• 한국산학기술학회논문지
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• 제10권10호
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• pp.2900-2906
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• 2009

e-health 시스템은 의료부문에 관련된 이해당사자들에게 의료서비스와 정보를 정보통신기술을 이용하여 제공하는 것이다. 이런 상황에서 보건의료 분야에서 'e-Health' 시스템의 구축을 통해서 보건의료부문의 효율성 증진, 서비스질의 향상, 의료비용의 감소 그리고 관련 산업 발전에 따른 대외경쟁력 강화를 위한 돌파구를 마련하고 있다. 의료분야가 다른 산업분야에 비해서 매우 전문적이고 폐쇄적이어서, 인터넷 기술을 적용하는데 어려움이 많다. 그래서 인터넷의 사용자 중심적인 속성을 의료분야에 활성화시켜야 소정의 목적을 이룰 수 있을 것이다. 본 연구에서는 의료 부문에서의 인터넷을 이용한 e-Health 시스템의 개념과 특성 그리고 유형을 고찰하고, 한국의 의료부문을 위한 e-Health 시스템의 구축을 위한 보다 진보된 새로운 개념의 설계 방법론을 연구하기로 한다. 본 연구자에 의해 제안된 발전된 모형의 방법론을 AHP 기법을 이용하여 그 타당성과 적용가능성을 검증해보도록 한다. 본 연구는 e-Health 시스템의 발전 및 활성화를 위한 정책개발 및 실현에 기초자료가 될 수 있을 것으로 기대한다.

• 보건행정학회지
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• 제8권1호
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• 보건행정학회지
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• 제27권2호
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• pp.103-113
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• 2017

There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

• Korean Journal of Health Education and Promotion
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• 제1권1호
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• pp.43-57
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• 1999

One of the most fundamental and the oldest issues in the provision of health care throughout the world has been the issue of the role of the public and private sector of health care, and the relationship between them. This paper describes issues associated with the concept of health oriented partnerships in the United Kingdom and seeks to contrast public and private partnerships both in health and in health care. In the United Kingdom it is suggested that health care is conceived by the population to equate to the National Health Service(NHS) with "add on" private health care for certain sectors of the community and within certain well defined clinical parameters. This paper can provide us with valuable information on the characteristics of UK health care systems, current health policies as well as issues relating to the public and private partnerships in health/ health care in the UK, thus offer important policy implications for the improvement of Korean health care system which lacks health-oriented coordinations and partnership between public and private sector very considerably.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7463-7473
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• 2015

본 연구는 장기요양 1등급 건강보험가입자를 대상으로 장기요양서비스 이용자와 미이용자의 의료비 지출 차이를 비교하고, 의료비 지출에 미치는 영향 요인을 규명해 보고자 시도하였다. 연구 대상은 건강보험가입자로 2009년 1월 1일부터 12월 31일까지 1등급 판정을 받은 21,213명 전수를 대상으로 국민건강보험공단의 장기요양급여, 건강보험급여 자료를 활용하였다. 연구결과 2007년부터 2009년의 연간 총 진료비 변화량의 경우 서비스 이용자에 비해 미이용자는 5,337천원 증가하였으며, 연간 요양병원 진료비 변화량은 5,449천원 증가하였다. 연간 총 입원일 변화량의 경우 서비스 이용자에 비해 미이용자는 87.31일 증가하였으며, 요양병원 입원일 변화량은 79.47일 증가한 것으로 나타났다. 이 같은 결과는 장기요양 서비스 미이용자의 의료이용, 특히 요양병원의 의료이용이 높게 나타남에 따라 미이용자에 대한 적정의료와 요양서비스 지원 정책을 통해 장기요양과 의료서비스의 효율적 연계가 필요로 된다.

• 대한간호학회지
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• 제11권2호
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• 한국지능정보시스템학회:학술대회논문집
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• 한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
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• pp.373-377
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• 2001

This study is to examine the factors that influence the performances of service quality in university hospitals by investigating systematically the condition of service quality. A synthesis of the health care quality is conducted to identify physical quality, operating process quality, and human resources quality that relate to both the overall satisfaction and intention of revisit. Based on the proposed hypotheses, the relationships between the service quality factors and performance are examined using data collected from 167 patients in three hospitals, Korea. Reliability and validity tests are performed for examining its relationship with service quality in health care systems. Total eight independent variables with respect to three service quality levels and two dependent variables for performance are identified for relationships between service quality and performance in health care systems. The results provide health care managers with a managerial insight to the planning function of performance with service quality in health care systems as well as other operations (business, government, or other service organizations) systems. Implication of the study for theory, future studies, and practices are discussed.

• 전기학회논문지
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• 제59권3호
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• pp.657-663
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• 2010

Today, rapid evolution of Internet makes various types of services in ubiquitous environment are intelligent and active. As a result, user's demand on high quality of life increases and health care service based on ubiquitous environment draws a lot of attention. However, user's private information used for health care service is illegally distributed and exposed, causing serious individual and social problems. Therefore, this thesis is intended to suggest a secure health care service to prevent unauthorized third party's access and to protect user's privacy in health care systems. The proposed scheme establishes a session key through communication channel between health care system and user based on explicit mutual authentication and provides secure communication and access control, improving security as one of the leading health care systems.

• 보건행정학회지
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• 제5권1호
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• pp.31-58
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• 1995

The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

• 한국치위생학회지
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• 제20권4호
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• pp.457-467
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• 2020

Objectives: This study confirms the current status of visiting oral health-care services for the elderly to draw policy implications for revitalization of the visiting oral health care services in the future. Methods: First, a survey was conducted on health centers about the current status of the elderly visiting oral health-care service and how to revitalize it. Next, the number of oral hygiene services provided to the elderly was checked in the long-term care insurance system. Results: Oral health education (100%) was the most common practice in visiting oral health-care service for the elderly, and the most difficult thing in providing services was the lack of dental hygienists (38.9%). The status of oral health-care services in the long-term care insurance system for elderly revealed that the total number of service claims has been confirmed to be zero since the introduction of the system. Conclusions: Despite the existence of a system that provides elderly visiting oral healthcare services, to revitalize it, the law must be amended to secure a dental hygienist as the main agent of the activity and to further take responsibility for autonomous authority and performance.