• Journal of Preventive Medicine and Public Health
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• v.54 no.5
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• pp.360-369
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• 2021

Objectives: The purpose of this study was to investigate public preferences regarding allocation principles for scarce medical resources in the coronavirus disease 2019 (COVID-19) pandemic, particularly in comparison with the recommendations of ethicists. Methods: An online survey was conducted with a nationally representative sample of 1509 adults residing in Korea, from November 2 to 5, 2020. The degree of agreement with resource allocation principles in the context of the medical resource constraints precipitated by the COVID-19 pandemic was examined. The results were then compared with ethicists' recommendations. We also examined whether the perceived severity of COVID-19 explained differences in individual preferences, and by doing so, whether perceived severity helps explain discrepancies between public preferences and ethicists' recommendations. Results: Overall, the public of Korea agreed strongly with the principles of "save the most lives," "Koreans first," and "sickest first," but less with "random selection," in contrast to the recommendations of ethicists. "Save the most lives" was given the highest priority by both the public and ethicists. Higher perceived severity of the pandemic was associated with a greater likelihood of agreeing with allocation principles based on utilitarianism, as well as those promoting and rewarding social usefulness, in line with the opinions of expert ethicists. Conclusions: The general public of Korea preferred rationing scarce medical resources in the COVID-19 pandemic predominantly based on utilitarianism, identity and prioritarianism, rather than egalitarianism. Further research is needed to explore the reasons for discrepancies between public preferences and ethicists' recommendations.

• Journal of Preventive Medicine and Public Health
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• v.54 no.5
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• pp.293-300
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• 2021

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.

• Journal of the Korean Society of Industry Convergence
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• v.25 no.6_3
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• pp.1183-1190
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• 2022

Recently, the Ministry of Strategy and Finance announced a plan to reduce the proportion of economic evaluation in non-metropolitan areas and strengthen balanced development evaluation through the reorganization of the preliminary feasibility study system. In addition, the social value of the quality of life, such as job, environment, and safety, which may be affected by the implementation of transportation facility investment projects, was reflected as the main item of policy evaluation. In this study, the ripple effect of the project in terms of social value was reviewed for the Gangil-Chuncheon. The effect of highway opening was investigated by reviewing the feasibility report, post-evaluation report, and statistical indicators. Recently, the Gangil-Chuncheon highway is getting used by around 110,000 people per day. The number of tourists in Chuncheon rapidly has increased from 5 million a year to more than 11 million now. In addition, it was confirmed to produce effects such as population migration, net inflow and land price increase, improvement of living convenience, and expansion of emergency medical care. Although this ripple effect was influenced by various socio-economic factors as well as the opening of the highway, it is clear that it is difficult to occur without the opening of the highway. It is judged that the evaluation of indirect benefits and social values due to the opening of the highway can be quantified through continuous research and data construction. Post-evaluation of construction works, including project efficiency evaluation and ripple effect evaluation, is performed for construction works with a construction cost of more than 50 billion won. In the future, we will continuously improve the evaluation system in order to evaluate the indirect benefits and social values of public investment projects.

• Health Policy and Management
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• v.33 no.1
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• Health Policy and Management
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• v.33 no.1
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• pp.107-113
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• 2023

Unmet healthcare is an important indicator for measuring accessibility of healthcare services. We analyzed the following four data from a nationally representative sample of South Korean population: Korea Health and Nutrition Examination Survey (KNHANES, 2007-2021), Community Health Survey (CHS, 2008-2021), Korea Health Panel Survey (KHP, 2011-2019), and Korean Welfare Panel Study (KOWEPS, 2006-2021). The proportion of individuals reporting unmet healthcare needs were 6.0% (KNHANES), 5.1% (CHS), and 13.1% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.4%, -9.4%, and -5.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES), 0.5% (CHS), 2.7% (KHP), and 0.4% (KOWEPS). The APC was -10.4%, -16.1%, -11.5%, and -19.1%, respectively. Compared to the previous year, the rate of unmet healthcare needs decreased slightly, but the rate of unmet health care needs due to cost tended to increase. Overall, higher rates of unmet healthcare needs were reported in the low-income and the elderly population. Although it was confirmed through the APC that the rate of unmet healthcare experience has decreased over the past decade, it can be seen that there is still a disparity by income level and age. These results suggest the need for an appropriate health benefit coverage policy for the low-income and the elderly.

