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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
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Volume & Issues
Volume 13, Issue 4 - Dec 2003
Volume 13, Issue 3 - Sep 2003
Volume 13, Issue 2 - Jun 2003
Volume 13, Issue 1 - Mar 2003
Selecting the target year
Development of Program Evaluation Indicator ： Community Health Center's Health Promotion Program
Health Policy and Management, volume 13, issue 4, 2003, Pages 1~27
DOI : 10.4332/KJHPA.2003.13.4.001
The purpose of this study was to develop the evaluation indicator for the health promotion programs of the Community Health Centers and to test its validity. The modified logic model was used as the evaluation model based on the literature reviews. Using this model, four dimensions, eleven subdimensions, and fortyone individual indicators were developed. These evaluation indicators are superior in reflecting the distinctiveness of the community health promotion programs, and also flexible enough to accommodate diverse programs. These indicators also emphasize the role of process evaluation, and the diversity of outcomes. To test content validity, survey method of experts in the community health promotion field was conducted. Eleven in three expert groups(professionals, practitioners in Community Health Centers, and policy makers) generally agreed with the validity of evaluation indicators. To examine criteria and construct validity, these indicators were used to evaluate the health promotion programs conducted by the 18 Key Community Health Centers. The data came from the interview surveys of the main health promotion practitioner and 30 visitors from each center. The ranks of these eighteen Community Health Centers were computed from these data. There was no significant difference in ranking either by these indicators or by the existing indicators, which was developed by Technical Support and Evaluation Team for criteria validity. There was no statistically significant difference in ranking between input, process and outcome dimensions. Based on these study results, evaluation indicators developed in this study are valid to evaluate Community Health Center's health promotion program. It can be used both by the Community Health Center for internal evaluation, and by the stakeholders for external evaluation.
User's satisfaction of health care service in public health centers -in a metropolitan area-
Health Policy and Management, volume 13, issue 4, 2003, Pages 28~47
DOI : 10.4332/KJHPA.2003.13.4.028
The purpose of this study was to assess the user's satisfaction of health care service in public health centers in Busan. The study respondents were 212, those who visited health centers for health care service. Data were collected in July 2002 by using SERVQUAL(comprehensive service quality measurement scale) and 3 open questions for more details about service satisfaction and the needs for health care service. SERVQUAL has 5 dimensions； tangibles, reliability, responsiveness, assurance and empathy. The results were as follows ： 1. The users reported more satisfaction at 'just service cost', 'convenient service procedure' and 'clean physical environment' at SERVQUAL. Among them the highest rated item was 'service cost'. And the less satisfaction items were 'understanding and individual concerns about service users', 'medical equipment' and 'health center facilities'. 2. There were no statistical differences by general characteristics except for the kind of services rendered. Those who visited for physical examinations and laboratory tests reported lower satisfaction than any other groups. 3. At the open questions, the respondents expressed that they were satisfied with the low service cost, kindness of employee and clean environment. But they criticized the old facilities and worn medical equipment, in addition to the less than kind attitudes. These strengths and weaknesses of health center's service could be applied for planning of customercentered health care service.
Korean Pharmaceutical Expenditure according to OECD's System of Health Accounts
Health Policy and Management, volume 13, issue 4, 2003, Pages 48~65
DOI : 10.4332/KJHPA.2003.13.4.048
Detailed analyses of total health expenditure and its subcategories are essential for the evidencebased health policy(EBHP). These analyses, again, should be based on timely and reliable data that are comparable across countries. The System of Health Accounts (SHA), published by the OECD in 2000, provides an integrated system of comprehensive and internationally comparable accounts. The author has implemented the SHA manual into Korean situation, and examined overall expenditure estimate and its basic functional breakdown following the manual. This study explains how pharmaceutical expenditure is estimated. The results are, then, analyzed particularly from the international perspective. Both administrative data in Statistical Yearbooks (National Health Insurance, Medical Aid, Industrial Accident Compensation Insurance) and survey data on Health and Nutrition are used for the estimation. Per capita pharmaceutical expenditure in Korea (183 US$ PPPs) was far less than the OECD average (308 US$ PPPs) in 2001, but pharmaceutical expenditure share in total health expenditure (20.3％) was higher than the average (16.7％). This can be explained by the fact that there is a statistically significant correlation between pharmaceutical expenditure share and per capita GDP of each country. Korean people follow the tendency of relatively lowincome countries to spend less than OECD average for health care, but follow again their tendency to spend more on drugs than on other health care services. In consideration of results and analysis as above, per capita pharmaceutical expenditure in Korea is expected to grow in the future, but the growth rate of the pharmaceutical expenditure is expected to be less than that of overall health expenditure.
