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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
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Volume & Issues
Volume 11, Issue 4 - Dec 2001
Volume 11, Issue 3 - Sep 2001
Volume 11, Issue 2 - Jun 2001
Volume 11, Issue 1 - Mar 2001
Selecting the target year
The Employees' Perception of the Effectiveness of Team System at University Hospitals in Korea
Health Policy and Management, volume 11, issue 3, 2001, Pages 1~30
This study was conducted to evaluate the effectiveness of team system at university hospitals in Korea. Data were collected from administrative and medical support workers at 4 university hospitals through the self-administered questionnaires and analyzed using frequency analysis, t-test, and oneway ANOVA. The results of this study are as follows. First, teams with higher team management characteristics show higher level of quality of work life and performance effectiveness. Second, teams which consist of members with variety background and skills show higher level of quality of work life and performance effectiveness. Third, team which have the higher autonomy, technology variety, job significance, and feedback show higher team effectiveness. Fourth, team which have team leaders with higher leadership score show higher level of quality of work life and performance effectiveness. Fifth, there are differences in team effectiveness in terms of sicio- demographic variables such as average age, position, and tenure of team members, length of team system, and team size. Sixth, the job autonomy of team members and the leadership of team managers have significant effects on the quality of work life variables. Seventh, the leadership of team leaders, job autonomy of members, and individual contact between team managers and members have significant effects on the team performance variables. In conclusion, in order to increase the effectiveness of team system in university hospitals, it is required to consider the characteristics of team management, diversity of team members, the autonomy of team members, the leadership of team manager, and the socio-demographic factors of team members.
Reclassification of healthcare utilization of inpatients to estimate the demand for long-term care services
Health Policy and Management, volume 11, issue 3, 2001, Pages 31~45
With an economic development and epidemiologic transition, the burden of disease due to chronic diseases and accidents is increasing. However, in most of developing countries, long-term care facilities are not available, therefore acute care facilities should provide both acute and long-term care services. It is also true in Korea. The demand for long-term care services needs to be estimated to establish the adequate supply system of health resources. This article introduces the reclassification methodology of inpatients' healthcare utilization to acute and long-term care services. All discharged patients from hospitals for one month were analyzed. The distribution of inpatients' hospital days were fitted to Chi-squared distribution by ICD disease categories, and they were grouped in five clusters. For each cluster, the lower and upper limit of classification criteria to acute and long-term care services were chosen. Summarizing all hospital days corresponding to acute and long-term care respectively, 24 to 28 percent of inpatient services fumed out to be long-term care services. The study results are consistent with those of the existing studies. They can be used practically in the allocation of long-term care resources.
The Escalation of Medical Aid Expenditure and the Degree of Contribution of Its Components in Korea(1992~1999)
Health Policy and Management, volume 11, issue 3, 2001, Pages 46~70
Medical Aid expenditure Increased rapidly at a higher rate than that of Medical Insurance during the period 1992-1999. To establish an effective cost containment strategy, knowledge of the cause and the nature of the increase of Medical Aid expenditure is required. The purpose of this study was to analyze increasing rates of Medical Aid expenditure by the components of medical expenses. Data were collected using the Medical Aid Statistical Yearbook during the period of 1992-1999. The major findings were as follows: 1. The annual mean increasing rate of Medical Aid expenditure between 1992 and 1999 was 22.8%, which exceeding that of Medical Insurance expenditure (17.5%) between 1992 and 1999. Since 1998, Medical Aid expenditure increased even more rapidly than in previous years, with the increase in number of Medical Aid beneficiaries. 2. Of Medical Aid expenditure, that of inpatient and outpatient annually increased 24.2% and 22.8% respectively and that of type 1 and type 2 increased annually 28.8% (outpatient) ∼29.9% (inpatient), 14.3% (outpatient) ∼ 15.5% (inpatient). Therefore, Medical Aid expenditure of inpatient and type 1 led the increase of Medical Aid expenditure. 3. Between 1992 and 1997, the frequencies of utilization per beneficiary and the charges per case positively contributed to the increase of Medical Aid expenditure while the number of beneficiaries contributed negatively, but since 1998, the number of beneficiaries increased and positively contributed to the increase of Medical Aid expenditure. 4. According to the analysis of the charges per case, the increase of the price index led to the increase of the charges per case but the days of medication and service intensity also contributed to the increase of the charges per case variably by year. Considering the above findings, factors associated with the Medical Aid system affected the increase of Medical Aid expenditure in addition to the general factors of the increase in medical expenditure. In conclusion, it appears that a more intensive cost containment strategy is required to control rapidly increasing Medical Aid expenditure. For this, more precise analysis and development of policy considering the effect of the number of beneficiaries and the increase of price index is needed.
