• Journal of Home Health Care Nursing
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• v.20 no.2
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• pp.141-151
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• 2013

Purpose: The purpose of this study was to examine the economic effectiveness of by conducting a literature review of published articles, masters theses, and doctoral dissertations. Method: Prior to the literature review, inclusion-exclusion criteria were established. We then reviewed 1,029 CINAHL, MEDLINE, and Cochrane DB papers, and 153 RISS papers collected between Results: A total of 12 studies met the inclusion-exclusion criteria.-effectiveness: 6 cost-effectiveness studies, 1 cost-utility studies, and 5 cost-benefit studies. Each of the 12 reviewed studies concluded that home care nursing had greater economic benefits than other compared healthcare services. Conclusion: Home care nursing has significant economic benefits in multi health care service settings and for various patient groups. Therefore these results will be used a critical evidence for the development of economically effective home based health care systems for future policy making.

• Korean Medical Education Review
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• v.21 no.2
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• pp.73-79
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• 2019

Academic medicine is built from a foundation of education, research, and patient care. Since good patient care results from the application of medical research and continuous education, these three components cannot be separated for medical development to occur. In Korea, many obstacles hinder the achievement of academic medicine, such as an inefficient medical delivery system, limitations of primary care, low insurance prices, and no long-term health care plan. Medical education has changed to outcome-based education, but presented temporal integration status. Governance of healthcare research is not centralized, and Korea is awarded relatively fewer grants than other countries. Medical professors have reached a burnout state due to patient care responsibilities in addition to research and education duties. Many medical systems, including the medical delivery system and insurance problems, may contribute to distrust between doctors and patients. The government is not involved in a long-term health care policy. The multitude of factors mentioned here are hindering the achievement of academic medicine in Korea.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.1-7
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• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

• Health Policy and Management
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• v.30 no.2
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• pp.253-262
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• 2020

Background: The public health care system of a country is shaped and driven by its historical background as well as social, economic, and cultural structures. This study sheds light on the unique features, strengths, and weaknesses of the health insurance systems of South Korea (Korea) and Peru. Methods: The capacity mapping tool was used to explore the Korean and Peruvian population and geographical structures; health insurance laws, regulations, and policies; payment systems; eligibility and contribution collection; and long-term care insurance. Results: The study found that the Korean government took the lead in integrating multiple insurers into a single-payer system in an effort to reinforce and stabilize its health insurance system in 2000. Peru has been developed mixed model such based on taxes and contributions, to address a gap between different social classes. Peruvian government developed a two-axis system, one for low-income earners, financed by taxes, and another financed by contributions paid by workers and government officials in the formal sector. Peru has introduced many variations to its fee payment and insurer systems, target population, and coverage scope, and maintains its health insurance system accordingly to this day. Conclusion: The current study provides observation of the Health Insurance System in two different countries and helps to understand possible ways to improve the health insurance system in both countries. Based on this study, Peru will be able to see how its system differs from Korea's and benefit from the related policy implications.

• Health Policy and Management
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• v.33 no.3
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• pp.273-294
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• 2023

Background: Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: "burden of medical expenses," "time constraints," and "lack of care." The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%-13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are "lack of care," "time constraints," and "burden of medical expenses." Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to "lack of care" is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%-14.1%) than in Busan (1.3%; 95% CI, 1.3%-1.4%). The probability due to "burden of medical expenses" is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%-4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%-0.4%). Conclusion: Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents-similar to the approaches of the United Kingdom and France.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.300-308
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• 2013

Objectives: The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review. Methods: The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients ($R^2$) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost. Results: Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%). Conclusions: As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.