The Effect of Self-Efficacy on Job satisfaction for the Hospital Employees
Health Policy and Management, volume 13, issue 4, 2003, Pages 66~83
DOI : 10.4332/KJHPA.2003.13.4.066
Self-efficacy is a person's perceived capability to perform a behavior. We have studied the antecedents of selfefficacy, and its moderating role on the relationship between job characteristics and job satisfaction. Data is collected through questionnaire from 910 employees of 6 large hospitals in Korea. The results show that individual's internal locus of control has positive relationship with selfefficacy and self-efficacy has positive relationship with job satisfaction. Contrary to the hypothesis, supervisors' transformational leadership doesn't show any relations with selfefficacy. The moderating role of self efficacy on the relationship between job characteristics and job satisfaction is supported. These results suggest that hospital managers should manage the selfefficacy as an important instrument of enhancing productivity and employee satisfaction.
The Pricing Strategy for the Performance of Medical Service - Based on the Segmentation for the Nblock tariff Pricing of Medical Examination -
Health Policy and Management, volume 13, issue 4, 2003, Pages 84~98
DOI : 10.4332/KJHPA.2003.13.4.084
This research objective is to determine the optimal price break points for nblock tariff, because comparing nonlinear pricing with uniform pricing on the basis of profit, nblock tariff outperforms twopart tariff, all unit discount price schedule, and uniform pricing. Although the merits of nonlinear pricing are well documented, the attempt to practice the non-linear pricing in medical service sector has been relatively rare. The determination of the parameters under nblock tariff is the interesting decision making agenda for marketers. Under nblock tariff, the marketers should decide the optimal price break points and the optimal marginal price for each price zone. The results can be summarized as follows: The researchers found that mixture model can be the feasible methodology for determining the optimal number of nblock tariff and identifying the optimal segmentation criteria. We demonstrate the feasibility and the superiority of the mixture model by applying it to the database of medical examination. The results appear that the number of patients per month can be the optimal segmentation variable. And 6block tariff is the optimal price break for this medical service.
The relationship between social class distribution and mortality
Health Policy and Management, volume 13, issue 4, 2003, Pages 99~114
DOI : 10.4332/KJHPA.2003.13.4.099
This study was performed to determine the effect of social class distribution as measured by lower social class rate on all cause and cause specific mortality in Korea. I obtained data on social class, fiscal autonomy of municipalities, number of medical doctors, region(Si/Gun) from 1955 Korea Census Data and Regional Statistics Data. And all of the data on mortality adjusted for age for 1995 for each district from the National Statistics Office. Lower social class rate ranged from 18.9％ for Kangnam gu to 85.7％ for Imsil gun and age standardized mortality ranged from 385/100,000 population for Kangnam go to 803/100,000 population for Sinan gun. Lower social class showed had a significant correlation with total mortality adjusted for age(r=0.81, p<0.0001). The association of the rate to total mortality remained highly significant after adjusted for number of medical doctors per 1,000 population, fiscal autonomy of municipalities and region(p<0.0001). Effects of the lower social class were also found for neoplasm (p=0.0008)； cardiovascular disease (p<0.0001)； infectious disease(p=0.0115)； respiratory disease(p=0.0085)； gastrointestinal disease(p<0.0001)； accident ＆ poisoning (p<0.0001). The findings suggest that policies that deal with the inequality in social class may have an important impact on the health of the population.
Factors associated with delay in reperfusion therapy in patients with acute myocardial infarction
Health Policy and Management, volume 13, issue 4, 2003, Pages 115~130
DOI : 10.4332/KJHPA.2003.13.4.115
Reperfusion delay in patients with acute myocardial infarction leads to increased morbidity and mortality. We sought to measure the rates of reperfusion delay and to identify factors associated with reperfusion delay after arrival to hospitals. We included 360 patients who had acute myocardial infarction with ST-elevation or left bundle branch block on electrocardiogram and received reperfusion therapy from the three participating academic medical centers from 1997 to 2000. Through retrospective chart review, we collected data about time to reperfusion therapy, patient and hospital factors potentially associated with reperfusion delay. Factors independently associated with reperfusion delay were determined by logistic regression analysis. Median doortoneedle time was 60.0 minutes, and median doortoballoon time was 102.5 minutes. According to recommendation of the American College of Cardiology/American Heart Association Guidelines, 226 out of 264(85.6％) of thrombolytic patients and 43 out of 96(44.8％) percutaneous transluminal coronary angioplasty(PTCA) patients experienced reperfusion delay. The significant factors associated with delay were type of reperfusion therapy, patient factors including hypertension and delayed symptom onset to presentation(>4 hours), and hospital factors including nocturnal presentation(6pm∼8am), weekend, and an individual hospital. A significant proportion of patients experienced reperfusion delay. The identified predictors of reperfusion delay may help design a hospital system to reduce the delay in reperfusion therapy