• Quality Improvement in Health Care
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• v.25 no.2
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• pp.16-25
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• 2019

Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

• Health Policy and Management
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• v.30 no.4
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• pp.522-530
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• 2020

Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.

• Health Policy and Management
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• v.28 no.3
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• pp.288-293
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• 2018

In 1994 Korea government began to develop the healthcare industry, since then the government has tried to create opportunities to promote the industry through various political efforts and policies. The biggest achievement was attracting foreign patients from 2009 to 2016 with a cumulative 1.56 million and total revenue of 3 trillion won. But Korea still loses the opportunity to become a global leader in the health care industry due to regulations and various ideological disputes. Accordingly, it is necessary to facilitate policy understanding and present a practical road map so that Korea's healthcare industry become a new growth engine that will lead the trend of global market in the future. It also suggests a national economic development paradigm, the health economy as health and economic value are rotated through a shift in view of health care. At this point, 20 years after the beginning of the healthcare industry development, it is necessary to evaluate the related policies and discuss effective future directions. In this sense, the purpose of this study is to examine the policies and limitations of the healthcare industry by each government division, and based on it, to propose political tasks for the future.

• Health Policy and Management
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• v.32 no.1
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• pp.113-121
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• 2022

This study aims to compare the healthcare status of South Korea and other member of the Organization for Economic Cooperation and Development (OECD) using the OECD health statistics 2021. We used the position value for relative comparison (PARC) index to measure the five elements of the healthcare system, demand, supply, accessibility, quality, and cost. For the statistical analysis, Mann-Kendall test was performed to examine the trend of the PARC values from 2000 to the most recent year. The results showed that supply, demand, accessibility, and quality were above median than the OECD median and the cost was below median. In sectors such as primary care, health employment and mental health care were below median average. With these result, necessary steps for a sustainable healthcare should be taken into effort by policy makers.

• Health Policy and Management
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• v.20 no.2
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• pp.53-68
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• 2010

In health care, the process of resource allocation becomes a controversial process of rationing, as scarce resources are allocated between the numerous health care interventions. Especially for the last few years, decisions to define and expand the benefit package of National Health Insurance have always become the object of fierce criticism. It is partly because we have not reached a collective agreement as to what the most important criteria for spending priorities are. This paper considers the procedures and the principles which could be used to determine rationing in health care, and emphasizes the need to have explicit principles which determine patient access to care and to have an evidence base to inform rationing decisions. Also, the need to set up a public committee is suggested to take rationing decisions on behalf of government and NHS and to present them as evidence-based decisions.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6177-6180
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• 2014

Background: Our study objectives were to evaluate the medical economics of cervical cancer prevention and thereby contribute to cancer care policy decisions in Japan. Methods: Model creation: we created presence-absence models for prevention by designating human papillomavirus (HPV) vaccination for primary prevention of cervical cancer. Cost classification and cost estimates: we divided the costs of cancer care into seven categories (prevention, mass-screening, curative treatment, palliative care, indirect, non-medical, and psychosocial cost) and estimated costs for each model. Cost-benefit analyses: we performed cost-benefit analyses for Japan as a whole. Results: HPV vaccination was estimated to cost $291.5 million, cervical cancer screening $76.0 million and curative treatment $12.0 million. The loss due to death was $251.0 million and the net benefit was -$128.5 million (negative). Conclusion: Cervical cancer prevention was not found to be cost-effective in Japan. While few cost-benefit analyses have been reported in the field of cancer care, these would be essential for Japanese policy determination.

• Health Policy and Management
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• v.10 no.4
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• pp.20-56
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• 2000

The purpose of this article was to evaluate the effects of reimbursement system on the basis of diagnosis-related groups(DRGs). We searched articles which was published from 1970 to 2000 using MEDLINE ； Key words "diagnosis-related groups, DRGs, prospective payment system, PPS. Then we reviewed 97 articles on classifying them into several categories of contents. It seems that the effects of DRGs in controlling hospitals cost in the U.S. was not clear cut. The U.S. Medicare PPS using DRGs remains vulnerable to compensatory increases in ambulatory care and long-term care facilities utilization despite cost per case and cost per admission being reduced. Also some research indicated the possibilities of deterioration in health care service quality. So putting theses results together, much more consideration is needed before the application of DRGs reimbursement system in Korea. Particularly there is the crucial difference between U.S. health care system and Korean, we must be aware of the limitations of DRGs and revise the DRG system to applicable in Korea.orea.

