• Tuberculosis and Respiratory Diseases
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• 제70권2호
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• pp.143-149
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• 2011

Background: Stopping medical treatment by tuberculosis (TB) patients prior to completing treatment period is a major concern in private hospitals. We evaluated the impact of public-private mix (PPM) project on increasing treatment success rate of TB in a private tertiary hospital in Korea. Methods: Starting in February 2009, TB patients treated at Dankook University Hospital received health education and case monitoring activities by specially trained public health nurses (PPM project). On a retrospective basis, we reviewed medical records and compared the treatment outcome of TB patients treated under the PPM project (PPM group) to patients treated without the PPM project (control group) between January 2008 and June 2010. In addition, we also evaluated the risk factors treatment non-completion. Results: The number of patients in the PPM group and control group were 123 (85 pulmonary TB and 38 extrapulmonary TB) and 146 (101 pulmonary TB and 45 extra-pulmonary TB), respectively. The PPM group had demographic and clinical findings comparable to those of control group. The PPM group showed a significantly higher treatment success rate (93.5%) compared to the control group (77.9%). However, development of complications, proximity to the hospital, and presence of co-morbid disease did not influence the treatment success rate. Conclusion: The PPM project was effective at increasing the TB treatment success rate. An effort to improve and to expand the PPM project is needed in private Korean hospitals.

• 한국지역지리학회지
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• 제15권2호
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• pp.226-249
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• 2009

이 논문은 장소마케팅 전략의 지역믹스 유형을 분석하고 시론적 모델을 제시하는 것을 목적으로 한다. 이를 위해 광주 전남 지역의 최근 2년간 장소마케팅 관련 사례들을 분석한 결과, 총 87개의 지역믹스 사례가 도출되었다. 지역믹스 유형을 공간별, 주제별, 주체별, 대상별, 요소별로 분석한 결과, 총 27개의 지역믹스 유형이 도출되었다. 공간별 지역믹스 유형은 도시믹스, 권역도시믹스, 패키지도시믹스, 권역믹스, 공간패키지믹스 등 5가지 유형으로 나타났고, 주제별 지역믹스 유형은 문화믹스, 역사믹스, 관광믹스, 산업믹스, 행정믹스, 생태믹스, 교통믹스, 홍보믹스 등 8가지 유형으로 나타났다. 주체별 지역믹스 유형은 중앙정부주도형 공공믹스, 지방정부주도형 공공믹스, 기업주도형 민간믹스, 시민사회주도형 민간믹스, 민관파트너십 믹스 등 5가지 유형으로 나타났고, 대상별 지역믹스 유형은 주민믹스, 관광객믹스, 기업믹스, 공동믹스 등 4가지 유형으로 나타났다. 요소별 지역믹스 유형은 조직믹스, 이미지믹스, 포인트믹스, 타깃믹스, 채널믹스 등 5가지 유형으로 나타났다. 이러한 유형화를 바탕으로 장소마케팅 전략의 지역믹스 모델을 1차 모델과 2차 모델로 도출하였다. 지역믹스 1차 모델은 총 22개의 모델로 나타났고, 지역믹스 2차 모델은 총 126개의 모델로 나타났다.

• 한국사회복지학회:학술대회논문집
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• 한국사회복지학회 2005년도 춘계학술대회자료집
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• pp.387-411
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• 2005

The purpose of this article is to analyse the expenditure structure of the welfare mix; in order to grasp the holistic feature of the Korean social welfare. Most of all, the article attempts to elaborate the estimation methods of social welfare expenditure by including the components from which has been excluded so far - indirect tax expenditure of the government, nursery payments of households, life insurance pay-outs for survivors, inter-household private income transfers and the value of caring work of the family. In so doing, the article estimates that the total social welfare expenditure including state, enterprise, market, NPOs and family reached at 24.7% of GDP in 2000, which is approximately 2.5 times more than public social welfare expenditure. It implies that non-state, private sectors dominates the structure of social welfare provisions in Korea. In addition, based on the analyses of the expenditure structure, the article defines the main feature of Korea's welfare mix as the 'mixed structure of the welfare mix dominated by the protective family', or 'expanded public sector, relatively limited market, and protective family'. Such a family-dominated welfare mix structure in Korea indicates that the fundamental source of solidarity of the Korean social welfare system is family and, therefore, the welfare regime of Korea can be classified as 'Conservative'.

