• International Journal of Contents
• /
• v.9 no.1
• /
• pp.42-48
• /
• 2013

This research explores the convergence of health care expenditure in Korea with different income groups and the world level by applying different concepts of convergence, including growth rates, trends, differences as well as rationality and statistical variation of health care expenditure. The empirical evidence shows that, in general, the health care expenditure in Korea seems to be on the right track in terms of both level and difference, given the fact that convergence exists with the expenditures of the high income group and the world level. It is also worth mentioning that the Korean public health care system has been performing much better than its private health care counterpart. Such a result suggests that the private health care system has to be more elaborately and systematically managed through the establishment of an operational policy to stimulate an increase in private health care expenditure.

• Journal of Home Health Care Nursing
• /
• v.15 no.2
• /
• pp.99-105
• /
• 2008

Purpose: We evaluated patient nutritional status in a home care setting. Method: We recruited 81 patients who received in-home care using a screening sheet. The level of nutrition-related serum marker (albumin) was checked via medical records and data analyzed using descriptive analysis, t-tests, and $X^2$-test. Results: Nutritional status varied according to the primary medical diagnosis. Poor nutritional status was significantly higher in cancer patients than in other diseases. Serum albumin levels were significantly lower in the malnutrition group than the good nutrition group. Conclusions: Nutrition screening can determine the nutritional status in home care patients. Home care nurse practitioners should consider nutritional status when assessing patient health.

• Journal of Korean Public Health Nursing
• /
• v.21 no.2
• /
• pp.134-145
• /
• 2007

Purpose: To test the effects of health education on the blood pressure, knowledge, and self-care of visiting nursing clients. Methods: The study subjects were 96 participants who had been diagnosed with hypertension or had high risk factors for hypertension among those registered at a public health center in Seoul. The education program was individualized and delivered to enhance the management of hypertension including life-style modification, medication, and complication managements. Data were collected using questionnaires from May to December 2006 and analyzed using descriptive analysis, t-test, paired t-test, and ANOVA. Results: The blood pressure of the participants after the education was significantly decreased compared to before the education. Education also significantly affected the increases of knowledge of the disease and self-care capability. However, the blood pressure and self care were not significantly improved for the age group over 85 years. Conclusions: This study proves that the individualized health education for visiting nursing clients was effective in improving blood pressure, knowledge, and self-care of hypertension. However, it is necessary to develop strategies that are specifically targeted at particular age groups in order to improve the capability of self-care of hypertension.

• Health Policy and Management
• /
• v.18 no.4
• /
• pp.66-84
• /
• 2008

Objectives: This study aimed to. offer some fundamental evidences for the stroke management policy by investigating the trends of medical care utilization and regionalization in stroke inpatients. Methods: We used the National Health Insurance claims and registry data for stroke inpatients from 1998 to 2005. Among all stroke inpatient claims data, self-employed insured and their dependents were only included in this study. The classification of stroke was based on ICD-10(I60-I69) and its subtype was divided by hemorrhage(I60-I62) and infarction(I63-I64) type. To evaluate regionalization of medical care utilization, relevance index was calculated by regions. The regions were classified 8 large catchment areas and 163 self authorized areas. Results: The overall medical care utilization rate of stroke inpatient has been increased, especially infarction subtype. Among medical care institutions, the utilization of hospital has been the most rapidly increased. Although considered annual rate of interest, total medical cost of stroke inpatients has been increased, Totally, more than 84% of stroke inpatient were admitted to medical care institutions in their own large catchment area during 1998-2005. The relevance indices in their own large catchment area (self sufficiency rates) were more than 70% in most areas regardless of stroke subtype except Chungbuk catchment area. Self sufficiency rates of stroke inpatients among 163 self authorized areas in 1998 and 2005 were 84.2% and 83.1% in metropolitan, 46.7% and 45.5% in urban, and 19.5% and 22.6% in rural areas, respectively. Conclusion: Stroke management policy for improvement of distribution at the district level, especially in rural areas, may be helpful for reducing regional inequality in stroke.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.24 no.1
• /
• pp.3-12
• /
• 2013

Most preschool children in Korea attend kindergarten (KG) or a child care center (CCC). CCCs, which focus on caring for the child, belong to the ministry of health and welfare. On the other hand, KGs are responsible for education, and belong to the ministry of education, science and technology. In order to resolve the decline in population due to low birthrates, the government is expanding the free child care and education policies. CCCs and KGs are combined together to form the 'NURI curriculum' and supporting funds have been increased in both governmental departments. In addition, economic support is provided for homeschooling households. Because this is a nationwide policy and applies to every single household, thorough preparation regarding the effect and side effects must be made. This policy is currently being implemented, and as child and adolescent psychiatrists, great consideration should be given to the influence on the population. Therefore, the Korean Academy of Child and Adolescent Psychiatry intends to investigate the effects and problems of the nationwide policy by analyzing the current condition of Korea's free child care and education and foreign policies. In the current paper, we reviewed the developmental process of Korea's free child care and education policy, as well as suggested future directions.

