• 보건의료기술평가
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• 제6권2호
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• pp.95-99
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• 2018

As technologies develop, the digital health sector is gradually expanding. Internationally, the global summit for Digital Health named Global Digital Health Partnership (GDHP) was launched in 2018. Many countries are participating in GDHP and share their policy experiences on digital health and find the ways to cooperate with participating countries (13 countries, including South Korea, and Hong Kong). This article reviewed the international trends in digital health policy environment and evidence assessment focusing on GDHP activities, and derived implications for health technology assessment of digital health. Consequently, to assess the intervention effects of digital health is very complex and the assessment should be considered multidimensional aspects (social, clinical, and technical). In addition the patient experience should be assessed qualitatively. Health technology assessment (HTA) should assess the effect of digital health policies to changes in health care systems resulting from the application of advanced technologies related to the 4th Industrial Revolution. Digital health is also related to new HTA, HTA of existing technologies, and R&D on the promising health technology. Therefore, it is necessary to review the trends of the technology's management policy consistently through the HTA of digital health.

• 보건행정학회지
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• 제32권1호
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• pp.113-121
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• 2022

This study aims to compare the healthcare status of South Korea and other member of the Organization for Economic Cooperation and Development (OECD) using the OECD health statistics 2021. We used the position value for relative comparison (PARC) index to measure the five elements of the healthcare system, demand, supply, accessibility, quality, and cost. For the statistical analysis, Mann-Kendall test was performed to examine the trend of the PARC values from 2000 to the most recent year. The results showed that supply, demand, accessibility, and quality were above median than the OECD median and the cost was below median. In sectors such as primary care, health employment and mental health care were below median average. With these result, necessary steps for a sustainable healthcare should be taken into effort by policy makers.

• 의학교육논단
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• 제24권1호
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• pp.35-45
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• 2022

Needs for public healthcare have recently increased. This paper proposes education topics for competency development in public healthcare in line with the needs of the times. In Korea, various lifelong education providers have already provided public health-related education. For example, the Research Institute for Health Policy (RIHP) under the Korean Medical Association provided an "executive course for physicians' public health care competencies" in 2019 and 2020. At the end of the course, the RIHP published a comprehensive report, entitled "Curricular development and evaluation for doctors' public healthcare competencies." This article is based on a summary of that report. To develop a curriculum for public healthcare, the RIHP adopted the following methodologies for a needs analysis; reviewing already-existing education subjects, evaluating end-of-course reports, and conducting in-depth focused group interviews and questionnaire surveys with doctors at public healthcare-related institutions. The results from the needs analysis can be categorized into two domains of education topics for public healthcare. The first domain includes education subjects related to the theory and practice of public healthcare, as follows: a general overview, community or population health, organizational administration, planning and evaluation, budget and finance, responses to disasters such as infectious diseases, health policy, and the legal system. The second domain contained education topics related to general professional competencies: leadership, communication, cooperation, teamwork, and professionalism. In conclusion, the curricular content for public healthcare will be an appropriate combination of competencies specific to public healthcare and core competencies for health professionals.

• 보건행정학회지
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• 제30권1호
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• pp.37-49
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• 2020

Background: Unmet healthcare needs have many advantages for measuring inequalities in healthcare use. However, the existing indicator is difficult to capture the reality of unmet healthcare needs sufficiently and is not quite appropriate in comparing regional inequality. The purpose of this study is to critically analyze the utilization of the unmet healthcare need indicator for regional healthcare inequalities research. Methods: We used the level of healthcare accessibility and healthcare need to categorize the regions that are known to cause differences in healthcare utilization between regions and verified how existing unmet healthcare need indicator is distributed at the regional level. Results: Four types of regions were classified according to the high and low levels of healthcare needs and accessibility. The hypothesis about the regional type expected to have the highest unmet healthcare need was not proved. The hypothesis about the lowest expected regional type was proved, but the difference in the average rate of unmet healthcare needs among regional types was not significant. The standard deviation of the rate of unmet healthcare needs among regions within the same type was also higher than the overall regional variation, which also disproved the whole frame of hypothesis. Conclusion: Failure to prove the hypothesis means the gap between the supposed meaning of the indicator and the reality. In order to understand the current state of healthcare utilization of people in various regions of Korea and to resolve inequality, fundamental research on the in-depth structure and mechanisms of healthcare utilization is needed.

