• Title/Summary/Keyword: health reform

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The way to achieve Universal Health Coverage: Focusing on the Historical and Cultural Context of Health Care Sector in Vietnam (보편적 건강보장을 향한 노정 : 베트남 보건의료 부문의 역사·문화적 맥락을 중심으로)

  • BEAK, Yong Hun
    • The Southeast Asian review
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    • v.28 no.1
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    • pp.173-218
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    • 2018
  • This study focuses on the healthcare sector in Vietnam which is promoting universal health insurance for the achievement of Universal Health Coverage (UHC) under Sustainable Development Goals (SDGs). The purpose of this study is to examine the characteristics of the reform process of the health care system and the law on health insurance through the historical and cultural contexts and its implications from the perspective of development. Based on the three dimensions of UHC - extension of protection for population, provision of various medical services, and financial protection, the current status of the Vietnam healthcare sector is summarized respectively as follows. First, according to the revised Health Insurance law which came into effect in 2015, the mandatory health insurance premiums are calculated based on household units. Second, there is a medical network that can provide preventive and healthcare services centered on primary health care facilities, for example commune health stations (trạm y $t{\hat{e}}$ $X{\tilde{a}}$). Third, out-of-pocket expenditure is still a large proportion although public spending has increased and private spending has decreased since the enforcement of the health insurance law and various schemes. Vietnam is currently striving towards a universal health care system. The development of institutions and systems should be designed in a way that is appropriate for the members of the society rather than efficiency. This article findings shed light on the role of social values, family culture, and informal institutions.

Korean HIV/AIDS Policy on International Migrants: Comparing with OECD Countries

  • Lee, Jung-Whan;Sohn, Ae-Ree
    • Korean Journal of Health Education and Promotion
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    • v.23 no.5
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    • pp.47-73
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    • 2006
  • Objectives: This study aims to identify gaps between knowledge regarding migration and the spread of HIV/AIDS, to improve understanding of migrants with HIV/AIDS and their human rights, and to make suggestions for Korean policy makers to reform laws and policies towards granting migrants with HIV/AIDS more human rights and access to treatment and care. Methods: This study is based on an extensive literature review, questionnaire surveys and in-depth interviews from randomly selected 8 countries from 5 different continents: Japan from Asia; Australia from Oceania; Finland, Germany, Ireland and United Kingdom(UK) from Europe; and Canada and United States of America(USA) in North America. Results: This study has found that Korea has a discriminating policy regarding HIV/AIDS and foreigners. Classifying HIV/AIDS into a legal communicable disease, it requires a presentation of HIV/AIDS test results from foreigners wanting a long-term stay before entering. In principle, foreigners with HIV/AIDS cannot either enter or stay in Korea. If they are known infected with HIV/AIDS by any reason, they became to face an immediate deportation regardless of their sojourn statuses and purposes. Conclusion: With the results, this study suggests three reasons why Korean government needs to change the current HIV/AIDS policy on foreigners: 1) HIV-related travel restrictions have no public health justification, 2) its strict HIV/AIDS policy on foreigners could result in restriction on the mobility and migration of its people by the other countries, inversely, and 3) it needs to meet international guidelines and to observe conventions that international organizations suggest to maintain its status as a member of the international society.

Determinants of Welfare Attitudes towards Healthcare Services: Focusing on Self-Interest, Symbolic Attitude, and Sociotropic Perceptions (의료서비스에 대한 복지태도의 결정요인: 자기이해, 상징적 태도, 사회지향적 인식요인들을 중심으로)

  • Seo, Wook-Young;Moon, Daseul;Chung, Haejoo
    • Health Policy and Management
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    • v.27 no.4
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    • pp.324-335
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    • 2017
  • Background: The aim of this study is to analyze determinants of welfare attitudes toward healthcare services in South Korea, using three main theories: self-interest (positive welfare attitudes if the policy fulfills people's personal interests), symbolic attitudes (positive welfare attitudes if the person is politically progressive or egalitarian), and sociotropic perception (positive welfare attitudes if the person experienced positive aggregated collective experiences of societal events and trends regarding the policy). Although the definition of the welfare attitude is rather ambiguous in literatures, in this investigation, we operationalize the concept as the 'willingness to pay higher taxes to improve the level of health care services for all people in Korea' which shows individuals' actional propensity. Methods: We used the health module from the International Social Survey Program 2011 for the analysis (N= 1,391). Five logistic regression models were built successively using two variables for each theory to measure key concepts of self-interest, symbolic attitudes, and sociotropic perceptions as independent variables. Results: The result showed self-interest and symbolic attitudes factors to be strong determinants of welfare attitudes towards healthcare services in South Korea, whereas sociotropic perception factors have inconsistent effects. Conclusion: For a more politically elaborated healthcare reform in South Korea and elsewhere, there needs to be further research on various dimensions and determinants of welfare attitudes to understand popular basis of welfare expansion, especially in the era of inequality.

