• 기술혁신학회지
• /
• 제19권2호
• /
• pp.358-394
• /
• 2016

이 연구는 연구장비 공동활용 정책의 꾸준한 시행에도 불구하고 저조한 공동활용의 원인이 정책집행이 현장관료 또는 정책대상자의 입장에서가 아니라 정책결정자의 시각에서 이루어져 왔다는 문제의식에서 시작하고 있다. 따라서 이 연구는 정책집행의 상향적 접근법에서 기초연구사업을 수행하는 현장 연구자들과 장비 관리자들을 대상으로 연구장비 공동활용의 현황을 분석하였다. 분석결과는 공동활용에 대한 연구 책임자들의 중요성 인식이 여전히 낮은 편이며, 실제의 공동활용 과정에서는 필요한 집행자원이 부족하며, 공동활용의 지속성을 확보하기 위한 일상적인 관리단계에서의 유인책도 충분하지 못한 것으로 나타나고 있다. 이에 따라 기초연구사업에서의 연구장비 공동활용을 증진하기 위한 정책대안을 관리단계별로 정책집행의 상향적 관점에서 유인도구와 정보도구 중심의 정책수단 도구들을 개발 논의하고자 노력하였다.

• Journal of Preventive Medicine and Public Health
• /
• 제52권1호
• /
• pp.41-50
• /
• 2019

Objectives: The aim of this study was to investigate cancer patients' utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. Methods: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). Results: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. Conclusions: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

• 한국유기농업학회지
• /
• 제20권4호
• /
• pp.459-474
• /
• 2012

Based on the general policy called "Green Growth", the Korean government planed to establish a biomass town in South Korea in order to recover energy from organic waste and to substitute for fossil fuel at rural region. Technical and financial support for the establishment of biomass town was insufficient so far. There are some policies to support biomass town establishment, however financial support from several Korean ministries seemed not to have been used efficiently. Some policies are planned excessively so that they cannot be realized on time. Therefore, there is a need to analyze the status of biomass utilization technology and policy in Japan from the point of view of an external biomass expert, since biomass utilization technology and policy of Japan take good achievement during the many developed countries. For the analyzing of technology and policy in Japan, literatures concerned biomass management policy and biomass town design were collected by visiting Japan Ministry of Agriculture, Forestry and Fisheries and interview of public officials in charge was carried out. There are several implications for the promotion of Korean policy concerned with biomass utilization and biomass town establishment.

• 보건행정학회지
• /
• 제18권3호
• /
• pp.90-109
• /
• 2008

Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.

• 보건행정학회지
• /
• 제33권3호
• /
• pp.325-337
• /
• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

• 보건행정학회지
• /
• 제30권3호
• /
• pp.326-334
• /
• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• 한국시스템다이내믹스연구
• /
• 제1권2호
• /
• pp.149-174
• /
• 2000

In recent years, how to promore the Utilization of Internet is a main issue of national information policy. In this study, we focused our approach to find promoting sttategies for Internet utilization on three sector's users, governments, enterprises, and households. Promoting the Internet utilization of these three sector's users is a very difficult problem, because their information levels are different and information gap among them can be regarded as bottleneck. And since the interactions between user's demands and diverse information seccor's factors are very complex, policy leverages can not find easily. By the system dynamics methodology, this paper examines the interrelationships between three user's demand mechanism and information policy sector. Information policy sector consist of four sectors, infrastruccure policy seccor, application-contents sector, governance sector, and access and price policy sector (free access policy, literacy policy, telecommunication price policy, etc.). To find and investigate policy leverage that will help understanding dynamic behavior of users in using Internet we build a causal loop diagrams and SD models by using survey data obtained from three sectors'specialized users, 488 persons.

• 보건행정학회지
• /
• 제1권1호
• /
• pp.42-53
• /
• 1991

Analysis of health care utilization is very important for health care policy development. Traditional studies of health care utilization were focused on measuring the level of health care utilization and on analyzing the determinants of health care utilization in the defined areas and populations. But there were some limitations in comparing the health care utilizations rates in traditional studies because so many factors were to be considered. Small area analysis is a method used to demonstrate substantial variations in health care utilization with popualtion-base use rates among similar geographic areas. This review discusses the methods, magnitude and trend of geographic variations, factors influencing small area variations, and makes suggestions for further study. Finally, the article discusses the necessity and feasibility of small area analysis in Korea.

• 보건행정학회지
• /
• 제9권2호
• /
• pp.40-54
• /
• 1999

The purpose of this study is to compare the health service utilization patterns between up and myun and to find the determinants of utilization. For this purpose. this study used different versions of utilization rates. such as crude utilization rates. utilization rates adjusted for population composition. and age-sex adjusted utilization rates. Data used in this analysis were the Community Health Interview Survey which was conducted by interviewing 741 households from August 31 to September 11, 1998 in HongCheon-Gun. KangWon-Do. The major findings of the analysis are summarized as follows: 1. There was a statistically significant difference in the level of health service utilization between up and myun. Depending upon the unit of analysis employed (those who were interviewed vs those who were sick). the difference between up and myun was reversed. 2. Determinants of health service utilization are analyzed using logistic regression. The result showed that predisposing factor influenced health service utilization in rural areas, while the enabling factor didn't.

• 보건행정학회지
• /
• 제23권1호
• /
• pp.19-34
• /
• 2013

Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.