• Health Policy and Management
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• v.12 no.1
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• The Journal of the Korea Contents Association
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• v.18 no.4
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• pp.290-304
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• 2018

The study proposes a discussion model for long-term care workers as a thought experiment, that strengthens speciality and presents an alternative education & training scheme for long-term care workers. First, the study unpacks the sociodemographic characteristics of license acquisitors and the employed as long-term care workers. In sequence, the study tries to present an alternative education & training scheme of the professional long-term care workers, that is comprised of a new education & training course with NCS in junior colleges for young peoples, intensification of speciality in education & training course through extension of times and deepening contents, introduction of legal refresher training, granting of roles of the NHIC as insurer in legal refresher training, introduction and legal employment of the professional tong-term care workers with career experience and speciality. At last, the study suggests a series of policy projects for realization of that alternative education & training scheme.

• Journal of Digital Convergence
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• v.12 no.12
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• pp.381-393
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• 2014

The purpose of this research was to analyze the work performance and the general characteristics influencing work performance of customized home health care nurse. Research participants were 204 nurses who worked in the customized home health care of 33 public health centers in Daegu city and Gyeong-Buk Province. The data were collected by self report questionnaires from July, 1 to August, 30, 2011. The highest degree of work performance was the diabetes mellitus service, while the lowest degree was pregnant women services. Age, marital status, education level, religion, career at public health center, visiting nurses career and work area were the significant factors related to work performance in these subjects. Customized home health care nurses management policy which includes assignment tasks and employment security considering general characteristics of visiting nurses should be established to enhance of activation and stable settlement of customized home health care service.

• Health Policy and Management
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• v.22 no.2
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• pp.207-224
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• 2012

This study estimates the total health expenditure of ambulatory dental care and explores the factors related to disbursements. The study used two waves of a 2008 Korea Health Panel (KHP) survey, of which each wave is composed of 7866 households and 24,659 persons. The KHP includes missing expanses of reimbursement data of the National Health Insurance (NHI), such as out-of-pocket, drugs, and private health insurance. The study estimates total monthly ambulatory dental expenditure and the sub-special categories of dental care. For influential factors analyses, the study exploits log-linear model with age, gender, education, job, equivalence income, the status of chronic diseases, means-tested benefit recipients, private insurance, and the composite deprivation index as independent variables. The total monthly outpatient health spending is estimated to be 102,468 won per household, and for dental, each household spends 31,115 won per month. Older age, means-test recipients, non-regular workers are more likely to spend less money on dental care, whereas private insurers, high income, and those who live in less deprived areas are more likely to spend more money for dental services. From the study we found that the KHP data are more suitable to estimate the total amount of health care markets, especially when the NHI coverage is low, such as for dental care in Korea.

• Health Policy and Management
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• v.16 no.1
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• pp.41-53
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• 2006

This study was carried out to investigate the linkage between health care and social services for the elderly in Jeonnam Province and its related factors. The subjects were 831 persons of visiting health service workers and social welfare workers in Jeonnam Province who responded the mail questionnaire (85.5% respondse rate). The data were collected from 15th May to 30th June, 2004 using the structured questionnaire. It was composed of the socio-demographic characteristics, the content and frequency of services referred between health care and social welfare workers, and interdisciplinary perception. Data was analysed by SPSS for Windows 12.0. 374(45.0%) reported having experience of service cooperation between health care and social welfare workers for the last three month. The most service that health care workers requested to social welfare workers was to get information for the client, on the other hand the most service that social welfare workers requested to health care workers was to visit and treat the elderly. These service providers in rural area and good attitude toward the cooperation between health care and social welfare service showed more linkage. The findings of this study could provide the basic data for the development of efficient coordinating program of health and welfare.

• Korean Journal of Social Welfare
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• v.58 no.2
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• pp.223-249
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• 2006

The purpose of this paper is to classify OECD countries in regard to levels of supporting fathers' care work. Several meaningful conclusions were reached. First, examining the level of supporting fathers' care work and the strength of the traditional bread-winner model, OECD countries can be classified into 5 different clusters. The result is different from the mainstream typology of welfare states and suggests the new typology of welfare states. Second, the level of supporting fathers' care work and the strength of the traditional bread-winner model were found to be related to total fertility rates and women's labor market participation rates. Third, in regard to the level of supporting fathers' care work, Korea was the lowest among OECD countries. This result points to one of the important reasons to the low level of total fertility rat, and low rate of women's labor market participation in Korea.

• Journal of Families and Better Life
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• v.31 no.3
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• pp.63-79
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• 2013

The aim of this study was to investigate the influence of family-friendly community policy and child care policy on parents with young children. Particularly, two specific questions were addressed: 1) Were there differences in the perception of community family-friendliness among parents with young children in Seoul provinces? 2) Were there differences in the perception of community family-friendliness among parents with young children, depending on child-care infrastructures in Seoul provinces? Data for this study were drawn from multiple sources. Individual-level indicators were drawn from the survey of 1,246 parents with children under age 6 in Seoul. Community-level indicators were drawn from the 2011 Seoul census data. Frequency, descriptive statistics, GIS mapping, and hierarchical linear model analysis were conducted to examine the perception of community family-friendliness by individual, child-care infrastructures, and the community at large. The major results of the present study are as follows: The perception of parents on community family-friendliness varied across the 25 provinces in Seoul. The perception of community family-friendliness was positively related with the total number of child day-care centers, and the number of infant-toddler child daycare centers. The number of accredited child daycare centers was negatively associated with the perception of community family-friendliness.

• Health Policy and Management
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• v.31 no.4
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• pp.508-517
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• 2021

Background: After the first case of coronavirus disease 2019 (COVID-19) in January 2020, Korea has experienced three waves in 2020. This study aimed to analyze changes in health care utilization according to the period of the 1st to 3rd waves of the COVID-19 pandemic. Methods: We analyzed 3,354,469,401 national health insurance claims from 59,104 medical facilities between 2017 and 2020. Observed-to-expected ratios (O:E ratio) with data from 2017 to 2019 as expected values and data from 2020 as observed values were obtained to analyze changes in medical utilization. T-test was used to test whether the difference of observed and expected values was statistically significant. Results: In 2020, the O:E ratio was 0.894, indicating a decrease in health care utilization overall during the pandemic. The O:E ratio of the 1st wave was 0.832, which was lower than those of the second (0.886) and third (0.873) waves. Health care utilization decreased relatively more among outpatient, women, children and adolescents, and health insurance patients. And health care utilization decreased more in small medical facilities and in Daegu and Gyeongbuk during the first wave. During the pandemic, the O:E ratios of respiratory diseases were 0.486-0.694, while chronic diseases and mental diseases were more than 1.0. Conclusion: Health care utilization decreased during the COVID-19 pandemic overall, and there were differences by COVID-19 waves, and by the characteristics of patients and medical facilities. It is necessary to understand the cause of changes in health care utilization in order to cope with the prolonged COVID-19 pandemic.

• Quality Improvement in Health Care
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• v.25 no.1
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• pp.11-28
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• 2019

Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.

• Health Policy and Management
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• v.32 no.2
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.