• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2005년도 제57차 추계 학술대회 연제집
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• pp.327-327
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• 2005

• 보건행정학회지
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• 제11권4호
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• pp.129-151
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• 2001

This study was conducted to describe trends of health services research (HSR) in Korea since 1968 and analyse the relevance of HSR to changes in health policy. Research methods are as follows: firstly, HSR articles were selected from 4 HSR related journals implicitly. Secondly, classification system of HSR was developed and then applied to previously selected papers in order to describe research trends. Finally, the frequency rankings of articles in research areas were compared with rankings in order of the importance of research area rated by experts. As a resesult, HSR articles have increased with time and three main research areas are health programme, health care financing, and health care organization/management. And many articles have been related to the efficiency and quality of health care since 1990. It seems HSR articles had little relevance to changes in health policy and policy environment. Especially, the recently disputed policy topic, namely the separation of prescription from disposing, has not received little attention since 1990. These findings suggest there is an urgent need for the reflection on HSR direction in Korea.

• 보건행정학회지
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• 제1권1호
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• pp.95-108
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• 1991

The World Health Organization and its member states, in 1978, declared that primary health care is a key to attain the goal of Health for All by the goal of Health for All by the yeas 2000. As a member state of WHO, the Republic of Korea has participated in the declaration of ALMA-ATA and committed to put national efforts for devedoping and implementing primary health care approach with the spirit and content of this Declaration. Since 1978, to translate the spirit of the Declaration into realization, Korean goverment has developed a new category of health manpower such as Community Health Practitioners serving people living in remote rural areas and Village Health Workers serving voluntarily their own village, strengthened the function of Health Centers and Health Subcenters through their reorientation and improved the infrastructure by their new construction or renovation. While primary health care is viewed as an essential health care in Korea, there are some circles who follow a narrow definition in referring to the health care at the periphey of a health system, which is erroneous. Considering the PHC is accepted as the best alternative approach to health care to solve problems that modern health systems are facing, we propose the followings as desirable health policy directions that modern health systems are facing, we propose the followings as desirable health policy directions which might translate the persopective into action at the national level after reviewing past and current PHC approach in Korea : 1. To improve the equity through the reduction of gaps between those who have access to health care and those who have not. 2. To reinforce multisectoral approach and intersectoral coordination through the re- establishment of the National Health Council or establishment of equivalent organization at the central level. 3. To stengthen community participation through lacal people's empowerment by leadership training, changing planning process from the top-down approach to bottom-up and giving the priority to human resources rater than technology, 4. To reinforce the Ministries of Health and Social Affairs through upgrading its role and function to Coordinate Ministries which involve human welfare policies, and creating a Division which is in charge of PHC in the Ministry.

• 보건행정학회지
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• 제26권3호
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• pp.195-206
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• 2016

Background: Concentration of patients to large hospitals is serious problem in Korea. The purpose of this paper is to propose appropriate policy direction to relieve concentration of patients to large hospitals. It is focused on evaluation of the possibility of family doctor system as a policy alternative to relieve concentration of patients to large hospital by empirically analyzing the effect of usual source of care (USC) on large hospitals medical care use. Methods: Korea Health Panel conducted 2009, 2012, 2013 by KIHASA (Korea Institute for Health and Social Affairs) and NHIS (National Health Insurance Service) was used for analysis. For dependent variables, first, the ratio of the amount of using large hospital to total amount of using medical care, and second, the amount of using large hospital are estimated. Independent variables are having an USC and type of USC. Panel analysis was done with above variables. Results: Main results are as follows. First, having an USC increases using large hospital. Second, having a domestic clinic type USC decreases using large hospital and ratio of using large hospital. Third, the effect of domestic clinic type USC is greater in older group, less income group, worse health status group, not having private insurance group, and having chronic disease group. Conclusion: These results show that family doctor program can be a policy alternative to relieve concentration of patients to large hospital. Nonetheless, primary care system in Korea is unsatisfied. It is recommended to reinforce primary care system and family doctor system to relieve concentration of patients to large hospitals.

