• 의학교육논단
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• 제24권1호
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• pp.10-17
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• 2022

South Korea is not a wasteland of publicly funded health care-instead, it has a good medical social security system known as the national health insurance (NHI). The NHI of Korea has three unique features; (1) low premiums, low insurance fees, and low coverage; (2) obligatory designation of medical institutions; (3) and allowance of non-benefit services. These features have made hospitals and doctors interested in profit-seeking. However, the commercialization of medical institutions has taken place in both private- and public-established sectors. A basic problem of commercialization is the co-existence of the obligatory designation of medical institutions and non-benefit services. The problem became worse in the Kim Dae-Jung government because it officially permitted non-benefit services. Since 2000, the Korean government has consistently pursued benefit extension policies, but the coverage rates of the NHI have stagnated. In addition, premiums and current medical expenses have markedly increased because policy-makers have emphasized accessibility to the NHI, while ignoring important principles of medical social security such as a needs-based approach and patient-referral system. In order to resolve the commercialization problem, the obligatory designation of medical institutions to the NHI should be changed to a contract system, and non-benefit services should be prohibited at NHI institutions. We must re-establish the patient-referral system via a needs-based approach. We also need to build a primary healthcare system and public health policies. We should make a long-term plan for healthcare reform.

• 대한한의학회지
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• 제44권1호
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• pp.1-15
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• 2023

Objectives: National health insurance herbal prescription of Korean medicine has been serving important role in public healthcare in spite of continuous demand on revision of system. However, the categories of insurance herbal prescriptions are not equally distributed throughout the KCD-based major disease categories. We analyzed statistical database of claimed national health insurance classified as major disease categories by years. We classified all 56 herbal prescriptions as per their total medical indications into 22 major disease categories to analyze their distribution. Significant increase of M and S-T code claims were found, whereas decrease of U code claims by years. We figured out that the 56 prescriptions were unequally distributed along with enrichment of certain codes such as K and J. Meanwhile, the insurance claim of each prescription was positively correlated with number of code types of their indications. As a result, we believe that the reform of national health insurance herbal prescription list is necessary to promote use of it in clinic.

• The Journal of Korean Physical Therapy
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• 제10권1호
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• pp.253-263
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• 1998

To provide physical therapy service of good quality keeping people healthy and obstain structural reformation coping with the demands of in medical service market to foreign intercourse on 21C, we should make legal system fer the physical therapy practice. Thus we suggest the Ministry of Health and Health and the authorities should, 1. Exclude the provision of physical therapist from the classfication of medical technician on the Medical Technician Law Article 2. and establish the independent Physical Therapist Law 2. Eliminate the provision of physician or dentist's guide the Medical Technician Law Article 1. or reform it to physician or dentist's request so that physical therapists may have a independent practice, or 3. Add the provision of the physical therapy center to the Medical Technician Law, the enforcement ordinances and enforcement regulations, such as the provision of optometrist or dental technician.

• 한국안광학회지
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• 제12권4호
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• pp.9-14
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• 2007

본 논문에서는 매년 증가되는 안경광학과 입학정원 증가에 따른 문제점들을 연구하였다. 주된 문제는 안경사 인력의 과잉공급과 열악한 근무환경에 기인하며 이를 해결하기 위해서는 안경사 인력의 수적 불균형을 해소하겠다는 관계자 모두의 공통된 정책적 시각을 가져야 한다. 또 보건의료 인력의 수요와 공급을 예측하고 정확한 정책을 수립하기 위해서는 보건의료 인력개발을 담당할 상설기구와 중장기적인 계획이 필요하다. 안경사 인력의 질적 불균형의 해소를 위해서는 정확한 직무 영역을 설정하고 전문교육과정을 재편하며 국가고시 실기평가의 방법을 구체화하며 보수교육의 내용과 방법을 혁신해 가야 한다.

• 보건행정학회지
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• 제8권1호
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• pp.135-154
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• 1998

In Korea, the institutional reform for the national medical insurance system is in process. Eventually, three kinds of the national medical insurance system, i.e., medical insurance program for the industrial workers, the govemment employees and the private school teachers, and the self-employeds, would be merged into an unifed system. In this study, I analyzed the annual trends of the finance in the medical insurance system in Korea, in which I found the financial instability especially in the medical insurance program for the self-employeds. The regression analysis was carried out to forecast the accumulated reserve at the end of this year for the medical insurance program for the self-employeds. I also analyzed the economic effect of the merge of the medical insurance program for the self-employeds by using the case of Japan and Korea. I found that the medical insurance for the self-employeds is expected to have financial deficit at the end of the year 1998 after the merge. In onclusion, it seems to be quite difficult to solve the financial instability in the medical insurance program for the self-employeds after it would be merged. That means that there would be a lot of problems on the way to the merge.

• 의학교육논단
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• 제22권1호
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• pp.32-45
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• 2020

This narrative review introduces global trends in pharmacovigilance (PV) education for healthcare professionals and the status of PV education in Korea. Proactive participation of healthcare professionals, including physicians, pharmacists, and nurses in reporting suspected adverse events is the main driving force for effective operation of the spontaneous adverse event reporting system database, which in turn facilitates early safety signal detection of otherwise unknown suspected adverse events. The World Health Organization recognizes PV education curriculum as a key aspect in promoting awareness of PV and adverse event reporting among healthcare professionals, and multiple studies have demonstrated that PV educational interventions for healthcare professionals have increased overall adverse event reporting. Considering the global trends in PV education, the curriculum in Korean universities still has room for improvement in promoting PV obligation among future healthcare professionals. Further research is needed to develop PV education curriculum. We suggest a three-step project for innovating PV education in Korea to meet the global PV educational standards: a survey to gauge current PV competencies among healthcare professionals, reform of current PV academic curriculum, and evaluation and fine-tuning of the reformed curriculum.