• 한국노년학
• /
• v.32 no.2
• /
• pp.467-485
• /
• 2012

National Health Insurance Corporation initiated Home and Community Long-term care Agency Quality Assessment(HCLA-QA) program in 2010. This study aims to explore long-term care agencies' perceptions and attitudes toward HCLA-QA program, focused on the home-visit care agencies. Total 473 agencies completed the questionnaires(response rate 13.6%), using the e-mail and fax survey methods with high-capacity web-fax server of NHIC. On the results of this study, we found the agencies' different perceptions and attitudes on HCLA-QA program according to their quality ratings as QA results. Compared to the agencies with low quality ratings, the agencies with high quality ratings tend to have more time for preparation, better understandings about HCLA-QA program, more positive perceptions that quality indicators generally are valid, and more affirmative attitudes that the notifications of QA results are helpful for agencies. Our findings can be very useful for establishing strategies for improving the HCLA-QA program. The policy makers, the insurer, and the agencies need to consider the opinions of the agencies with high quality ratings as well as the ones with low quality ratings.

• Child Health Nursing Research
• /
• v.13 no.2
• /
• pp.128-135
• /
• 2007

Purpose: To investigate health problems in child day care centers, needs for Child Care Health Programs, and management of sick children by day-care staff. Methods: A cross-sectional descriptive study. Day-care staff (N=206) from 33 day care centers in Seoul, completed a structured questionnaire. Results: Almost half of the day-care staff (53.4%) experienced sick events in their child at least once a month. The most frequently reported difficulty in having a sick child was in not having a health professional to consult, and almost all day-care staff (99.5%) had asked parents not to bring a sick child to the day care center. The biggest reason of exclusion was due to infectious disease including measles, chicken pox, mumps, diarrhea·vomiting, and pink eye. The majority of day-care staff (97.6%) agreed that there is a need for Center-based Child Care Health Program (CCCHP), and expected general health & illness management, and special care for chronic disease from CCCHP. Conclusion: These results showed a high incidence of sickness in children in day care centers, and there were great demands for a Center-based Child Care Health Program for day-care staff. Also the results of this study can be utilized as a basis for the establishment of child care policy in Korea.

• Health Policy and Management
• /
• v.27 no.1
• /
• pp.56-62
• /
• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• Journal of Korean Academy of Nursing Administration
• /
• v.11 no.4
• /
• pp.401-414
• /
• 2005

Purpose: This study was to evaluate the utilization of health care service and to provide supportive data for health care policy making in one urban area in Korea. Method: This study tested the significance of public health service using the database of an university hospital and public health center from Feb. 2000 to Dec. 2004. Data were analyzed by multidimensional analysis and data mining technique and produced the information on the classification of utilization characteristics by main disease and the total cost of use and disease association with the users of the public health center. Results: The Results were as follows: 1) Top 10 diseases in the area accounted for 22.4% of total frequency for the most recent 5 years in university hospital, while 59.0% in public health center. 2) There were significant correlations between university hospital and public health center user's insurance type and place of residence: It showed higher use of public health center for free service beneficiaries residing in Seoul than residents in nearby or local area. The medical insurance types for hospital users were more various than those for public health center users. 3) The use of hospital for patients of hypertension, diabetes mellitus and hyperlipidemia was tended to concentrate in mostly autumn and winter since August 2000, while the cost of using public health center for those patients has been steadily reduced since July 2000. 4) As a result of cluster analysis, there were classified into three homogeneous groups according to the total cost of using public health service, age, and the frequency of use. 5) The association analysis on patients with chronic disease in public health center produced a detailed information on accompanying diseases related to the incidence rate of disease of high frequency due to aging, information on drug abuse and immune disease. Conclusion: The health care policy for local community should be evaluated continuously. And the policy to build an integrated data warehousing by public health indicator system and to enhance the faithfulness of data is required.

• Health Policy and Management
• /
• v.11 no.1
• /
• pp.107-130
• /
• 2001

During the last year, we had a very severe situation with the strike of physicians working in medical facilities. From that time, many politicians and scholars insisted on the expansion of public hospitals to enhance the public role in the medical care sector. They think that private medical facilities work for profit motivation and that the high proportion of private to whole facilities is an obstacle to the public function of medical care under social insurance system. They found that one of the reasons for failing to prevent the physicians' strike was the high proportion of private facilities. Others insisted that the strike was not a good reason for the expansion of public hospitals. The physicians' strike was a very rare case, and it is not a good basis for generalization of the discussion of public hospitals. Last year almost all apprentice physicians in public facilities took part in the strike, and consequently the public hospitals also lost the role of public function. They view this increasing involvement of government in the medical sector as improper and the cause of inefficiencies. In this paper we review the debate over the expansion of public facilities. To clarify the debate, we review traditional criteria for the role of government in a market system and to apply these criteria to medical care. There are two traditional areas where government Is acknowledged to have a role in a market system: market imperfections and market failure. Where market imperfections and market failure exist, there may be a role for government. The justifications for government intervention are consumer protection and the existence of externalities. One of externalities is to provide medical care for the poor. The appropriate measures to provide medical owe to the poor can be sought in both demand and supply side subsidies. National health insurance is a method of demand subsidies and establishment of public hospitals is a method of supply side subsidies. Under the National Health Insurance System, the expansion of public hospitals is not an appropriate subsidy policy.