Go to the main menu
Skip to content
Go to bottom
REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
Editor in Chief :
Volume & Issues
Volume 10, Issue 4 - Dec 2000
Volume 10, Issue 3 - Sep 2000
Volume 10, Issue 2 - Jun 2000
Volume 10, Issue 1 - Mar 2000
Selecting the target year
Emerging Currents in Health and Medicine - A Socio-Cultural Critique of Their Discourses and Practices -
Health Policy and Management, volume 10, issue 4, 2000, Pages 1~19
We have witnessed several kinds of new discourses and practices in health and medicine since the 1970s, such as popular concerns with alternative or complementary medicine, inordinate attention to the promotion of 'healthy' living, rapid resurrection of traditional medicine and ecological management of health. Four structural and situational factors are discussed to underlie these new trends：(i) as 'crisis' in health care of the 1970s was translated into health care reform of the 1980s backed up by neo-liberal political philosophy, the state responsibility for nation's health is being transferred to the individual ；(ii) it resulted from the limits of biomedical paradigm in dealing with chronic diseases；(iii) medico-scientific knowledge of disease is transformed into the subjective discourses and technologies of health in postmodern society ； and (iv) it is deeply associated with the considerable increase in environmental risk perception of health and disease. There are some inherent countervailing forces in these new discourses and practices. First, while they derive from lifestyle-oriented behavioral change, medicalization of life and death is still consolidated in the new trends. Second, inasmuch as new tides are reliant upon science, they. are likely to be remote from techne that means not the practical application of theoretical knowing but a special form of practical knowing. Third, as new discourses and activities accomplished＇in the name of health＇increasingly occupy important strategies in forming the self-identity, they serve as moral apparatus which involves prescriptions about how we should live our lives and conduct our bodies, both individually and collectively. Therefore, two points are suggested to consider seriously whether these streams will succeed in improving the‘healthy’living of all the people. Instead of limiting tile perspective to medicine, healing and health care, a new matrix that interweave welfare, ecology and labor along with them is timely needed for enhancing the health for all. In addition, as the World Health Report fm strongly shows, inequality in health heavily depends upon socio-economic development of a society, and it is not the richest countries that have the best health status, but those that have the smallest income differences between rich and poor.
A Critical Review of the Application Experiences of the DRG Reimbursement System in the USA
Health Policy and Management, volume 10, issue 4, 2000, Pages 20~56
The purpose of this article was to evaluate the effects of reimbursement system on the basis of diagnosis-related groups(DRGs). We searched articles which was published from 1970 to 2000 using MEDLINE ； Key words "diagnosis-related groups, DRGs, prospective payment system, PPS. Then we reviewed 97 articles on classifying them into several categories of contents. It seems that the effects of DRGs in controlling hospitals cost in the U.S. was not clear cut. The U.S. Medicare PPS using DRGs remains vulnerable to compensatory increases in ambulatory care and long-term care facilities utilization despite cost per case and cost per admission being reduced. Also some research indicated the possibilities of deterioration in health care service quality. So putting theses results together, much more consideration is needed before the application of DRGs reimbursement system in Korea. Particularly there is the crucial difference between U.S. health care system and Korean, we must be aware of the limitations of DRGs and revise the DRG system to applicable in Korea.orea.
Cognitive Discrepancies of the Mutual Development Strategies of Western and Oriental Medicine in Korea - A Comparison between Western and Oriental Medical Practitioners and Health Professionals -
Health Policy and Management, volume 10, issue 4, 2000, Pages 57~74
This study is conducted to compare how the Western.Oriental medical practitioners and health professionals perceive reciprocal development strategies respectively of Western.Oriental Medicine in Korea. A total of 3,273 persons were questioned by direct distribution, e-mail, and mail with a self-developed questionnaire. Of those questioned, 362 responded (the response rate of 11.1%), and of them n persons (Western medical practitioners 206, Oriental medical practitioners 90, and health professionals 64) were analyzed with SPSS for Windows. The results were as follows： The need for legislation on the mutual development system for Western.Oriental Medicine was recognized by 66.9% (218 persons) of respondents. Among them, largest group who agreed with this need was the health professionals. Western medical practitioners chose the "the difference of approach methods on the diseases between Western.Oriental Medicine" as their response, and Oriental medical practitioners ＆ health professionals selected "the indifference or bias of Western medical practitioners"as the reasons for the inactivity in developing a mutual system of Western.Oriental Medicine. Therefore, Western medical practitioners and health professionals selected the category of "the reformation of educational system", while Oriental medical practitioners selected the category of "the activation of joint research on Western.Oriental medical care" as the most important condition for setting a precedent. Also, Western medical practitioners preferred "cooperative health care system for Western medical care supported by Oriental medical care", but Oriental medical practitioners and health professionals preferred “cooperative health care system of Western.Oriental medicine on equal terms" In conclusion, Western '||'&'||' Oriental medical practitioners have to make every effort to close the gap between differing views through mutual understanding and respect if joint research of Western.Oriental medical care is to become a reality. The government should continuously enforce the health policy on development of a legal and systematic infrastructure for mutual development strategy of Western.Oriental Medicine in Korea.strategy of Western.Oriental Medicine in Korea.