Challenges and opportunities in integrating complementary and alternative medicine into mainstream of the Malaysian healthcare system

  • Tahir, Nurul Ain Mohd;Thomas, Paraidathathu;Li, Shu Chuen
    • CELLMED
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    • v.5 no.4
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    • pp.23.1-23.6
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    • 2015
  • Complementary and alternative medicine (CAM) practice is still popular among the Malaysian population nowadays although western or allopathic medicine is the first line of treatment. Dissatisfaction with health services and therapeutic effects of western medicine or preference for holistic, integrative approach in treatment are common reasons favouring the increasing popularity of CAM practices. The efforts toward integration of CAM and western medicine in Malaysia were rather slow and in a piece-meal fashion. Strategic efforts in strengthening government and self-regulation among practitioners, formalizing education, promoting research, and cultivating national and international networks are necessary to achieve an integrative system. Regulations to restrict the practice and sale of CAM products to licensed practitioners, strict and mandatory registration of the practitioners, inclusion of CAM in essential medicines list, and pricing regulations must be comprehensively discussed. Development of curriculum, offers of scholarship and incentives, promotion of courses and seminars for professionals is necessary to increase the numbers of CAM experts. Malaysia should follow the efforts of other countries on the production and documentation of local CAM data, allocation of funding, and establishment of research centres to assess the efficacy of potentially useful local products. Local and international collaboration in research and continuous education is important for exchange of knowledge and skills. In conclusion more coordinated efforts in regulation of CAM practice and products, formalizing CAM training and education would significantly move the process forward and allow the public to enjoy more health benefits from CAM practice in Malaysia.

Telemedicine in Japan and Role of the Community-based Occupational Therapy (일본의 원격의료현황과 지역사회작업치료의 역할)

  • Kim, Do-Hoon;Yoon, Tae-Hyung
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.2
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    • pp.23-30
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    • 2015
  • Objective : The aim of this study is to analyze the telemedicine in Japan and discuss the role of the community-based occupational therapy. Methods : This study was collected and analyzed data on telemedicine status in Japan. It examined the definition and forms of telemedicine and analyzed for the appearance to the background telemedicine in Japan. Thus, we discussed the role of the community-based occupational therapy. Results : Due to increased medical costs, low fertility rate and aging in Japan, it had provided the telemedicine as a more efficient form of health care services. Also, telemedicine emerged due to the lack of doctors, development of medical technology, and regional deviation between rural and urban area. In the case of Korea, similar to Japan, therefore, there is a demand for the telemedicine. Conclusion : With regard to telemedicine, occupational therapy in community-based rehabilitation is expected to be able to treat for patients as health care professionals. Therefore the reform of the educational system is needed for this.

A Criminal Abortion and Protected in the Right to Life (낙태죄와 생명보호)

  • Jung, Hyo-Sung
    • The Korean Society of Law and Medicine
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    • v.10 no.1
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    • pp.323-361
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    • 2009
  • In Korea, Abortion in the Criminal Law is an illegal act in exception of on which abortion may be carried out through the grounds are very limited and related such a emergency situation of women's physical health, rape, incest and genetic diseases. The Criminal Law regulates the mother's act of abortion and the doctor's surgical performance of abortion. The Mother and the Child Health Law prescribes the medical, ethical, and genetic grounds for the legal permission of abortion. Many people tend to abuse of abortion even though they are fully aware of its illegality. The law lead to be inconsistent with its enforcement. In this paper, I would like to suggest some proposals about the legal analysis of the Abortion Regulations th reform the existing regulation and increase th effectiveness of the regulations. Recently, in a case of the a maternity hospital where a midwife left alone a diabetes pregnancy women who had a baby, and the overweight baby(5.2Kg) died in the uterus due to hypoxic states. Supreme Court of Korea 2007.6.29. 2005do3832) had given a verdict of "not guilty". It looked like there were very fair with current crime law. But, we want this case to be investigated if there weren't any logical contradictions as well as concurrent translation within Constitution Law. Now the Mother and the Child Health Law prescribes the medical, ethical, and genetic grounds for the legal permission of abortion. But this law does not include social and economic grounds.