• 보건행정학회지
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• 제24권3호
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• pp.228-241
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• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

• 보건행정학회지
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• 제20권4호
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• pp.1-18
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• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.

• 보건행정학회지
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• 제27권4호
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• pp.304-314
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• 2017

Background: This study aimed to analyze effects of postpartum care services to women after birth, identify the factors affecting their use, and examine the extent of income-related inequality in the postpartum care services utilization and expenditures using Korean Health Panel data between 2010 and 2013. Methods: The panel data of the year 2010-2013 of the 247 women after birth were used. First, EuroQoL-5D was used to evaluate the effects of postpartum care service to women's quality of life. Second, multinominal logistic regression analysis was used to identify determinants of the use of the postpartum care services. Finally, concentration index and HIwv (horizontal equity) index were used to find that the concentration index for the inequality in the use of postpartum care services showed negative sign, which implied pro-rich. Results: The estimation results showed that utilization of the postpartum services has a positive effect on women after birth. Also age, area of residence, and number of household members turn out to be the factors of using postpartum services. And there are inequality in the use of postpartum care services whose HIwv index showed positive sign, which implied pro-rich. Conclusion: Therefore, the government's policy of the postpartum care service is necessary to be expanded and diversified considering the personal characteristics and equity of the women after birth.

• 보건행정학회지
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• 제30권1호
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• pp.131-138
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• 2020

The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

• Journal of Hospice and Palliative Care
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• 제20권1호
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• pp.8-17
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• 2017

종합적인 보건시스템을 지원하기 위한 완화의료정책의 개발과 강화가 세계적으로 강조되고 있다. 우리나라에서는 암정복 10개년 계획과 국가암관리종합계획의 기틀 하에 암정책의 일환으로, 호스피스완화의료정책이 시행되어왔고, 2003년 암관리법(Cancer Control Act)을 제정하여 법적 근거를 마련하였으며, 최근 호스피스 완화 의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법을 제정하여 시행할 예정이다. 호스피스완화의료정책의 대상은 최근 관련법의 제정에 따라, 말기암환자에서 암(Cancer), 후천성면역결핍증(Acquired immune deficiency syndrome, AIDS), 만성 폐쇄성 호흡기질환(Chronic Obstructive Pulmonary Disease, COPD), 만성간경화(Chronic Liver Disease/Live Cirrhosis) 등으로 확대되었고, 급여체계는 2015년에 모든 의료기관에 일당 정액수가와 행위별 수가의 복합지불방식으로 완화의료 건강보험제도가 시행되었다. 전달체계관련 건강보험제도는 입원형과 자문형, 그리고 가정형으로 구분되고, 완화의료전문기관의 지정 평가 지원제도가 운영되고 있으며, 재원체계는 건강보험기금과 국가지원금으로 조달되고 있다. 호스피스 완화의료 관련법의 시행에 앞서, 정책대상의 사회적 합의가 요구되며, 낮은 급여체계의 현실화, 민관협력을 통한 호스피스완화의료 표준설정과 전문요원양성, 질 관리 및 평가체계정립, 그리고 장기요양보험과 호스피스기금 등을 활용한 안정적인 재정체계를 마련해야 할 것이다.

• 한국생활과학회지
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• 제16권1호
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• pp.49-59
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• 2007

The purpose of the present study was to examine how working females evaluated and perceived the employer-supported child care services, and how the evaluations and perceptions were different depending on their socio-demographic characteristics. A survey was administered to 164 working females, mostly, in professional jobs, to investigate their satisfaction to the employer-supported child care service and current child care policy. Major findings are as follows: Working females showed higher degrees of satisfaction on the employer-supported child care service and showed lower degrees of satisfaction on the current child care polidy. The more they work in professional jobs and the more they have high educational background, the more they showed satisfactions to the employer-supported child care services.