• 보건행정학회지
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• 제28권2호
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• pp.105-106
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• 2018

Korea, which entered the aged society in 2018, is accelerating the progress of the aged society due to the rapid decrease in birth. Although the low birth rate is the important issue, comprehensive measures to cope with the aged society should be established. In particular, the reform of the healthcare system in response to the aged society is very urgent. The reorganization of the healthcare system in response to the aged society should focus on improving the functional abilities of the elderly and should be transformed into integrated older person-centered health service. The benefit package of National Health Insurance should be diversified and appropriate payment of each benefit package should be applied. The ageism should be overcame, and it is important to recognize that the measures for the older person are investments in future society. The reform of healthcare system for older person are very urgent in Korea, which is advancing into a rapidly aged society.

• 한국병원경영학회지
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• 제19권4호
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• pp.57-68
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• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5265-5270
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• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.

• 한국산학기술학회논문지
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• 제10권8호
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• pp.2141-2149
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• 2009

본 연구는 2007년 대한간호협회 간호정책연구소에서 발간한 간호통계연보를 토대로 하여, 우리나라 보건의료 전문 인력의 수급실태와 그에 따른 문제점을 분석해보고 이를 해결하기 위한 방안의 하나로 외국인 전문 인력의 이민정책의 방향을 제시해보고자 하였다. 연구결과 연도별 보건의료인력 면허등록 현황 중, 간호사 등록현황을 보면 2004년을 제외하고 매년 1,000명 이상씩 더 등록된 것으로 나타났으며, 의사는 2002년에 4,000명 대로 등록된 반면 2004년도는 750명으로 그 편차가 매우 크게 나타났다. 보건의료는 국민의 건강 및 생명 유지를 통하여 노동력을 담보할 수 있는 기간재이기 때문에 국가는 기본적으로 모든 국민들이 보건의료 서비스를 공급받는데 지장이 없도록 해야 한다는 당위성을 갖는다. 때문에 의료서비스에 대한 접근성이 현저하게 떨어지는 낙후 지역을 중심으로 선진국의 사례를 모범으로 삼아 외국인 보건의료 전문 인력을 유치하여 활용하는 것은 낙후지역 주민들의 삶의 질의 향상시키고 지역적 통합에도 기여할 수 있을 것으로 사료된다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권2호
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• pp.47-49
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• 2016

• 디지털융복합연구
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• 제10권3호
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• pp.241-250
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• 2012

저출산은 생산인구의 감소와 함께 보험료 부담을 가중시키는 문제 뿐 아니라, 종국에는 국가의 존립을 위협하는 묵과할 수 없는 국가적인 정책과제가 되었다. 이에 본 연구는 현 정부의 출산장려정책 중 경제적 지원인 고운맘 카드의 실효성을 알아보고 산모들의 인식조사를 바탕으로 도출된 문제점에 대한 개선안을 제언하고자 한다. 분석방법은 인식도 조사를 위해서는 빈도분석을 이용했으며, 출산장려정책에 대한 선호도를 파악하기 위해 다중응답분석, 고운맘 카드 사용에 대한 만족도와 재출산 의사정도를 알아보기 위한 카이제곱 테스트를 시행했다. 분석결과, 고운맘 카드 사용으로 인한 산모들의 만족도와 재출산 의사간에는 유의한 관련성을 보였다. 또한, 산모들은 정부기관 및 의료기관과 구전으로 전파된 내용에 의해 해당 정책에 접근하는 것으로 나타났다. 그리고 정부의 지원금액 범위 내에서 병원 청구할인서비스 정도만 활용하는 것으로 나타났다. 그러나 지원금액 및 l일 사용 한도금액과 같은 금전적 요인에서 주로 불만을 표출했다. 그에 따른 상향 조정된 희망 개선안을 요구했다. 위의 결과를 토대로, 정부는 정책시행의 궁극적 목적인 출산률의 상승을 위해 고운맘 카드를 개선 발전시켜나가야 할 것이다.