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The Job Status of Health Teacher, School Nurse, during Epidemic Outbreak of Influenza H1N1 in School (학교 신종플루 확산기 동안의 초등학교 보건교사의 직무현황)

  • Shin, Sun-Mi;Kim, Hye-Soon;Hong, Min-Soon;Lee, Hee-Woo
    • Journal of the Korean Society of School Health
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    • v.23 no.1
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    • pp.63-70
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    • 2010
  • Purpose: To identify the need to reform in the crisis response of Health Teacher, School Nurse, in elementary school during epidemic outbreak of influenza H1N1. Methods: 139 elementary health teachers, school nurse, in seoul elementary school responded in the questionnaire, and we analysed by using frequency and percent, t-test, and paired t-test. Results: The Job status became 121% more 'during influenza H1N1 (flu) outbreak' than Job status of 'before outbreak'. The proportion of the flu-related duty among their daily workload was up to 77.5%. The administration-related workload of the flu-related duty was 30.8%. and students' health assessment including temperature measurement 18.7%. Furthermore, an impediment of usual daily work due to an increaed flu-related workload was 95.7%, and no alternative plan such as disposition of assistant labor force was 86.1%. Especially, an impediment of health education was 61.0%, so the major concern was the loss of health education. We compared average scores (a five-point Likert scale) of health teachers' work motivation, exhaustion, work relationship and Job management of 'during' with 'before' flu-outbreak. The difference range of 'during' minus 'before' work motivation score was from -0.4 points to -0.9; work exhaustion range from 1.8 to 1.9; the difficulty of relationship between students, school personnel, parents of students, and health teachers from 1.4 points to 1.3 points; and the consideration of changing Job, taking time off from the Job and retirement from 1.4 to 1.6 points. Conclusion: The health teachers had a heavy workload due to flu-outbreak. They also experienced the impediment of usual work implementation. However, there was a shortage of alternative plan such as disposition of an assistant labor force. Under their Job status like this, the health teachers' motivation score was decreased and work exhaustion was increased. Furthermore, they had a lot of relation difficulty with students and school personnel. Therefore, we suggested that in contrast to the usual Job status, there is a need to have a prepared response during school crisis like flu-outbreak such as improved response system in seoul metropolitan education office, simplification or dispersion of administrative work, and temporary call-center for simple inquiries or advices.

A Critical Perspective on the Central Governmental Reorganization of the Social Service Delivery System for People with Disabilities (장애인서비스 전달체계 개편방안에 대한 비판적 고찰)

  • Lee, Sun-woo
    • Korean Journal of Social Welfare Studies
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    • no.39
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    • pp.221-252
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    • 2008
  • The current social service delivery system for people with disabilities has four critical problems: absence of needs assessment, absence of case management, shortage of professional workers, and absence of local social welfare agencies. The Ministry of Health, Welfare, and Family of Korea has pushed forward with a project to reform the welfare infra-structure for people with disabilities since 2007. It's main purpose is to reorganize the social service delivery system for people with disabilities. A report from the project makes two suggestions: introduction of new standards for disability and set-up of disability service determination centers. The new standards for disability are suggested to include a work ability test and a welfare needs assessment tool as well as a medical standard. Three models for disability service determination centers are suggested: independent model, local governmental model, and public corporational model. Tentative operations using the three models are on the way in the second half of 2008. In order to reform the social service delivery system for people with disabilities, this study makes a fundamental suggestion: set-up of about 120 local welfare agencies over which the Ministry of Health, Welfare, and Family can have direct control, and which are equipped with professional workers who are able to perform needs assessment and case management. In actuality, welfare centers for disabled people are the best options for local welfare agencies for disabled people.

Formation, Development and Task of the Health Insurance Act (건강보험법의 형성과 발전, 그리고 과제)

  • CHEON, Kwang Seok
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.3-45
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    • 2019
  • Health insurance is the main instrument to protect the people against sickness. To examine the task of in the future it would be necessary to extract and understand the components formed in its formation and development, benefit related and normative characteristics of the health insurance itself. The health insurance oriented itself to the universal coverage at a law level. Paradoxically this worked positively for the universal development of the health insurance. The task of the health insurance is on the one hand universal, positive and open. On the other hand it has to shape type of allowed method, art and content of the medical treatments into the regulation to ensure the equal benefit as well as the financial stability. That is, the health insurance should check the aberrant medical treatment, and at the same time should be compensated for the their necessity and effectiveness. However there are always some structural differences between both requirements. This article aims to restate and analyse the development of the health insurance, based on the characteristics formed hitherto show the way to reform the health insurance. The problem to enhance the coverage of health insurance, its institutional as well as financial crisis, its peculiar governance would be handled.

Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis

  • Zandian, Hamed;Takian, Amirhossein;Rashidian, Arash;Bayati, Mohsen;Moghadam, Telma Zahirian;Rezaei, Satar;Olyaeemanesh, Alireza
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.2
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    • pp.83-91
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    • 2018
  • Objectives: One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households' income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.