• Korean Journal of Occupational Health Nursing
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• v.17 no.2
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• pp.166-179
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• 2008

Purpose: This study was conducted to understand the situation of general hospital worker's health management and health promotion. Methods: To investigate the current situation of health management in the hospital, structured questionnaires were sent to 122 occupational health providers by post. About 79% hospitals returned questionnaires. The data were analyzed using descriptive analysis, ${\chi}^2$-test by SPSS 12.0 program. Results: A quarter hospitals responded set up separated health care office for workers, 87.5% provided health educations, and 56.5% operated health promotion projects. In the contents of health promotion program embraced both health behavior practice and disease prevention, musculoskeletal disease control, infection control, smoking cessation, and exercise program were most commonly provided to the workers in order. Occupational health care provider chose the item such as budget limitation, manager's apathy, lack of employee's participation, cooperation provider, and so on as the reason of difficulty to run health promotion program in the hospital setting. Conclusion: Hospital managers need to construct infra to manage and promote worker's health. For example, establishing Industrial safety and health committee in hospital and arranging nurses who being fully responsible to worker's health. And occupational health care provider should advertise health promotion projects both managers and workers actively.

• Health Policy and Management
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• v.26 no.2
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• pp.107-114
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• 2016

Background: Over the last few decades, because hospitals in South Korea also have undergone dramatic changes, Korean hospitals traditionally have provided specialized health care services in the health care market. Inner Herfindahl-Hirschman Index (IHI) measures hospital caseloads based on patient proportions, independent of patient volumes. However, IHI that rely solely on patient proportions might be problematic for larger hospitals that provide a high number of diagnosis categories, as the patient proportions in each category are naturally relatively smaller in such hospitals. Therefore, recently developed novel measure, category medical specialization (CMS) is based on patient volumes as well as patient proportions. Methods: We examine the distribution of hospital specialization score by hospital size and investigate association between each hospital specialization and length of stay per case and hospital cost per case using Korean National Health Insurance Service-cohort sample data from 2002 to 2013. Results: Our results show that IHI show a decreasing trend according to the number of beds and hospital type but CMS show an increasing trend according to the number of beds and hospital type. Further, inpatients admitted at hospitals with higher IHI and CMS had a shorter length of stay per case (IHI: B=-0.104, p<0.0001; CMS: B=-0.044, p=0.001) and inpatients admitted at hospitals with higher IHI and CMS had a shorter hospital cost per case (IHI: B=-0.110, p=0.002; CMS: B=-0.118, p=<0.0001). Conclusion: This study may help hospital policymakers and hospital administrators to understand the effects of hospital specialization strategy on hospital performance under recent changes in the Korean health care environment.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4895-4900
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• 2015

Physician recommendation is an important predictor of HPV vaccine acceptance; however, physician willingness and preferences regarding HPV vaccination may be influenced by factors including patient age, vaccine type, and cost. A cross-sectional survey was administered to a convenience sample of health care providers in Da Nang, Vietnam, to evaluate awareness, perceptions about HPV and HPV vaccines, and willingness to vaccinate a female patient. Willingness to vaccinate was evaluated using a full-factorial presentation of scenarios featuring the following factors: vaccine cost (free vs 1,000,000 VND), patient age (12, 16, or 22 years), and HPV vaccine type (bivalent vs quadrivalent). Responses from 244 providers were analyzed; providers had a mean age of $34{\pm}11.9$ years; a majority were female, married, and had children of their own. Thirty-six percent specialized in obstetrics/gynecology and 24% were providers in family medicine. Of the three factors considered in conjoint analysis, vaccine cost was the most important factor in willingness to vaccinate, followed by patient age, and vaccine type. The most favorable scenario for vaccinating a female patient was when the vaccine was free, the patient was 22 years of age, and the HPV4 vaccine was described. In multivariable analysis, older age, being a physician, being married, and having children were all associated with increased willingness to recommend HPV vaccination (p<0.05). Provider willingness is an important aspect of successful HPV vaccination programs; identifying preferences and biases in recommendation patterns will highlight potential areas for education and intervention.

• Health Policy and Management
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• v.10 no.3
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• pp.1-18
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• 2000

This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.

