• 보건행정학회지
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• 제17권3호
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• pp.106-128
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• 2007

The Korean health care system is under great controversy. Over the last 30 years, main goal of health policies was to pursue equal access of health care services. However, another goal of health policies laid on efficiency and Quality of care, it had lower priorities. Superficially, controversy stems from priority setting among goals of health care system, equity, efficiency and quality. At a deeper level, arguments arise from disagreement and confusion about the values of Korean health care system. One of the value spectrums believes that health care is the basic right of human beings, therefore it should be produced and distributed on need approach, and needs are known to be decided by professionals. If we accept need approach, health care is a pubic good. Another value of spectrums considers that health care should be distributed on demand approach. Demand approach means that health care is a consumption good on the positive economics, while normative judgement believes that health care is a public good. In equity aspect, health care is considered as a public good. Over the last several years, some of scholars proposed health care reform based on the principle of competition which is based on demand approach. Others argue that the competition principle based on demand approach is not appropriate for the reform proposal, because health care has to be approached on need base. If we do not make explicit values we should adopt, consensus building for reform is nearly impossible. From this perspective, this article will review an ideology and reality in health policies in Korea.

• Journal of Preventive Medicine and Public Health
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• 제52권1호
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• pp.41-50
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• 2019

Objectives: The aim of this study was to investigate cancer patients' utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. Methods: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). Results: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. Conclusions: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

• 보건행정학회지
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• 제31권3호
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• pp.255-260
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• 2021

Background: Korea National Health Checkup Programs are aimed at the prevention and early detection of cardiovascular disease in adults. To establish a countermeasure for this tendency, The current Korea National Health Checkup Programs have been providing Health Risk Appraisal (HRA) since 2009, thereby focusing on individual lifestyle correction. However, from 2018, the dyslipidemia screening exam cycle has been changed from 2 to 4 years. Methods: In this study, we try to investigate whether policy decisions are valid based on domestic reports that have influenced policy decisions. First, considering the epidemiology of the domestic cardiovascular disease, dyslipidemia, and metabolic syndrome, the change of the 4-year cycle is appropriate or not. Second, whether the research method that applies came to make policy decisions appropriate or not. Third, our study also investigates whether the direction of policy decision was suitable for the second comprehensive national examination plan. Results: The data that are used in the previous study were that of 10 years ago and there also was a problem in selecting the data, especially the use of one of the research methods to calculate the signal to noise ratio that was aimed at improving health had some problems. This is a research method that does not match with the aim itself. Conclusion: Changing the screening cycle for dyslipidemia does not match the recent trend of general screening to effectively prevent cardiovascular disease in improving individual lifestyles in the national health checkup plan. Studying the relationship with metabolic syndrome, which can be an intermediate stage of cardiovascular disease, could be a policy direction that is more suitable for the national health examination comprehensive plan.

• 보건행정학회지
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• 제19권4호
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• pp.53-65
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• 2009

Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

• Journal of Preventive Medicine and Public Health
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• 제38권3호
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• pp.252-258
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• 2005

Major approaches of Social epidemiology; 1)holistic, ecological approach, 2)population based approach, 3)development and life-course approach, 4)contextual multi-level approach, have stressed the importance of not only social context of health and illness, but also the population based strategy in the health interventions. Ultimately, it provides the conceptual guidelines and methodological tools to lead toward the healthy public policies; integrated efforts to improve condition which people live: secure, safe, adequate, and sustainable livelihoods, lifestyles, and environments, including housing, education, nutrition, information exchange, child care, transportation, and necessary community and personal social and health services.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.495-496
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• 2002

• 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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• 제29권3호
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• pp.323-331
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• 2019

Background: The purpose of this study is to analyze the effect of impartiality in providing public health services on subjective health happiness and the mediated effects of public health service quality. Based on this, this study intends to present policy implications to improve public health services. Methods: The research method is multiple linear regression analysis. The analysis of the mediating effects is performed by Baron & Kenny's test, Sobel-Goodman's test, and Bootstrap. Results: The impartiality of public health services and the quality of public health services are shown to have a statistically significant effect on subjective health happiness. Quality of public health service appears to be mediating the relationship between impartiality in providing public health care and subjective health happiness. Conclusion: To promote people's subjective health happiness, it is necessary to secure impartiality in providing public health services in the first place and improve the quality of public health services.

• 보건행정학회지
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• 제5권2호
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• pp.1-17
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• 1995

This paper porports to explicate the factors determining the scope of public health in advanced capitalist countries. A few studies have veen conducted for such a purpose, yet even these studies show the deficiency of failing to consider a very important factor : the influence of medical profession. Since medical profession has played a significant role in the health policymaking, it is necessary to incorporate the hypothesis that assumes the causal links between the differing medical professional power and the vrying scope of public health. Following this view, this paper examined the various hypothese, including the power of medical profession, and found that the variables related to medical professional power as well as social democratic perspectives are its significant factors. In particular, our result shows that the power of medical profesion is the most important determinant, thereby supporting the hypothesis developed in this paper.

• Journal of Preventive Medicine and Public Health
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• 제39권3호
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• pp.195-198
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• 2006

The identity crisis of preventive medicine appears to have been deepening. As a solution, it is insisted that preventive medicine should focus on clinical preventive medicine. However, in the field of heath policy and management, the better solution should be found in a serious search for visions and perspectives of its study on population and society. In this regard, the specialist who studies the field can be defined as a medical doctor majoring in public health. In this paper, I first forecasted major socioeconomic changes to occur in medical and public health arena and explored the role of those studying health policy and management. Secondly, I summarized their career paths and main activities in order to establish visions. Finally, I proposed curriculums on health policy and management for medical school undergraduates and for specialists majoring in preventive medicine, respectively.