A Cost-effectiveness Analysis of the Medication for Osteoporosis
Health Policy and Management, volume 11, issue 3, 2001, Pages 71~88
The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991ｇ/
, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834ｇ/
Measuring the Burden of Hypertension using DALY in Korea
Health Policy and Management, volume 11, issue 3, 2001, Pages 89~101
This study estimated the burden of disease due to hypertension in Korea in disability-adjusted life years(DALYs) using vital registration data and the National Health Examination Survey data. Firstly, we estimated the years life lost due to premature death (YLLs) of hypertension using the vital registration data. Secondly, to calculate the years lived with disability (YLDs), we estimated the average age at onset and disease duration using the National Health Examination Survey data. The disability weights for hypertension were estimated by person trade off method. Finally, the burden of hypertension was calculated in DALYs, which are the sum of YLLs and YLDs. The burden of hypertension for males was attributed mainly to YLD(97.9%). DALYs for females were also attributed mainly to YLD(96.7%). DALYS for males were 993,950 person-years and for females were 743,282 person-years. Results of this study provide a rational basis to plan a national health policy regarding the disease burden of hypertension in Korea. We will need accurate epidemiological study results and other study results of national burden of disease in Korea to get more accurate results of this burden of disease study.
e-Business Strategy of Healthcare Industry
Health Policy and Management, volume 11, issue 3, 2001, Pages 102~120
This paper examines the current situation and major impacts of e-business on healthcare industry: hospital, pharmaceutical, medical device and health-related internet sectors. Of the 137 samples collected with mail survey, the utilization rate of B2C e-commerce is 31.4% and B2B is 13.1%. And 74.5% of respondents remains the first development stage which represents the simple advertisement such as the one-way information offering. The key obstacle of expansion of health care e-commerce turns out to be the illogical and outdated medical-related law and institution. Finally, policy recommendations are proposed based on the evaluation of the current policy implemented by government.
Provider's Behavior Change after the Public Release of the Information on the Cesarean Section Rate
Health Policy and Management, volume 11, issue 3, 2001, Pages 121~150
This study was conducted to investigate provider's behavior change after releasing the information on the Cesarean section rate. Claims data filed at the National Health Insurance Corporation was used for this analysis and the focus of this study was the change of cesarean rate after the public disclosure of information. Average rates of the year 1999 and 2000 were compared, on the institutional basis, and range and coefficient of variation were estimated. For the last decade, Cesarean section rate has been increased dramatically. Clinical or demographic factors could not adequately explain the increase. Instead, nonclinical factors, such as financial incentive, physician's convenience, practice characteristics, etc., were more significant in explaining the increasing rate. Providers' behavior was significantly affected by the public release of information: after the release, average rate was decreased by 10.2%, and variations were also decreased. In particular, the extent of decrease was explained mainly by nonclinical factor rather than clinical ones. The results suggest that disseminating practice information to providers and consumers could contribute to reducing unnecessary medical service.
College Students' Understanding on the System of Separation between Proscribing and Dispensing
Health Policy and Management, volume 11, issue 3, 2001, Pages 151~164
This study is to investigate the level of understanding of the separation of dispensing and prescribing health policy in Korea and its associated factors. A questionnaire survey was conducted upon a sample of college students responded from 540, response rate 77.1%, 4 months after the introduction of the policy. The understanding level was measured using 4 question items describing the goal and motivation of the policy, and 8 items describing its operational rules. For each item, respondents were asked to mark whether the description was true or false. While the goal and motivation of the policy was relatively well informed (mean understanding score: 69.6 out of 100), the students did not have good understanding of the operational details of the policy (mean score: 32.5). The results of regression analyses showed that personal interest and agreement with the need of the policy were the most significant factors affecting the understanding level. It is suggested that, for other health policies in the future, policy makers in Korea need to develop more effective media communication strategies to inform general public of the practical details of the policy.