• Journal of agricultural medicine and community health
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• v.17 no.1
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• pp.17-24
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• 1992

The medical care insurance system has been adopted in rural areas in 1988, since then, the utilization of medical care services has increased rapidly in rural areas. The government has restructured the 15 health centers, which are located in remoted rural areas and these 15 health centers were strengthend to provide the curative care to the residents in order to meet the curative can demand of the residents. Besides the reorganization of the health centers, the government has implemented the oriental medical care demonstration project at the health center in a designated rural areas. This study was aimed to analyze the utilization and expenses of medical and oriental medical care services in a designated rural areas. Number of annual visits of residents to health centers in 1991 showed slightly decreased compared with that in 1989. However number of annual visits to the hospitalized health centers was an increase of 49.3%~64.5%. Regarding the coverage of curative care for the residents in rural areas, the hospitalized health centers are functioning more effective than that of health center. Expenses per case of medical care rendered by health center was lower than that of oriental medical care, while the expenses of the medical care was quit higher than that of oriental medical care in the hospitalized health centers. According to the above mentioned study results, the hospitalized health centers were more effective and suitable to provide a curative care to the residents than the health centers, and also the oriental medical care could be needed to be provided by public health network in the near future.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.127-136
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• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• Health Policy and Management
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• v.26 no.4
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• pp.265-270
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• 2016

Public health system for more prevention-oriented health promotion rather than hospital-based curative service, focusing population rather than individual, and comprehensive health management in the local community strongly needs to be constructed to solve major issues on efficiencies and equity problems which Korean healthcare system is facing nowadays. Public health promotes and protects the health of people and the communities where they live, learn, work, and play. Medical care tries to cure those who have diseases, but public health tries not to become ill and not to be injured. Debates on how we build or rebuild public health system, which is contrasted with medical care system, are needed in Korea, focusing how needs for healthy community and right to health are fulfilled. Public health specialists for practising population health at local community level should be systematically recruited, the function of public health centers should be strengthened, and new government organization should be established for place-based health management.

• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1460-1467
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• 2004

Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

• Health Policy and Management
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• v.32 no.3
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• pp.258-271
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• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• Journal of Korean Academy of Nursing
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• v.24 no.2
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• pp.313-318
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• 1994

To build a suitable National Health Care System for the coming 21s1 century, Nursing must also be renewed. The future Korea will be united and the majority of its population will raidly consist of the aged. Economically standing on the same level with developed countries the growth of scientific technologies will foster communications, firing astounding changes in the medical field. While the overall life style pattern of Koereans not to mention the structure of diseases undergo change, the possibility that the reckless induction of high-tech health care may only cause medical fees to eascafate. It can전so be expected that the health care system will evolve towards the consumers. Nursing in the 21s1 century will be of two scenarios according to WHO, which presents the role of the nurse. The first scenario is that "a gen-eric health care work force" namely a "care giver" will replace all other health professions. If Nursing does not become the compatent profession fitting to this purpose it will eventually dei out. The second scenario is that nurses who are educated in a well grounded and extensive general background and have command of a specialized area will undertake services varying from health pro-motion to treatment and rehabilitation both direct and indirectly, while supervising other personnel. The nurse here would become the "care giver". To become the necessary health care profession in the 21s1 century, nurses should be provided with more educational opportunities, variating in its con-tents, course, and system, enabling them to grow. Clair Faign points out that the minimal educational entry for the nursing profession is a 4 year undergraduate education in this aspect, now in the time to set the future of Nursing into the course of the first scenario. A new educational system stipulating a baccalaureate nursing degree is in urgent need, and aside from govermental actions nurse themseives should formaily officiallze this process, striving for quality assurance. While considering 6 years nursing education programs, multifarious degree courses for existing 3 years educated nurse should be provided Junior nursing schools must devise measures to grow into baccalaucate institutions, also. Among the existing courses, the Self Study Degree Program should be converted into RN, BSN courese provided by universities, and clinical training for the University on the Air must be supplimented, The possibility of establishing nursing courses into commercial high school programs only jeopardizes the development of the nursing profession.

• Health Policy and Management
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• v.4 no.1
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• pp.138-175
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• 1994

The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

• The Korean Journal of Applied Statistics
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• v.27 no.5
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• pp.667-679
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• 2014

National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.

• Korea Journal of Hospital Management
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• v.9 no.3
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• pp.18-48
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• 2004

Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.

• Korea Journal of Hospital Management
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• v.14 no.2
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• pp.60-74
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• 2009

This study purports to verify managerial effectiveness of the integrated delivery system(IDS) of Japanese health care institutions through comparing the managerial performance between hospital groups providing with both acute and nursing care and those with acute care only. Data on the managerial performance of 697 hospitals providing with nursing care together and 819 hospitals providing with acute care only were collected from Japanese Central Social Insurance Medical Councils 2001, 2003, 2005, and were analyzed using mean comparison test(t-test) between the two groups. The results revealed that there were significant differences between the two groups in such indicators as ratio of material cost, labor cost, depreciation rate, total margin, operating margin, average number of outpatient per day, average revenue of an inpatient per day, total amount of labor cost, gross revenue per employee, and labor productivity. However, we could not find out any consistent evidence which support the effect of integrated delivery system on the hospital managerial performance. Further discussion was made on the limitation of the study and future research agenda relevant to the topic.