• Research in Community and Public Health Nursing
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• v.26 no.3
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• pp.278-291
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• 2015

Purpose: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. Methods: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. Results: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. Conclusion: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

• Journal of Environmental Health Sciences
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• v.44 no.5
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• pp.452-459
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• 2018

Objectives: We aimed to examine whether dental waste was being managed adequately at different types of dental institutions in City D in South Korea. Methods: The staff responsible for disinfection at 101 dental offices and clinics (six dentistry departments of general hospitals, 12 dental hospitals, and 83 dental clinics) was interviewed. Results: Solid suction pump waste was handled appropriately at four of the general hospital dentistry departments (66.7%), six dental hospitals (50.0%), and 15 dental clinics (18.1%). Solid spittoon waste was handled appropriately at four general hospital dentistry departments (66.7%), seven dental hospitals (58.3%), and 14 dental clinics (16.9%). Developer and fixer were handled appropriately by a subcontractor at two general hospital dentistry departments (100.0%), five dental hospitals (100.0%), and 24 dental clinics (75.0%). Impression materials were handled appropriately at four general hospital dentistry departments (66.7%), six dental hospitals (50.0%), and 11 dental clinics (13.3%). The plastic covers of intra-oral radiography films were handled appropriately at five general hospital dentistry departments (100.0%), eight dental hospitals (72.7%), and 22 dental clinics (30.1%). Conclusion: South Korea must implement detailed and specialized guidelines for the disposal of solid and general medical waste from dental institutions. Moreover, waste disposal training should be provided annually, and not only once every three years.

• Health Policy and Management
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• v.31 no.3
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• pp.280-291
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• 2021

Background: Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications. Methods: Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present. Results: As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders' perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens' use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized. Conclusion: While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.

• The Journal of the Korean dental association
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• v.55 no.1
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• pp.53-62
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• 2017

As the citizens' life and body are the object of medical practice, it should ultimately protect the citizens' right of health. For this reason, medical practice possesses characteristics of non-profit and public and such special characteristics caused heavy regulations in the medical industry as exemplified by medical advertisements. For advancement of market economy, the government has been moving toward relaxing regulations in the medical industry and this trend can be shown in medical advertisements. Moreover, as a type of commercial advertisements, medical practitioners should be able to express their freedom of expression and freedom to occupation. From the perspective of patients who are medical consumers, they need access to information to locate appropriate medical practitioners and institutions for their symptoms. Therefore, medical advertisements can help realize the patients' right to know. This study will first analyze the general theories behind the necessity of medical advertisements and details of regulations, then analyze the issues from the cases of the supreme court and the constitutional court that are related to dental medical advertisements.

• Health Policy and Management
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• v.16 no.2
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• pp.77-95
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• 2006

The present study was conducted to examine the degree of variation in length-of-stay (LOS) among health care institutions participating in 17 diagnosis-related groups (DRGs) payment system and to find out hospital characteristics affecting the variation. Electronic medical claims data for treatments of severity classification '0' of 17 DRGs provided for two $years(2003{\sim}2004)$ were collected. For each DRG, the degree of variation in average LOS among health care institutions were analyzed using the random effect model. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS. Significant variations in LOS were observed 9 DRGs including unilateral/bilateral lens procedures, adult/child tonsilectomy, other anal procedures, bilateral adult/child herniorraphy, unilateral child herniorraphy, and hysterectomy, and hysterectomy using laparoscopic procedure. Among the 9 DRGs, five DRGs were selected to investigate the factors explaining for the variation. It was observed that the location of institution was significant predictors for all five DRGs. Within the same DRGs, LOS was significantly shorter among the institutions located in Seoul than those in other areas. As compared to clinics, hospitals and general hospitals/tertiary care institutions showed significantly longer LOS for DRGs of lens procedures, tonsilectomy, and other anal procedures. It is recommended that the institutions located in other than Seoul area benchmark the strategies of the institution in Seoul in efficiently managing LOS. Also, significant variation within the same severity classification such as other anal procedures implies the imminent need for improvement of patient classification system.

• Journal of Preventive Medicine and Public Health
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• v.44 no.1
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• pp.2-8
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• 2011

Objectives: Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. Methods: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. Results: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. Conclusions: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5875-5881
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• 2012

Research objectives: This research is focused on the multicultural families based on the existing studies. The problems that the women of the multicultural families experience in this society were studied, in relation to the adaptability to Korea by identifying the elements related to the use of and satisfaction level towards medical institutions. As such, this research is expected to be used as a data that can help to provide quality medical service to the women of the multicultural families. Research method: 188 women of the multicultural families were targeted to carry out research by conducting interview and by leveraging translated survey questionnaire. Then, SPSS 18.0 program was used to conduct statistical analysis. As for the analysis methods, frequency analysis, technical statistics, ANOVA and multiple regression analysis method were used. The results of the research were as follows. First, for the satisfaction level towards medical institutions for each class following each nation, Vietnam manifested highest satisfaction level when it comes to the public sanitation clinic, followed by the Philippines and China in the order listed. Meanwhile, Japan manifested the lowest satisfaction level. In case of the Asian medicine hospital, Japan manifested the highest satisfaction level contrary to the public sanitation clinic, followed by Philippines and China in the order listed. Meanwhile, Vietnam manifested the lowest satisfaction level. Second, 'satisfaction level towards nationality, education level, income, degree of adaptation and access to the medical institutions via transportation,' degree of adaptation towards the Korean society was manifested as an influential variable. As the degree of adaptation towards the Korean society increased, satisfaction level towards the degree of access to the medical institutions via transportation was proven to be high. Third, 'Nationality, education, income, hospital administration to help adapt the level of satisfaction' income if the first 1,5 million to 2,0 million won that low satisfaction than from 1 million to 1,5 million won and Higher of Korean society to adapt was higher Hospital Administrationon the level of satisfaction Conclusion: Nationality, education level, income, degree of adaptation towards the Korean society affect satisfaction level towards medical institutions. To increase the elements that increase the satisfaction level towards the medical institutions, multi-dimensional approach by each nationality, education level and income is required. In particular, it would be considered necessary to increase the level of adaptability to Korea.

• Journal of agricultural medicine and community health
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• v.49 no.2
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• pp.132-145
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• 2024

Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4641-4650
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• 2015

This study aims to further strengthen the medical expertise to offer specialized medical care specialization strategies to gain a competitive edge through the customer segmentation of the Regional Public Hospital. Investigation period was selected to study the inpatients 26,658 people January to December 2013. The method of analysis are Cluster analysis and Decision Tree Analysis. In conclusion, female, age over 60, and diseases in musculoskeletal system and connective tissue were commonly selected as identifiers of the target market of Regional Public Hospital. Customers in this target market are loyal to specialized medical service and keeping continuous relationship with these customers through communication and monitoring of results of provided medical service would be important because the effect of word of mouth propagated to other group of customers having equivalent scale of consumption is expected. And the concentration of the scope of medical service of Regional Public Hospital and the collaboration and mutual reliance of medical service under the strategic alliance with other institutions and private hospitals are also needed.

• Journal of Korean Public Health Nursing
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• v.5 no.1
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• pp.70-95
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• 1991

The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.