• Korean Journal of Social Welfare Studies
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• v.41 no.2
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• pp.159-187
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• 2010

The main purpose of this paper is to attempt an alternative measurement and analysis of poverty considering income as well as time in order to present an effective antipoverty policy. Based on Korea Welfare Panel Study (2005), the income poverty, time poverty, and double poverty of household in which householders were under 60 years were measured. Moreover this paper found that households experiencing the time poverty might be faced with additional income poverty because of the necessity to purchase care services in the market to compensate for the time. As a result of the analysis, income poverty rate is 9.5%, time poverty rate is 15.7%, and time-adjusted income poverty rate is 10.8%. And low-educated single parents with young children are more likely to experienced income as well as time poverty. Therefore, this paper proved that the 'welfare to work' policy without considering situations in household could be faced with the limit. Furthermore, this paper suggests that social welfare policy should aim at minimizing the tradeoffs among different works and activities, and then support to improve the quality of life.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1053-1068
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• 2020

In accordance with the new healthcare policy of government (Moon Jae-In Care) to strengthen health insurance coverage, the National Health Insurance (NHI) coverage of brain magnetic resonance imaging (MRI), brain/neck MR angiography (MRA), and head and neck MRI have been expanded since 2018 in Korea. This article has been reviewed focusing on the "Detailed matter concerning criteria and method for providing reimbursed services in the NHI. Some revisions" regarding reimbursement for MRI, which was revised from October 2018 to April 2020 and is currently in effect. It included the MRI reimbursement system in Korea, recent adjustment of the reimbursement coverage for patients with headache or dizziness, and reimbursement coverage, standard imaging, and radiologic report of brain MRI, brain/neck MRA and head and neck MRI. This article could help radiologists gain knowledge on health insurance to protect the expertise of the radiologist and to play a leading role in the hospital. As the policy changes, detailed matter concerning criteria and method for providing reimbursed services in the NHI may be revised. Therefore, radiologists should update issues related to insurance reimbursement for MRI continuously.

• Korean Journal of Child Education & Care
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• v.17 no.4
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• pp.1-30
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• 2017

The purpose of this study is to investigate the awareness of daycare teachers by the nursery school operation performance of the National Competency Standards(NCS). For this purpose, 35 public and private daycare center, home daycare centers and corporation daycare center teachers were randomly sampled in Busan Metropolitan City. We conducted a questionnaire consisting of 230 sub-elements based on 45 sub-competency unit elements extracted from 12 areas of job ability of the national competence standards. Final questionnaires were collected from 117 questionnaires of 28 national daycare teachers, 30 private daycare teachers, 30 home daycare teachers, and 29 corporation daycare teachers. As a result, there was a difference in the awareness of importance among the four groups in all 12 performance capability units. For the 12 job performance units, the importance was recognized in the order of corporate daycare center, national daycare center, home daycare center, and private daycare center. Among them, "Establishment of Child Care Center Management Policy", "Construction of Child Care Service", "Child Care Activity Management", "Infant and Child Playing Guide", "Body and Art Activity Guidance", "Language, Nutritional guidance" there were no differences in the awareness of the importance of corporate daycare teachers and national daycare teachers, and there was no difference between national daycare teachers and home daycare teachers. However, there was a difference between corporate daycare teachers and home daycare teachers.. There is also a difference in the awareness of importance between home daycare teachers and private daycare teachers. In the remaining five job competence units, "Child Care Assessment", "Support for Infant and Toddler Development", "Cooperation with the Home and Community", "Child Care Management", and "Child Care Research", corporation daycare centers, national daycare centers. There was no statistically significant difference in the awareness of importance, but there was a significant difference from the private daycare teachers. Also this tendency was consistently observed in 45 sub-capacity unit elements.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.6
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Journal of Family Resource Management and Policy Review
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• v.25 no.3
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• pp.103-120
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• 2021

Recently, the importance of the fathers role in the care of young children has been emphasized in Korea for the balance of childcare responsibilities between mothers and fathers. This study investigates the trends in paternal childcare in Korea over the last 15 years. Childcare is divided into primary and developmental care and fathers's Childcare time and participation rates are inverstigated for dual- and single-income households. Data are collected from the four waves of the five-yearly Statistics of Korea Life Time Surveys between 2004(t₁) and 2019(t₄) including the workday time diaries of fathers with preschool children(n₁=2,264, n₂=1,242, n₃=959, n₄=952). Three major results are identified. First, paternal childcare time and participation rates have increased with dual-income fathers spending 24 more minutes a day with their young child(ren) in 2019 than in 2004, which is nearly double. Second, in the analysis of fathers' childcare time use and participation rates comparing primary and developmental care, primary care is found to have increased more than developmental care, especially among dual income fathers: this further exhibits a reversed relation between primary and developmental care over time. Third, the determinants of paternal childcare time are fathers' age, market labor time, commuting time, gender equality consciousness, and education. In particular, market labor time was significant in all four waves, while gender equality consciousness is only significant for single-income fathers. Based on these results, a specific agenda is provided for family-friendly policies to improve the balance of childcare roles between fathers and mothers, especially encouraging increased(significant and sufficient) participation of fathers in primary care activities.