• Health Policy and Management
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• v.26 no.2
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• pp.148-152
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• 2016

The hospital readmission rate has been widely used as an indicator of the quality of hospital care in many countries. However, the transferrability of this indicator that has been developed in a different health care system can be questioned. We reviewed what should be considered when using the risk-standardized readmission rate (RSRR) as a generic quality indicator in the Korean setting. We addressed the relationship between RSRR and the quality of hospital care, methodological aspects of RSRR, and use of RSRR for external purposes. These issues can influence the validity of the readmission rate as a generic quality indicator. Therefore RSRR should be used with care and further studies are needed to enhance the validity of the readmission rate indicator.

• The Korean Journal of Health Service Management
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• v.10 no.1
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• pp.39-51
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• 2016

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

• Health Policy and Management
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• v.28 no.3
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• pp.257-262
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• 2018

This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

• Health Policy and Management
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• v.11 no.4
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• pp.21-37
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• 2001

The purpose of this study is to examine internet agent of IT(Information Technology) in health care industry Since IT is essential for corporate strategy in service management, this section examines IT in health care service, especially from the view of 'Agent Technology' that has been recently issued. Intelligent agent is a new paradigm for developing software applications. More than this, agent-based computing has been hailed as 'the next significant break-through in software development' and 'the new revolution in software'. And health care service is a non-mechanic, human-based service. This paper reviewed what possible suggestions or advices can be made to the health care service. Since many health care services using internet have been attempted over the recent years, this study will hopefully be able to come up with good suggestions from many aspects. Thus, information inequality between producer(physician) and consumer(patient) in health care service will be decreased through the introduction of agent technology.

• Health Policy and Management
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• v.13 no.3
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• Health Policy and Management
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• v.8 no.1
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• Journal of Family Resource Management and Policy Review
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• v.13 no.2
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• pp.85-105
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• 2009

The purpose of this study is to compare the laws and policies relating to work-family balance with foreign cases, and to analyse the problems in implementing those laws and policies. For these purpose, this study compares family leave policies, working hams policies, public care policies in other countries. And these laws in Korea are shown. This study also analyse the policies for work-family balance in labor policy, family policy, gender policy and saeromaji plan. The results are as follows; policies for work-family balance are limited to child care and family leave. Laws for family leave are various and proper. But implementing rate of policy goal is low and a few people can benefit by those laws and policies. So, wide-range policies for work-family balance which all the families can benefit are needed.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.411-418
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• 2006

Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

• Korean Journal of Social Welfare Studies
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• v.40 no.3
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• pp.5-40
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• 2009

As of June 2008, the government's expansion policy for the long-term care service infrastructure has achieved an outstanding 96.4% occupancy rate of facilities across the country. Despite such achievement, practical issues including the physical lack of facilities, disproportional regional spread and decline in government accountability have raised concerns about the effectiveness of the policy's implementation. This study was aimed at defining the implementation procedure of expansion policy for long-term care service infrastructure, analyzing variables that affect it, examining the problems revealed in implementation procedure, and suggesting improved plan on that policy. Research methods were to review literatures on infrastructure expansion policy, to conduct case studies on K province, C city and 4(2 corporations and 2 privately owned) facilities in C city for studying practical implementation procedure on a local government level, and to use Alexander(1985)'s framework for analyzing variables of policy implementation. As a result of this study, policy variables including the clarity and adequacy of policy goal, nature of service providers, task and responsibility between government authorities, and implementation variables such as propensity toward budget allocation, financial restraint, swift utilization of budgets and the streamlining of involved procedures and inter-agency relations stood out as the main factors affecting policy implementation. In adddition, this study suggested several improvement measures such as accounting facilities need based on real local demand and supporting to private participation and so on.

• Health Policy and Management
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• v.20 no.1
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• pp.87-102
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• 2010

The objective of this study were to examine the impact of medicaid coverage expansion policy aimed at improving access to primary care. The case-control study was conducted to compare preventable hospitalization(PH) rate in new medicaid recipients versus national health insurance(NHI) enrollees form 1996 to 2001. Rates of preventable hospitalization associated with ambulatory care sensitive conditions(ACSC) were calculated and standardized by age and sex. Multinomial logit regression model was used to control the confounding factors such as age, gender and charlson comorbidity index Annual PH rates in the new medicaid increased 1.64 times after medicaid expansion, with controling confounding factors. Meanwhile, annual PH rate in the NHI increased 1.68 times during the same period, with adjusting confounding factors. Current findings suggest that the new medicaid PH rate was less likely to rise than NHI PH rate after implementing medicaid expansion. This study is expected to provide policy-relevant evidence of medicaid expansion to include population with low income.