• Title/Summary/Keyword: care policy

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The reform of inspection of adult social care market in the UK and policy suggestions for long-term care in South Korea (영국 성인돌봄서비스 시장에 대한 감독 개혁과 한국 장기요양의 시사점)

  • Chon, Yongho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.203-210
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    • 2018
  • The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

Impacts of Implementation of Patient Referral System in terms of Medical Expenditures and Medical Utilization (의료전달체계 정책효과 분석)

  • Jung, Sang-Hyuk;Kim, Han-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.1 s.49
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    • pp.207-223
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    • 1995
  • A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospitals could not get any insurance benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992) from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it showed statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary care hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode. and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary care hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.

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Impact of Changes in Medical Aid Status on Health Care Utilization

  • Kim, Woorim;Nam, Chung Mo;Lee, Sang Gyu;Park, Sohee;Kim, Tae Hyun;Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.4
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    • pp.513-522
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    • 2019
  • Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

Changes in Parenting Support Policy and Opening Day Nurseries to Local Communities in Japan (일본 자녀양육지원정책의 변화와 보육소의 지역사회 개방(開放))

  • Choi, Mi-Mi
    • Korean Journal of Comparative Education
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    • v.27 no.4
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    • pp.285-310
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    • 2017
  • This study reviews recent changes in parenting support policy in Japan, and examines the roles and functions of day-nursery as the base for parenting support in the local community. The purpose of this study is to provide implications for the direction of the parenting support policy and child-care facilities for the local communities in South Korea. The analysis concentrates on the official national reports such as the Declining Birthrate White Paper and Japan's National Guidelines for Care and Education at Day Nursery by the Japanese Cabinet Office. The study finds that the Japanese government has introduced comprehensive medium and long-term policies for all the members of the community with recognizing the changes in the domestic and foreign child-rearing environments and social needs. These policies have also helped to improve the social awareness of parenting. The role of the day-care center has been raised as a significant part of the support for child-rearing in the local community due to the revision of the Child Welfare Act for nursery school teachers in 2001 and the official announcement of Japan's National Guidelines for Care and Education at Day Nursery in 2008. The study also concludes that the social responsibility of the nursery center has been strengthened by being utilized as a public resource for the community. From the findings, we can elicit the conclusions and implications that the roles and functions of child care centers as a significant base for parenting support in the local communities need to be considered. We also listen to the voices of stakeholders such as parents and staff of child care centers. Last but not least, we would understand the social role and importance of bringing up children by cooperation of the community members, and promote the role of child care centers as a central place providing and communicating information on child-rearing in the local communities.

A Study on the Care Policy for the Elderly in Super-aged Society (초고령 사회의 노인 돌봄 정책에 관한 융복합 연구)

  • Dong-Gun Kim
    • Journal of Digital Convergence
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    • v.22 no.2
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    • pp.21-28
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    • 2024
  • This study analyzed the current status of care policies and senior citizen issues in Korea, which has entered a super-aging society, and attempted to suggest improvement measures for desirable convergence policies. The problems of the elderly in Korea have emerged as health problems, poverty problems, loss of roles, and care problems due to changes in the concept of family, values, and socioeconomic structure. In addition, poor seniors need jobs and employment policies, and healthy middle-class seniors need policy development to enable leisure activities and volunteer activities. In particular, it is necessary to establish policies to enable people to spend the rest of their lives in elderly care facilities and elderly care hospitals through community care policies. The super-aging society accounts for more than 20% of the total population among those aged 65 or older, and according to the National Statistical Office, it is expected to become a super-aging society by 2025. Elderly welfare policies must provide various programs and the needs and services of elderly care, and in the future, a super-aging society will need to secure a lot of financial resources and maintain a productive population to cover the financial resources. In other words, the human life cycle is from birth to death, and when the ratio of natural deaths of the elderly and infants born is appropriate, the society and the country can be seen as stable, vibrant, and healthy societies.