• Korean Journal of Health Education and Promotion
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• v.25 no.3
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• pp.1-19
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• 2008

Purpose: The research was performed to distinguish the group of users of the health promotion programs in health care center, to identify the characteristics of this group, and to investigate the factors that have influence on the use of the health programs. The specific research purposes are: First, to compare the group which uses the health promotion program of health care center and that which does not. Second, to analyze the factors that have influence on the use of the health promotion program. Method: This study was done from November 15th 2006 and March 30th 2007. The study subjects were Seoul and Provinces. Seoul was divided into 4 areas of eastern western, northern, and southern area. Provinces were Gimchon, Gumi and Sosan. From each area, one health care center was chosen from the ones that wanted to participate. Total number of observations was 994. The survey questionnaire consisted of individual, interpersonal, organizational, community, policy factors based on socio-ecological model. The analysis method was logistic regression. Results: Odds ratios of individual factors is sex(1.39), age(1.05), marriage status(1.71) severity(1.20). Odds ratios of interpersonal factors is use and support of family(1.96), use and support of resource persons like friends and neighbor(4.58). Odds ratios of organizational factors is the comfortness of space(0.74), the satisfaction of health care center facility(1.40), kindness of employ(1.97). Odds ratios of community factors is health care center program recognition(1.70). Odds ratios of policy factors is advertisement(4.69) and expense(1.42). Conclusion: Socio-ecological model of health promotion in health care center is obtained based on five factors and health planners should consider these determinants of health promotion program in health care center and develop intervention methods.

• Journal of Korean Public Health Nursing
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• v.5 no.1
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• pp.70-95
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• 1991

The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.36-49
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• 2015

In Intensive Care Units (ICUs), where severely ill patients are treated, importance of reducing Hospital Acquired Infection (HAI) cannot be overstated. One of the simplest and most effective actions against HAI is proper hand hygiene (HH) behavior of Health Care Workers (HCWs). However, compliance varies across different cultures and different job types of HCWs (physicians, residents and nurses). This study aims to understand determinants of HH behavior by HCWs' job types in Korea. Qualitative analysis was performed based on Reasoned Action Approach style interviews with staff physicians, residents and nurses across 7 teaching hospitals. We found that all HCWs strongly believe HH is important in reducing HAI. There were, however, job type-specific HH behavior modifying factors; staff physicians stated feeling pressure to be HH behavior role model. Residents identified Quality Improvement team that measured compliance as a facilitator; a notable barrier for residents was senior physicians not washing their hands, because they were afraid of appearing impudent to their seniors. Nurses designated their chief nurse as a key referent. All participants mentioned heavy workload and lack of access to alcohol-based sanitizer as situational barriers, and sore and dry hand as deterrents to HH compliance.

• Health Policy and Management
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• v.22 no.1
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• pp.85-108
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• 2012

One of the ways to achieve the principle of equal access for equal needs, availability and geographical accessibility of health care resources regardless of resident sites is important. The purpose of this paper is to measure socioeconomic inequities in distribution of health care resources among regions in the Republic of Korea (hereafter Korea). Data were extracted from regional statistics of National Health Insurance, Community Health Survey, Korea Social Science Data Archive, and Korean Statistical Information Services at the same period of 2009. The dependent variables were the number of health workforce and health care facilities in each region. The proxy indicator of regional socioeconomic status was local tax per person. To identify whether inequalities among regions, we examined the concentration index(CI) and indirectly standardized CI by controlling each region's demographics and need factors. Total observations were 232 districts in nationwide, and we analyzed separately Seoul(25 districts) and non-Seoul areas(207 districts). The standardized CI values of health care resources were positive(favoring the rich region) across the nation in almost all kinds of resources. Especially the number of specialist, dentist, dental clinics, clinics, oriental medical clinics, pharmacists, and pharmacies were statistically significantly favoring the rich region. But the CI for the number of long-term care hospitals, public health centers were negative(favoring the poor region). The tendency of CI presenting positive values were increased in Seoul area. But in the case of non-Seoul, the CI indexes were nearly zero. The results suggest that except the Seoul area, little regional socioeconomic-related inequalities were observed in the distribution of health care resources in Korea.