• Journal of Periodontal and Implant Science
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• v.46 no.6
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• pp.405-414
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• 2016

Purpose: This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods: A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results: Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions: The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

• Health Policy and Management
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• v.24 no.3
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• pp.205-218
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• 2014

Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.

• Health Policy and Management
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• v.33 no.3
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• pp.325-337
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• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.329-329
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• 2005

• 대한예방의학회:학술대회논문집
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• 1995.10a
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• pp.241-242
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• 1995

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.328-328
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• 2005

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.365-366
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• 1996

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.84-92
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• 2010

Objectives: To investigate the patterns of unintentional home injuries in Korea. Methods: The study population was 12,382,088 people who utilized National Health Insurance services due to injuries (main diagnosis codes S00 to T28) during 2006. Stratified samples(n=459,501) were randomly selected by sex, age group and severity of injury. A questionnaire was developed based on the International Classification of External Causes of Injury and 18,000 cases surveyed by telephone were analyzed after being projected into population proportionately according to the response rates of their strata. Domestic injury cases were finally included. Results: Domestic injuries (n=3,804) comprised 21.1% of total daily life injuries during 2006. Women were vulnerable to home injuries, with the elderly and those of lower income (medical-aid users) tending to suffer more severe injuries. Injury occurred most often due to a slipping fall (33.9%), overexertion (15.3%), falling (9.5%) and stumbling (9.4%), with severe injury most often resulting from slipping falls, falls and stumbles. Increasing age correlated with domestic injury-related disability. Conclusions: The present findings provide basic information for development of home injury prevention strategies, with focus on the elderly.

• Korean Parent-Child Health Journal
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• v.6 no.1
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• pp.59-69
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• 2003

Objective : Recent government policy for encouraging increased birth rate and its historical background were reviewed from the standpoint of a midwife. Suggestions were made for an effective policy to encourage more births. Possible roles of midwives regarding this new policy were also discussed. Methods : Literature reviews and internet research Results : Korea has been very successful in implementing its population control policy since the 1960s. It now considers a policy to encourage increased births due to falling birth rates. There are two opposite sides on this policy. One is positive and the other is negative opinion. The health of women and children should be given top priority in any policy -making or decisions, so that the quality of their lives can be improved. Midwives can be active members in the establishment and implementation of such policies. Conclusion : This policy to increase birth rates can be a good opportunity for midwives to publicize the fact that normal deliveries can be handled economically, efficiently, and safely by them. This will attract more women to employ midwives and use their clinics. If midwifery clinics in the form of a corporation or a consortium with other health care professionals can be established, they could be developed as One-Stop Women's Health Care Centers, where health needs of, not only pregnant women, but all women over the course of their lifetimes can be satisfied.

• Journal of the Korean Society of School Health
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• v.26 no.3
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• pp.133-143
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• 2013

Purpose: The purpose of this study is to provide basic data for a more reasonable health teacher placement policy sending teachers to more appropriate sites, by analyzing the change process of the health teacher placement standards and the problems caused by an unreasonable placement policy. Methods: This study mainly analyzed relevant research data and existing studies focusing on a literature analysis. Results: To date, the placement policy for health teachers has changed, going through expansion, reduction, and retrogression, since its establishment. The standard, placing health teachers only in elementary schools with more than 18 classes, was created in 1952. Despite the expansion of the role of health teachers and the revision of the school health law in 2007, this standard has been applied to date without modification. In the meantime, there have been many problems caused by inappropriate placement of health teachers. It was difficult for health teachers in large schools to carry out proper health education; and, in many schools, passive health management, such as first aid, health tests, and student health management, was mainly executed rather than active health management. Students in small schools were not even given an opportunity to receive health education and health management owing to the absence of health teachers. Also, compared to teachers teaching other subjects, health teachers have had very unfair placement standards. Conclusion: The placement policy for health teachers, which has been applied to the present, has never reflected social change, the increase of student health issues, and the demand from the school area. Although the role of health teachers expanded with the execution of health education, the current placement standards for health teachers are very unreasonable. Accordingly, it is necessary to review the health teacher placement policy in a reasonable manner and to revise the standards considering the reality.