 영상검사에서의 의사의 노동을 적절히 평가받을 수 있도록 노력해야 한다.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.175-179
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• 2015

The intensive care unit (ICU) is the most common place to die. Also, ethical conflicts among stakeholders occur frequently in the ICU. Thus, ICU clinicians should be competent in all aspects for ethical decision-making. Major sources of conflicts are behavioral issues, such as verbal abuse or poor communication between physicians and nurses, and end-of-life care issues including a lack of respect for the patient's autonomy. The ethical conflicts are significantly associated with the job strain and burn-out syndrome of healthcare workers, and consequently, may threaten the quality of care. To improve the quality of care, handling ethical conflicts properly is emerging as a vital and more comprehensive area. The ICU physicians themselves need to be more sensitive to behavioral conflicts and enable shared decision making in end-of-life care. At the same time, the institutions and administrators should develop their processes to find and resolve common ethical problems in their ICUs.

• Journal of health informatics and statistics
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• 제43권4호
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• pp.274-281
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• 2018

Objectives: The purpose of this study is to comprehensively compare the trends of health administration and health policy in the field of health care using the semantic network analysis in the inaugural address of the Ministry of Health and Welfare of each regime in Korea. Methods: This study used a language network analysis method that uses Korean Key Words In Context (KrKwic) program and NetMiner program in sequence. The analysis was conducted by Minister Hwa-joong Kim during the Moo-hyun Roh government, Minister Jae-hee Jeon during the Myung-bak Lee government, Minister Young Jin of Geun-hye Park government and Government Jae-in Moon's inaugural address of Neung-Hoo Park Minister, respectively. Results: The key words differentiated by each regime are that the Moo-hyun Roh Government's Minister Hwa-joong Kim had high connection centrality values in the words 'balanced development', 'comprehensive' and 'reform'. Minister Jae-Hee Jeon of Myung-bak Lee Government had high connection centrality values in the words 'poverty' and 'return'. In the case of Minister Young Jin of Geun-hye Park Government had high connection centrality values in the words 'demand', 'Customized' and 'Life cycle'. In the case of Minister Neung-Hoo Park of Jae In Moon Government had high connection centrality values in the words 'Welfare state', 'Embracing' and 'Soundness'. Conclusions: If the role of health administration in the health care field and the health care policies are constantly changed according to the policies of each regime, it is inconsistent and it is difficult to approach from the long term perspective for public health promotion. In the future, health policy should be developed and implemented with a long-term perspective and consistency based on the consensus and participation of the people with less influence on the change and direction of each government's policies.

• 보건행정학회지
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• 제29권3호
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• pp.374-378
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• 2019

After the announcement of Moon Jae-in Government's plan (Moon's Care) for Benefit Expansion in National Health Insurance in August 2017, it is necessary to monitor the effects of the policy, especially household out-of-pocket payments (OOP). This paper aims to observe the current status and trend of OOP in Korea. Current health expenditure (CHE) was 144.4 trillion won in 2018, which accounts for 8.1% of gross domestic product (GDP) increased 9.7% from the previous year. Although GDP's share of CHE has been close to the average of the Organization for Economic Cooperation and Development (OECD) countries, the public fund's share was 59.8% of the total in 2018, which was lower than the OECD average of 73.5%. OOP's share was 32.9% in 2018, which decreased from 37.4% in 2008. The share of OOP of non-covered services was 20.0% in 2018, which decreased from 22.9% in 2008. The share of cost-sharing with third-party payers was 12.9% in 2018, which decreased from 14.5% in 2008. The OOP of non-covered services was significantly decreased in hospital and inpatient curative care, but the OOP of non-covered services was significantly increased in the medical clinic. The effect of Moon's Care was not showed in OOP through the results of 2017 and 2018, but further monitoring is needed because the Moon's Care is progressing and the observational period is short.

• 보건행정학회지
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• 제18권1호
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• pp.43-62
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• 2008

The purpose of this study is to evaluate the causal relationship among health care criteria in Korean National Mental Hospitals, using Malcolm Baldrige National Quality Award(MBNQA). The survey instrument consists of 92 Questions from the seven the MBNQA health care criteria. Structural Equation Modeling (SEM) is used to analyze the empirical data and estimates the path coefficients among the seven categories. The result of this study indicates that Leadership drives Foundation and Direction, which influence on Systems that creates Results. Conclusively, among 18 hypotheses, 15 are statistically significant.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제5권8호
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• pp.7-14
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• 1999

Current Korean healthcare facilities face on a difficult period as much as financial difficulty in Korean economy. Most of all the hospitals have difficulty in minus profit margin and hospital investments are also reducing rapidly. Probably, these seem to set in the period of re-organizing its structures and enhancing productivity from the rapidly growing period, which was to concentrate its resources and prefer large scaled structures. Analyzing the developing process and future trend in the U. S. health care facilities, already experienced in financial difficulty of current Korean health care facility in 70s thru. 80s, this paper is to present directions in future Korean health care policy and healthcare facility planning.

• Journal of Preventive Medicine and Public Health
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• 제40권1호
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• pp.51-58
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• 2007

Objectives : The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. Methods : We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. Results : The average continuity of care in the entire population of 1,498,327 patients was $0.89{\pm}0.17$ as calculated by MFPC and $0.92{\pm}0.16$ by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. Conclusions : The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.

• 보건행정학회지
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• 제29권4호
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• pp.379-381
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• 2019

Korea's healthcare is in great danger of sustainability. In 2020, the baby boomer will begin to be older, and there is no promise that the total fertility rate of 1.0 or less will rebound, and Korea's economic growth rate is predicted to be less than 2%. Together with these phenomena, Plan for Benefit Expansion in Nation Health Insurance (Moon Jae-in Care) will seriously threaten the sustainability of health insurance finance. In addition, health care in Korea has many problems: excessive medical utilization, rapidly increasing elderly medical costs, concentrating patients into big hospitals, low healthcare personnel but many healthcare facilities and equipment, bad quality of primary and mental care, and fast-growing health expenditure. For sustainability, healthcare of Korea should be reformed. The direction of the reform is people-centered and integrated healthcare in the community which is composed of empowering and engaging people, strengthening governance and accountability, reorienting the model of care, coordinating services, and creating an enabling environment.