A Study of Human Resource Efficiency in Public Corporation Medical Centers
Health Policy and Management, volume 10, issue 4, 2000, Pages 75~98
This study applied Data Envelopment Analysis(DEA) and Ratio Analysis and Regression Analysis to a set of Korean Public Corporation Medical Centers to evaluate their relative human resource efficiencies. The output measure used in this study was based on health insurance system which was used in both in-patient departments and out-patient departments. Inputs included working time of the doctors, nurses, technicians, and managerial department staff. Based on the data provided on the inputs and outputs, the analysis showed 23 of the 34 hospitals to be relatively inefficient. Each hospital with an efficiency rating of less than 1 was considered relatively inefficient. In addition, managerial strategies based on dual variables were constructed to indicate the manner In which inefficient hospitals may be made efficient. A subsequent analysis of t-test revealed that the bed occupancy rate, medical revenue per 100beds, value added revenue per staff, medical revenue per staff were statistically significant. The results of this study suggest the DEA is a promising tool for evaluating relative human resource efficiency in hospitals which have multiple inputs and outputs and where the efficient production function is not specifiable with any precision. But it is considered that efficiency evaluations may be most effective]y accomplished by Incorporating a combination of methodologies such as ratio analysis and regression analysis.
A Study on the Budget Allocation to Public Health Programs Using Matrix Delphi Technique
Health Policy and Management, volume 10, issue 4, 2000, Pages 99~115
This study was conducted to get a resonable set of budget allocation to public health programs. Matrix Delphi technique was used to obtain the logic of study results and eventually to form a human model which could predict opinion of professionals on budget allocation. Thirty-two professionals in academic and governmental area responded to Delphi survey. Questionnaire was developed using matrix formation, and the matrix was formed by 6 decision criteria on budget allocation and 26 public health programs. The decision criteria are as following: size of problem(morbidity), severity of problem, social equity, importance of prevention, technical feasibility and efficiency of programs. Severity of problem dropped out of the model because it had significant correlation with the size of problem. A total score of each program was obtained by weighting the relative importance of each criteria which also were given by survey respondents. These total scores indicate that the most important public health program is vaccination for infants and children in terms of budget allocation. Monitoring communicable diseases, mental health program, and anti-smoking program are the next. In addition, respondents were asked of the desirable budget size of each program. The result was rearranged by multiple regression model using the scores of each decision criteria. In this process, the current budget size of central government was provided to the respondents, and included in the model. h set of desirable budgets modified using tile model was obtained. Considering the current size of budget, tile results of the model is very different from that of the total score. Managing dementia is ranked the first. Health promotion program for the elderly, rehabilitation of the disabled and monitoring communicable diseases are the next. The need to increase the budget of vaccination for the infants and children was not found as so high. The matrix structure in Delphi survey gave us the precise basis to make optimal decision, and made it possible to develop an opinion predicting model. However the plentifulness and diversity of professional opinions were not fully obtained due to the limited number of decision criteria.
An Empirical Analysis on Overhead Cost Drivers in the South Korea Hospitals
Health Policy and Management, volume 10, issue 4, 2000, Pages 116~143
Considerable attention has been devoted in the accounting literature to identify the factors that cause or drive the costs of overhead activities. This paper extends recent cost driver research to the health care provider. In various case studies, it has been suggested that overhead costs are driven by volume and complexity variables. This paper investigates the significance of these variables in determining hospital overhead costs, how they are structurally related and how the cost impacts of these variables can be estimated in practice. This paper analyzes the determinants of hospital costs using the sample of South Korea hospitals for seven year during the period 1952－1997. The paper focuses on the extent to which hospital overhead costs depend on complexity, efficiency in addition to depending on more conventional volume based measures of hospital activity. The results of regression analysis suggest that volume and complexity factors positively and significantly affect overhead costs in the hospital industry. The results show that the complexity-related cost drivers strongly affected on the overhead costs in tile health care provider industry more than manufacturing industry which is mainly affected by volume-related cost drivers. That means each Industry may have different cost structures. Therefore it Is Important to find their proper cost structures and cost drivers and use them. Futhermore identification of overhead or indirect cost drivers is likely to be particularly useful in heath care. The identification of cost drivers can be of benefit to all health care stakeholders because these facilitates more efficient management of the national resources devoted to health care. While this study has documented that the level of service complexity is a significant determinant of hospital overhead costs, caution should be exercised in interpreting this as supportive of the cost accounting procedures associated with ABC. It is an open question whether even a well-designed ABC system will provide suitable proxies for marginal costs for decision making purposes.