• Research in Community and Public Health Nursing
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• v.6 no.1
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• pp.34-54
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• 1995

Occupational health services in Korea have been operated as dual types: one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative. health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area: 154 places (39.4%) managed by designated. health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation due to the characterstics of each variable and analyzed for impacting factors with relation to the using multiple regression analysis using SPSS PC program, especially using t -test method in order to compare each type of health care management. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. The common sickness management is the most accomplished item in health care area of occupational health care services, while the preventive care and control for the workers who have serious health problems are insufficient in workers health care area. 3. An insufficient accomplishment of overall health education has been shown because it is difficult to perform health education due to almost no chance of the direct introduction at workplaces. Therefore a strong support system for making and supplying the media is necessary in order to activate indirect health education by means of media. 4. Because health care managers and the agencies managers where take the workplaces for this study are almost nurses who have been comparatively high work site rounding rate about an environmental management at the workplaces, that non-profession can also do it, the activities about the professional area not enough. Therefore, an appropriate referral system should be established in order to complement professional area. 5. Two factors which have an effect on the coverage rate of occupational health care services are : one is those from the workplaces such as type of services, the number of workers, the number of harzadous factors and safety & health committee, the other from health care organization about whether there is its own manager or not.

• Korean Journal of Health Education and Promotion
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• v.10 no.2
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• pp.11-21
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• 1993

Recently the structure of disease is changing its form into chronic disease. Taking into consideration this, the health care system doesn't cope with this tendency. With the health care system for acute disease, it is difficult to decrease medical care cost. At this point, Health education like primary health care can reduce risk factors and possibilities of occurrence of disease. This can cut off the medical insurance finance further more cuts off the rates of insurance cost. This is why health education is the principle part of medical insurance service. Though the law shows health education must be executed in the field of Medical insurance, still it is not enough. In order to carry out health education in the medical insurance organization, the efforts we should make are as follows: 1. Recognize the importance of health education. 2. Set the clear goals in health education. 3. Organize health education system. 4. Train health workers. 5. Systematize health education service. 6. Reform the medical insurance system. 7. Evaluate the effect of health education and practice the model.

• Journal of the Health Care and Life Science
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• v.9 no.1
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• pp.117-128
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• 2021

This study was performed to investigate health care system satisfaction and reform need using the data from the '2019 Health Care Experience Survey'. For 8,349 data with experience in medical use, health care system satisfaction and reform need level was analyzed by t-testing and ANOVA by characteristics of the study subjects, and multiple regression was conducted. Research has shown that health care users' recognition of the health care system is relatively low compared to reliability and satisfaction. It is necessary to promote policies and health care systems for senior citizens, low education levels. Since the reliability has the biggest impact on the satisfaction of the health care system, government should establish policies that they can trust, and in the process, they should gather opinions from the public and secure credibility through social consensus. Medical users were sympathetic to the need for reforms in the health care system, and felt the need to support vulnerable areas and vulnerable groups the most.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.450-461
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• 1995

This paper tested by using Micro TSP, an empirical econometric analysis to approve officially a hypothesis of price elasticity of the demand for medical care services in Korean national medical insurance and the economic effect of health care delivery system with time-series datas of Medical Insurance Statistical Yearbook$(1981\sim1993)$. The results suggest that the Korean medical insurance system shows moral hazard due to the change of coinsurance and the economic effect according to intervention of the health care delivery system, but it is different by insurers regardless of the same structure of the medical insurance scheme.

• Health Policy and Management
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• v.30 no.3
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• pp.301-310
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• 2020

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion: The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.472-484
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• 1995

The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

• Health Policy and Management
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• v.24 no.4
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• pp.396-412
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• 2014

Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.

• Journal of Preventive Medicine and Public Health
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• v.27 no.2 s.46
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• pp.186-193
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• 1994

This paper is an attempt to identify major challenges to be faced by the Korean health care delivery system for about 30 years in the future and to deliberate over possible policy responses to them. It is not intended to make a precise prediction of the future profile of the system, but the focus is given to understanding what we have to do from now on in order to develop health care in Korea toward a desirable direction. Although the discussion has been made in a rather fragmented manner, it would hopefully provide stepping stones for a systematic study of the Korean health care system from a long range perspective.

• Research in Community and Public Health Nursing
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• v.15 no.3
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• pp.365-375
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• 2004

Purpose: This study intends to make a database for hypertensive patients and middle-aged women who are visiting the Yeojoo County Health Center. While building up the database, the study reviewed the current assessment tools used in the health center, developed appropriate health care programs, and designed a computerized health care system. Method: The modeling of a database for the system was constructed by MS-Access for DBMS (Database Management System) and Visual Basic. The system is to be used only in the health center by being designed as a client server method, making it possible for many public employees to be interconnected, and enables them to retrieve and search data from the database simultaneously. Results: The health management system systematically follows nursing processes including assessment, diagnosis, intervention and evaluation. Diagnosis. once it is done according to the self determined criteria, saves time and provides appropriate health information for the members. Also, the health education program was developed to follow up on the health status of the members on a continuous basis. Conclusion: Based on these results, it is required to evaluate health care programs provided for the members by using the database system and to develop more practical health care programs. It is also necessary to connect the system to other databases. which contain information about members.

• Women's Health Nursing
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• v.2 no.1
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• pp.25-39
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• 1996

The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.