• Health Policy and Management
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• v.28 no.3
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• pp.315-319
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• 2018

This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial 'recovery support stage' with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are 'recovery support stage,' 'system homogenization stage,' and 'unified system stage.' Strategies at 'recovery support stage' suggested in this paper need to be pursued and followed by those at 'system homogenization stage' and 'unified system stage.'

• Health Policy and Management
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• v.21 no.1
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• pp.23-43
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• 2011

Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.

• Journal of Korean Academy of Nursing
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• v.37 no.5
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• pp.790-800
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• 2007

Purpose: This study was to identify knowledge, perception and health behavior about metabolic syndrome for an at risk group in a rural community area. Methods: A descriptive cross-sectional survey design was used. A total of 575 adults with hypertension, diabetes mellitus, dyslipidemia, and/or abdominal obesity were recruited from 11 rural community health care centers. A questionnaire was developed for this study. Anthropometric measures were measured and blood data was reviewed from the health record. Results: Knowledge about the metabolic syndrome was low as evidenced by only a 47% correct answer rate. Only 9% of the subjects ever heard about the disease, and 87% answered they do not know the disease at all. 87% of the subjects were not performing regular exercise, 31% drank alcohol more than once a month, 12.5% were current smokers, and 33.6% are did not have a regular health check-up. Conclusion: Development of systematic public health care programs are needed to prevent future increases in cardiovascular complications and to decrease health care costs. These might include educational programs for the primary health care provider and an at risk group, a therapeutic lifestyle modification program, and a health screening program to identify potential groups.

• Journal of Korean Academy of Nursing
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• v.16 no.2
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• pp.44-52
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• 1986

Maternal and child health(MCH) status is considered as an important indicator of the level of health and civilization of a community and a country. MCH services for the rural population in the remote ar deserves priority by the government, since more than half(52.9%) of the delivery was occured at home and almost half (45.5%) of the delivery was assited by family members or neighbors. The purpose of the study was to analyse the health fare behavior related to pregnancy and delivery, which can be contributed maternal health care policy mating for the rural people. Specifically, it was intended to analyze the variables which affect the health care behavior in selecting birth places and birth attendants. This study utilized the data which had been already collected for an experimental study on primary health program model in Korean rural communities, funded by the USAID. 184 sample households with women who had delivered a baby during March 1982 to February 1983 were selected. Discriminant Analysis was employed for statistical analysis by utilizing SPSS computer package program. Birth places and birth attendants were considered as dependent variables. Among 12 independent variables in 5 groups considered, 7 independent variables were found statistically significant to affect the selection of birth place. Significant variables by the order of importance are mother's age, order of baby, number of prenatal care, accessibility of emergency medical care, coverage of medical insurance, mother's membership in community organization and husband's educational level. The degree of correct classification of the grouped cases by employing a discriminant . analysis was significantly improved to 78.2％ in comparison to Cmax（56%) and Cpro(51%). Policy implications for each significant variable were discussed to improve the maternal and child health. in Korean ruralarea.

• Health Policy and Management
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• v.31 no.2
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• International Journal of Advanced Culture Technology
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• v.10 no.2
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• pp.79-85
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• 2022

Article 10 of the Constitution All citizens have dignity and values as humans and have the right to pursue happiness. There is a need for support measures such as a means to realize the respect of dignity and values as humans, and how to efficiently maintain policies on welfare for the elderly classified as the socially disadvantaged. It was considered necessary to develop an elderly-friendly city for economic, physical, and social life. Dasan Jeong Yak-yong's respect for adults was to practice the ideology of Confucianism, so this was the most important thing in the past Joseon Dynasty. In particular, it was considered important to think of adults first in practicing filial piety.This study focuses on the long-term care insurance system for the elderly, one of the welfare policy measures for the elderly. The significance of implementing the long-term care insurance system for the elderly is to benefit not only the elderly, but also all generations, including the middle-aged and children who were in charge of long-term care. To this end, the government should properly manage the factors of the social insurance financial crisis caused by the low birth rate and aging population.In addition, concerns about health insurance are high, so it is necessary to secure an appropriate level of government budget for health insurance financial management and minimize unnecessary non-benefit. In addition, it is necessary to induce appropriate medical use through connection with construction medical insurance.