• Journal of Korean Public Health Nursing
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• v.19 no.1
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• pp.148-160
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• 2005

Presented here are policy alternatives for understanding home health care for the long-term health care insurance system which is being developed for elderly people starting 2007. The summary of issues concerning home health nursing care under the long-term care insurance system include; 1) absence of comprehensive and systematic policy in home health care deliverly systems; 2) absence of community based home health agencies that are considered as the community residents in general. In order to overcome these problems and Issues, policy alternatives of home health care should 1) establish a comprehensive home health care policy for homebound persons; 2) establish the foundations for home health care nurses and community based home health care systems; 3) establish home health care facilities and infrastructure; and 4) promote research and development concerning home health care. Conclusively, a home health care system should be built on a comprehensive policy vision based on health policy, especially long-term care insurance system in the near future. Every homebound residents service has to be constructed systematically under suitable facilities considering the consumer characteristics and health conditions. By doing this, the consumer based comprehensive community home health care delivery system can be constructed in view of the long-term health care insurance system for elderly people.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.67-75
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• 2004

Purpose: The purpose of this study was to identify the current management status and the policy issues of visiting nursing programs at public health center in urban area. Method: A questionnaire surveys was conducted on all public health nurses in 25 health centers in Seoul. Result: The major results were as follows: The characteristics of the visiting nurse showed that the average age was 41.1 years, and total nursing experience was 122 months. Their visiting nursing experience was only 30 months. The recipients of visiting nursing services consisted of 60.1% females, and 32.5% of the recipients were over 65 years. The major health problems of the recipients were hypertension, diabetes mellitus, arthritis and psychiatric problems. The visiting frequency was an average of 5.4 times per day, and 357 families were managed per visiting nurse. The major problems of visiting nursing programs were the shortages of visiting nurse manpower. The most important related policy issue was being in charge of a workload, which was not related to the visiting nursing services. Conclusion: By analyzing work for visiting nurses and identifying weak points, this research can present recommendations to be practically used as baseline data for establishing policy in relation to vitalizing visiting nursing programs.

• Health Policy and Management
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• v.28 no.1
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• pp.15-22
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• 2018

Background: Health is affected by various local factors. This study aims to investigate the age-standardized mortality variation of Seoul as well as the characteristics of the factors related to the mortality variation. Methods: The Korea Community Health Survey data, Seoul Survey data, Seoul statistics, and e-regional indicators of the National Statistical Office were used. To investigate the basic boroughs standardized mortality variation in Seoul, external quotient, coefficient of variation (CV), and systematic component of variation (SCV) values were suggested; correlation analysis and multiple regression analysis were conducted to investigate the characteristics related to standardized mortality rate. Results: The highest and the lowest standardized mortality rate of Seoul by boroughs had as much as 1.4 times difference; a low level of variation was shown in CV by 8.2; and was shown in SCV by 79. As a result of the multiple regression analysis of the factors that affect standardized mortality variation, the higher the rate of householders with college or higher, the lower the standardized mortality rate, and the higher the high-risk drinking rate, the higher the standardized mortality rate. Of the two, the rate of householder with a degree equivalent or higher than college was shown to have the biggest impact, followed by high-risk drinking rate. Conclusion: We found a variation in age-standardized mortality rate of boroughs in Seoul. The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2821-2826
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• 2016

Implementation of no tobacco policies in schools is associated with lower tobacco use among teachers and students. In this study we assessed the extent that a school-based intervention for teachers resulted in adoption and implementation of tobacco control policies. From a random sample of government schools ($8^{th}-10^{th}$), 72 were randomized into intervention and control conditions. Intervention included health education programs for teachers and support for tobacco control policy implementation. Adoption and implementation of policies were assessed at baseline and immediately after intervention. All 36 intervention and one control school adopted a tobacco-control policy. Higher enforcement of tobacco-control policy was at post intervention (OR=3.26; CI: 2.35, 4.54) compared to baseline in intervention schools. Some 64% of intervention and 28% control schools showed "improvement" in policy implementation. Adoption and implementation of no tobacco policies was positively impacted by intervention. This study provides support for scaling up of school-based tobacco control interventions to promote school tobacco control policies.

• Journal of Preventive Medicine and Public Health
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• v.52 no.6
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• pp.427-432
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• 2019

Objectives: In Indonesia, 61 million adults smoked in 2018, and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement a smoke-free policy (SFP), and the city of Jayapura enacted a local bill (1/2015) to that effect in 2015. This study aimed to evaluate compliance with this bill and to explore challenges in implementing it. Methods: We conducted a mixed-methods study. Quantitatively, we assessed compliance of facilities with 6 criteria (per the bill): the presence of signage, the lack of smoking activity, the lack of sale of tobacco, the lack of tobacco advertisements, the lack of cigarette smoke, and the lack of ashtrays. We surveyed 192 facilities, including health facilities, educational facilities, places of worship, government offices, and indoor and outdoor public facilities. Qualitatively, we explored challenges in implementation by interviewing 19 informants (government officers, students, and community members). Results: The rate of compliance with all 6 criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. Spatial patterning was absent, as shown by similar compliance rates for SFP facilities within a 1-km boundary around the provincial and city health offices compared to those outside the boundary. Implementation challenges included (1) a limited budget for enforcement, (2) a lack of support from local non-governmental organizations and universities, (3) a lack of public awareness at the facilities themselves, and (4) a lack of examples set by local leaders. Conclusions: Overall compliance was low in Jayapura due to many challenges. This information provides lessons regarding tobacco control policy in underdeveloped areas far from the central government.

• Health Policy and Management
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• v.19 no.4
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• pp.78-97
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• 2009

This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

• Health Policy and Management
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• v.23 no.4
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• pp.326-342
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• 2013

Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

• Health Policy and Management
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• v.29 no.3
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• pp.342-356
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• 2019

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.239-240
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• 1996

• Korean Medical Education Review
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• v.24 no.1
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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.