• Korean Journal of Hospice Care
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• v.5 no.1
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• pp.50-62
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• 2005

The elderly people was over 8.3% in 2003. This seament is projected to grow to 14.4% by 2019(Aged society) and over 20% by 2026(Super aged society). As the elderly population is increasing and young population is declined social issues around elderly care are emerged in Korea. As a result of that, they are in the condition of poor system of the welfare of the old and it is the worst one in Korea. And because of the worst financial independence and difficulty in Korea, welfare facilities and medical instruments are so insufficient and deteriorated, so the quality of service is getting low. Furthermore the mortality of cancer is rapidely increased in recent years. So it is expected that the number of families who are caring for terminal cancer patient will be increased. We can not solve those problems only with government's policy such as to secure ample budget and to enlarge the aged welfare institutions. Definitely, to acheve the suggetions persistence concern about old people is most important, and family, community and national government should be linked to accomplish to goal. Accordingly, for this study attempts to provide conceptual framework of the respite care, spiritual care and home hospice, nursing home for the elderly. And this study is to discuss the necessity and effect about the construction of housing welfare infrastructure and to make a cooperation and linkage system among the aged welfare institutions, government and the aged welfare programs. As is well known, the issue of the increasing aged people is neither a matter of individuals nor of the family, but rather a complex matter of whol society. Therefore it can be resolved by the active participation of government. Conclusively this study tries to provide an direction of the improvement with regard to the welfare policy for the elderly. The study is as follwos: Chapters 1: The theological base, conception, essentiality, respite care, spiritual care and home hospice, nursing home for the elderly. Chapters 2: Definitions of respite care, spiritual care, hospice, patient of termina cancer and quality of life. And relations between respite care and nursing home. Chapters 3: The necessity of long-term care insurance and the perspectives of spiritual care. Chapters 4: Conclusions and summarizing(The directions of improvement of welfare policy for the elderly). To sum up, the problems of the aged people has not effects only to the aged people. This means that the problems of aged is the problems of the young generation today. Because young generation will be the old generation in the near future.

• 한국사회정책
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• v.23 no.1
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• pp.227-256
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• 2016

This study examines whether formal home care has led to a reduction in family member's allocation of time to care of elderly and changing the allocation of other time: informal care, market work, leisure, etc. Long-term care for the elderly is not the entire burden of elderly families anymore due to the increasing of the formal home care service for elderly since mid-2000's. This study uses triple difference(DDD) methods for evaluating policy reforms when reforms are equally and nation-wide accessible and analyzes data from the 2004 and 2009 Time Use Survey Data of the National Statistical Office in Korea. The treatment group is composed of the families of the elderly who need care and low- and middle- income family. Controlling for demographic characters, the three-way interaction term has statically significant and negative impact on care time of family members in treatment group statistically significant. The results reveal that the policy changes in elderly home care service affect time allocation of family members with old adults, which decreases caregiving time in a daily life. This result becomes apparent when we limit the case of women. But the level of reduction is not enough to change other kinds of time-informal care, market work, leisure, etc. The results indicate that formal home care for the elderly can reduce the burden of caregiving in families, but only minimally.

• Korean Journal of Human Ecology
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• v.14 no.6
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• pp.915-924
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• 2005

In this study, two controversial Child Care Policies will be discussed based on the perspective of Economics: Accreditation of Child Care Centers and Liberation of Child Care Service Tuition. Liberation of Child Care Service Tuition is to provide parents and children with exact quality which they want at a differentiated price. Accreditation of Child Care Center is to enhance the quality of child care service by evaluating the quality of centers and grading centers into three classes. This study concludes that success or failure of the policies mostly depend on the investment capability of the government to increase the supply of child care centers. Employing these two policies requires the child care rate more than certain level and more financial investment from the government since the responsibility of providing child care services relies mostly on the government in Korea.