• 의학교육논단
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• 제24권1호
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• pp.3-9
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• 2022

The concept of "public health care (public health and medical services)" as discussed in South Korea is used in an unclear sense, with a meaning unlike the terminology used worldwide. The terms "public health care (public health and medical services)" and "health care (health and medical services)" have the same legal definition in Korea. Globally, "public health care (public health and medical services)" refers to medical services provided to the public that are operated as publicly funded resources, but in Korea, this term is confined to limited medical services prescribed by the government. The following considerations regarding "public health care (public health and medical services)" in Korea are proposed: All medical services performed by the state, regional governments, health care institutions, or health care workers to protect and promote the health of the people should be clearly established as "public health care (public health and medical services)" by definition. The financial burden borne by the state through national health insurance should be increased to an appropriate level to clarify the state's responsibility. Improving public health is an urgent priority in Korea, and this goal can be achieved by improving regional public health through systematic relationships between the state and regional governments, establishing a Ministry of Health, and efficiently allocating public health doctors who are important for providing regional medical care in rural and remote areas. It will be possible to actively deal with infectious diseases at the national level through establishment of a Ministry of Disease Control and Prevention.

• 한국산학기술학회논문지
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• 제12권4호
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• pp.1696-1702
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• 2011

본 연구는 생활습관 개선을 통하여 질병의 사전 예방과 조기진단을 목적으로 발의한 건강관리서비스법안에 관한 방사선사와 치위생사의 의식을 분석하여 향후 건강관리서비스법안의 세부 내용 및 제공 요원의 선정에 기초 자료를 제시하고자 하였다. 조사대상은 방사선사와 치위생사 총 359명을 대상으로 2010년 7월부터 9월까지 3개월간 조사하였다. 분석 결과, 건강관리서비스법안이나 세부 내용에 관하여 인지도는 30%% 미만이었고, 필요하다는 의견은 78.0%로 높게 나타났다. 항목의 추가는 방사선사는 현행 유지를, 치위생사는 82.3%가 추가를 희망하여 대조를 보였으며, 추가 항목으로는 치과 질환을 선호하였다. 서비스 제공요원에 방사선사와 치위생사 등이 보건(의료)관련 교육을 이수하였으므로 포함되어야 한다는 의견이 높았으며, 건강관리서비스에 참여 의향은 평균 8.1점으로 높게 나타났다. 이상과 같이 건강관리서비스법은 필요하지만, 주요 내용과 서비스 제공요원 등에 관한 다양한 의견수렴을 바탕으로 보다 체계적인 연구가 요구된다. 특히 정규 대학(교)에서 보건(의료)에 관한 교육을 이수하고 임상에서 지속적으로 이수하고 있는 일정 경력 이상의 보건직(방사선사, 치위생사 등) 인력의 포함은 필연적이라고 사료된다.

• 간호행정학회지
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• 제16권4호
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• pp.409-418
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• 2010

Purpose: The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. Method: Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. Result: The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. Conclusion: Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population.

• 보건행정학회지
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• 제31권4호
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• pp.387-398
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• 2021

Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

• 보건행정학회지
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• 제25권3호
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• pp.221-228
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• 2015

Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.

• Journal of Preventive Medicine and Public Health
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• 제23권3호
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• pp.285-295
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• 1990

The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.

• 지역사회간호학회지
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• 제20권4호
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• pp.443-452
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• 2009

Purpose: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. Methods: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. Results: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. Conclusion: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.

• 가정∙방문간호학회지
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• 제24권1호
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• pp.69-78
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• 2017

Purpose: The purpose of this study was to identify the frequency and duration of primary health practitioners' work, and their job satisfaction, and to confirm differences in work and job satisfaction by type of primary health care post. Methods: Work frequency, duration of work, and job satisfaction were estimated by 371 primary health practitioners. Chi-square test and t-test were used to identify the differences in working patterns and job satisfaction by type of primary health care post. Results: Primary health practitioners were found to spend more time working with the elderly population than with students, pregnant women, children, people with disabilities, and multicultural families. Those in costal areas were more concerned with students than those working inland. In the latter group of practitioners, more time was spent working with patients with chronic diseases, pregnant women, women, children, multicultural families, and mental health clients. Also, the job satisfaction of inland primary health practitioners was significantly higher than that of costal practitioners. Conclusion: It is necessary to identify the characteristics of primary health practitioners' work, focusing on changes in the medical service environment. Furthermore, it is necessary to provide job training according to type of primary health care post, as practitioners' approaches should differ between posts.

• 한국지역사회생활과학회지
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• 제17권1호
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• pp.87-99
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• 2006

The purpose of this study was to explore the relationship between self-rated health and Activity of Daily Living (ADL) and self-care behavior of rural elderly in Korea, focused on the difference among three distinctive living arrangements; living alone, living only with his/her spouse, and living with their married children. For this purpose, data were gathered from a nationwide survey, a total of 586 elderly aged 65 or older and living in rural area, using the structured questionnaire. Also, self-care behavior were categorized into 4 groups; life-style practice, medical self-care, adaption to functional limitation, and emotional management. The major findings are as follows; 1) Rural elderly perceived their health little and more 'bad' but their ADL capacity were 'not difficult', especially among elderly living with spouse. 2) The level of 20 items in self-care behavior ($1{\sim}5$score) was ranged from 2.51 to 3.81 score. The behavior level of regular exercise, setting up additional phone, taking a nutrient, and testing BP or pulse regularly were low but that of taking a medicine according to prescription, close contact with other people, and regular eating were proportionally high. 3) The majority of self-care behavior were correlated with subjective health positively but medical self-care behavior were correlated with subjective health or ADL negatively. Based on these results, policy implications are discussed.

• 대한간호
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• 제37권2호
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• pp.63-76
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• 1998

This paper provides an overview of the current Health Care Delivery System in China with particular emphasis on the Nursing Delivery System. Based on recent data, the paper introduces the current Health Care System and emphasizes nursing resources, education, nursing policy, leadership, the role of nurses, community nursing and nursing outcomes.