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.85-86
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• 2021

• 응용통계연구
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• 제31권4호
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• pp.529-538
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• 2018

결핵은 높은 이환과 사망을 일으키는 질병으로 현대의학의 발달에 따라 발생률과 사망률은 감소하고 있다. 그러나 한국은 아직까지 OECD 국가 중 결핵 발생률과 사망률이 가장 높다. 이에 따라 한국은 결핵의 예방 및 통제를 위해 여러 정책 사업을 실시하고 있다. 본 연구에서는 공공민간협력(public-private mix) 결핵관리사업이 치료결과에 미치는 영향을 분석하고 결핵환자의 치료 성공에 영향을 미치는 요인을 확인하고자 한다. 질병관리본부에서 관리하는 결핵환자 신고 자료를 이용하여 2012-2015년 전국 결핵 신환자 코호트 약 13만명을 대상으로 분석하였다. 누적 발생 함수(cumulative incidence function)를 이용하여 요인별로 누적 치료 성공률을 비교하였으며. 주 관심사건(치료성공) 및 경쟁사건(사망)을 고려한 두 가지 경쟁위험모형(cause-specific Cox's proportional hazards model and subdistribution hazard model)을 사용하여 분석 결과를 비교하였다.

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.74-83
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• 2021

Background: This study compared the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) before and after the implementation of public-private mix (PPM). Factors affecting treatment success were also investigated. Methods: Data from culture-confirmed pulmonary MDR-TB patients who commenced MDR-TB treatment at Pusan National University Hospital between January 2003 and December 2017 were retrospectively reviewed. Patients were divided into two groups in terms of PPM status: pre-PPM period, patients who commenced MDR-TB treatment between 2003 and 2010; and post-PPM period, patients treated between 2011 and 2017. Results: A total of 176 patients were included (64 and 112 in the pre- and post-PPM periods, respectively). 36.9% of the patients were resistant to a fluoroquinolone or a second-line injectable drug, or both. The overall treatment success rate was 72.7%. The success rate of post-PPM patients was higher than that of pre-PPM patients (79.5% vs. 60.9%, p=0.008). Also, loss to follow-up was lower in the post-PPM period (5.4% vs. 15.6%, p=0.023). In multivariate regression analysis, age ≥65 years, body mass index ≤18.5 kg/m², previous TB treatment, bilateral lung involvement, and extensively drug-resistant (XDR)- or pre-XDR-TB were associated with poorer treatment outcomes. However, the use of bedaquiline or delamanid for ≥1 month increased the treatment success. Conclusion: The treatment success rate in MDR-TB patients was higher in the post-PPM period than in the pre-PPM period, particularly because of the low rate of loss to follow-up. To ensure comprehensive patient-centered PPM in South Korea, investment and other support must be adequate.

• 보건행정학회지
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• 제18권4호
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• pp.185-206
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• 2008

The National Health Insurance (NHI) has been the main body of health care system in Korea for the last 30 years since the NHI was founded. However, the inefficient management and strong regulations of the NHI have hindered the development of health care industry. The establishment of the MB government, whose interest lies on economic growth rather than equity, is expected to help the health care services gain a momentum. The essential measures that can step up public health care services overall are the following: the introduction of competition within NHI, the activation of private health care insurance, and the allowance of for-profit hospital. The private-public mix with market mechanism would level up the health care service for the public.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.282-291
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• 2004

Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

• 보건행정학회지
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• 제19권1호
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• pp.62-80
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• 2009

The purpose of this study was to examine the factors influencing the attitude toward the increasing role of private health insurance(PHI). In the Korea Welfare Panel Data 2007, a sample of 1,675 (adjusted by weight value: 1,607) respondents on an opinion on promoting PHI was used in the study. With independent variables including socio-demographic characteristics, health status, health-related behavior, and opinions on welfare service, ordered-probit model was used to analyze the attitude toward PHI. Negative opinion on the increasing role of PHI were responded by 54.6%(n=877) of the respondents, whereas 22.2%(n=373) were positive and 23.2%(n=357) were neutral. Old people, the better off, those with worse self-assessed health status, and those having an experience of health examination tend to have the positive attitude toward the increasing role of PHI. Women, those with chronic diseases or disorders and those who do not agree that comprehensive welfare benefits reduce work incentive showed negative attitude toward PHI. When comparing the needs for PHI before and after medical utilization, ex-ante need tends to strengthen the tendency to support private health insurance. This study will contribute to the discussion on the optimal mix of public and private health insurance in Korea by a better recognition of attitude toward PHI and health care system.

• 보건행정학회지
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• 제27권3호
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• pp.199-210
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• 2017

Background: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public-private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. Methods: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. Results: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. 'Transfers from government domestic revenue' share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to 'compulsory contributory health financing schemes,' 'Transfers from government domestic revenue' share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. Conclusion: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.