• 보건행정학회지
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• 제28권3호
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• pp.233-239
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• 2018

A rapid decrease of total fertility rate to 1.08 in 2005 prompted the Korean government to plan and implement a '5-year plan for ageing society and population policy' starting from 2006. The 1st and 2nd 5-year plans had not shown any discernible impact on the fertility and the 3rd 5-year plan was launched in 2016. However, the fertility rate is going down further. The author reviewed the contents and assessment reports of the fertility promotion plan to suggest ideas for complementing the shortcomings of it. Author defined the major determinants of marriage and child birth as philosophy, politics, sense of value, social norm, culture, healthcare, and education. The plan was examined in view of these determinants. Transformation of Korea from an agricultural society to an industrialized society in a short period of time had brought about changes in most of the determinants of marriage and child birth; in particular philosophy and sense of value. These aspects were not put into consideration in the plan. Author suggested to launch a social education program for the general public to establish a sound philosophy of life, reform the sense of value on family, child birth and education, and cultivate the skill to draw a consensus through discussions on the social issues. A special program to promote marriage of women at the optimum age for child birth was proposed. The government should implement well balanced policy for economic development and labor. Multidisciplinary approach was recommended for these tasks.

• 한국병원경영학회지
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• 제19권3호
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• pp.53-64
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• 2014

This research is designed to analyze the professionalism of administrators working in Korean hospitals as a way to make them a better expertise in the industry. For this purpose, we conducted a survey of 105 administrative professionals working in hospitals nationwide and statistical analysis was performed with the SPSS Windows version 15.0. The survey questions were developed based on the Spencer & Spencer's results of research in expertise variables. The results showed that the current Korean hospital administrator do have short of expertise required for their job position. Therefore, the curriculum reform is required for healthcare management programs in college and the Korean College of Hospital Administrators (KCHA) is required to change the contents of license exam based on the results of the study.

• 보건교육건강증진학회지
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• 제25권3호
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• pp.167-181
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• 2008

The prevention of life-style related diseases is an increasingly important issue in Japan, because not only have the number of patients with life-style related diseases increased but also medical care costs. This paper gives recent strategies for the prevention of cardiovascular diseases through life-style modification. Health objectives for the year 2010, called "Healthy Japan 21", were established in 2000 by the Ministry of Health, Labour and Welfare and the Health Promotion Act was enacted in 2002 to promote this health policy. However, the prevention efforts for life-style related diseases have not been effective in regard to the evaluation of the strategy objectives. The reform of the medical care system which included a new nationwide prevention strategy for life-style related diseases was presented in 2006. The new strategy starting from April 2008 included a "specific health checkup" and "specific health education" for those with metabolic syndrome. The specific health checkup is used to screen people according to criteria of the metabolic syndrome and divide them into 3 groups. These groups will receive specific health education. The purpose of this strategy is the early detection of those who have cardiovascular risk factors, and the early management of the clustering of cardiovascular risk factors of obese people aged 40-74 years old. It is mandatory for every insurer to conduct a specific health checkup and specific health education under the new Act. The implementation rate of the specific health checkup and the specific health education, and a reduction rate of individuals with metabolic syndrome among insured people will be evaluated every year. The national objective is to increase the rate of those undergoing the specific health checkup to 80% and the rate of those receiving the specific health education to 60% by the year 2015. The national objective also targeted a reduction rate of 25% for those with metabolic syndrome. This new strategy will be the biggest intervention trial in the world, and it will produce a big health care market in Japan. Not only public administrative institutions but also private institutions are now preparing to take part in this new strategy. However, various tasks remain, such as training more professionals in health education, developing more evidence based practices, and encouraging cooperation with various sectors, to enforce this new strategy.

• 보건행정학회지
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• 제17권2호
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• pp.1-17
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• 2007

Limited coverage for health care services of National Health Insurance(NHI) in Korea has been ongoing policy issue but additional NHI financing through raising contribution or taxes in order to improve coverage faces substantial obstacles. Private health insurance(PHI) is often considered as an alternative financing source to improve coverage. Recent reform that attempted to stretch the role of PHI allowed life insurance companies to provide complementary PHI, indemnity plan which will pay for uncovered services by NHI and out-of-pocket spending for covered services. Although complementary PHI may relieve financial burden of patients, it may significantly raise NHI spending as well as total health expenditure since little out-of-pocket spending may increase utilization of health care. So far, there has not been enough discussion about concerns of potential adverse effect resulting from extended role of PHI. This study investigated potential increase of NHI spending followed by extension of complementary PHI through sensitivity analysis. The amount of NHI spending for services that would be covered by complementary PHI was calculated using 2005 NHI statistics and expected complementary PHI enrollment rate by age and sex. Expected utilization increases were obtained based on price elasticities$(-0.2{\sim}-0.5)$ from previous studies and expected coverage rate$(50{\sim}80%)$ of complementary PHI and then converted to monetary figures. Because coverage rate of complementary PHI has not been determined yet, we employed the sensitivity analysis using coverage rate of $50{\sim}80%$. Findings demonstrate that additional spending for health care services is expected to be $426{\sim}1,702$ billion won, corresponding amount payed by NHI $298{\sim}1,192$ billion won. In conclusion, since complementary PHI may raise NHI spending significantly, there should be an agreement whether this additional cost would be accountable and acceptable in our society. Potential inefficiency resulting from extended role of complementary PHI should be considered since public and private financing do not operate in isolation and there should be more discussion on proper role of PHI in Korea.