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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
Editor in Chief :
Volume & Issues
Volume 19, Issue 4 - Dec 2009
Volume 19, Issue 3 - Sep 2009
Volume 19, Issue 2 - Jun 2009
Volume 19, Issue 1 - Mar 2009
Selecting the target year
The Study on national crisis management and bioethics
Ryoo, Hwa-Shin ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 1~20
DOI : 10.4332/KJHPA.2009.19.2.001
This paper examines some relations on national crisis management and bioethics. This study stars to discuss that chance and risk of biotechnology which is the 21st century`s pioneering core technology. This study reviews the traditional method that a nation(law) copes with the new scientific technique. The study also examines some difficulties of social agreement on the problems of bioethics because of nature of the rational disagreement. Then this paper attempts to incorporate the crisis of biotechnology, especially bioethics, in the system of national crisis management. this paper reviews the contents of the domestic "Act on Bioethics and Safety" on the side of the protection and restoration of crisis management. And this paper proposes some changes to manage the crisis of bioethics better, as it were, some problems of IRB and schems for improvement of it.
Self-perception of the Amount of Medical Aid Use of Outpatient Overusers in Korea
Shin, Sun-Mi ; Kim, Eui-Sook ; Lee, Hee-Woo ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 21~35
DOI : 10.4332/KJHPA.2009.19.2.021
Limited studies examined Medical Aid recipients` perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.
Is the amount of the medical care utilization affected by the cash benefits for patients in the geriatric hospital?
Kang, Im-Ok ; Han, Eun-Jeong ; Lee, Jung-Suk ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 36~50
DOI : 10.4332/KJHPA.2009.19.2.036
Korean Government had performed three pilot programs to introduce the long term care insurance system. Persons aged 65 or older who are dependent on others for daily living could use long term care services in the pilot program. The long-term care insurance covered nursing home services, home care services and cash benefits. The cash benefits are included that for elderly at home and for patients in geriatric hospital. This study investigated whether there had been any change in the medical care utilization according to cash benefits for geriatric hospitalization. This study used National Health Insurance claims and Long term Care Insurance claims 2003 through 2006. Data were composed of subjects who undertook both insurance coverage. The subjects was divided into two groups. Case group included participants with the cash benefits of geriatric hospitalization. Control group included persons without the cash benefits selected by random sampling according to the distribution of case group. This study showed that the amount of medical care utilization of the case group is more significantly increased than the control group after adjusted their health condition and functional condition. This result will be helpful for making decisions on whether the cash benefit of geriatric hospitalization can be introduced into long term care insurance system.
Continuity of Ambulatory Care among Adult Patients with Type 2 Diabetes and Its Associated Factors in Korea
Hong, Jae-Seok ; Kim, Jai-Yong ; Kang, Hee-Chung ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 51~70
DOI : 10.4332/KJHPA.2009.19.2.051
Background : Previous studies have reported that enhanced continuity of care prevented a sudden worsening in progress among chronic disease patients, and as a result was favorable for efficient spending of health care funds. This study aims to estimate the continuity of care of Korean with diabetes and to identify factors affecting the continuity of care. Methods : This study used the Korean National Health Insurance Claims Database which includes E11 (ICD-10) as a primary or secondary disease as of 2006. Study population is 1,160,725 type 2 diabetics (20-84 years). Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC) were used as indexes of continuity of care. Results : The continuity of care in the study population was
as calculated by MMCI,
as calculated by MFPC and
as calculated by COC. The lower continuity of care was shown in the patients who were female, 65 and over years old, Medical Aid recipients, 13 times or more visitors, hospital users as main attending medical institution, patients experienced hospitalizations or comorbidities. Conclusion : The continuity of care for adult patients with type 2 diabetes was high in Korea, and showed variation according to patients` characteristics. This result provides empirical evidence for policymakers to develop or strengthen programs for managing patients showing low continuity of care.
Factors Related to Admission via Emergency Room in Korean Hospitals with an Emergency Medical Center
Na, Baeg-Ju ; Lee, Sun-Kyung ; Oh, Kyung-Hee ; Kim, Keon-Yeop ; Chung, Seol-Hee ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 71~84
DOI : 10.4332/KJHPA.2009.19.2.071
Objectives : The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods : This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi-square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results : The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300-699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion : We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.
The Difference of Health According to employment Status and Income Level of Wage-Earners
Woo, Hye-Kyung ; Moon, Ok-Ryun ; Park, Jong-Hyock ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 85~110
DOI : 10.4332/KJHPA.2009.19.2.085
The aim of this study was to examine whether health status is different according to employment status and income level in wage-earners. We analyzed wage-earners of 2199 men and 1194 women aged 30-64 years, using data from the 2006 Korean Labor and Income Panel Study(KLIPS). The difference of health status according to employment status and income level was compared with the multiple logistic regression and the standardized concentration index of ill-health. The risk of ill-health was high when waged-earners had low income. The same is true for poor employment status when their employment status was unstable as in manual laborers, irregular workers, temporary, daily workers or part-time workers. furthermore, the wage-earners with lower income and a relatively disadvantageous employment status showed the lowest health status compared to other groups. Ill-health was relatively more concentrated in lower income group and poor employment status. This study identified the existence of health inequality among various employment status of wage-earners. It is suggested that policies that deal with the inequality in social class may have an important impact on the health of the population.
The Relationships of Transformational Leadership and Transactional Leadership on the Hospital member`s Organizational Commitment and Turnover Intention
Kim, Ji-In ; Jeong, Hyo-Sang ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 111~126
DOI : 10.4332/KJHPA.2009.19.2.111
The purposes of this study were (1) to describe the effects of transformational leadership and transactional leadership on the hospital member`s organizational commitment and turnover intention, (2) to provide with fundamental data in enhancing organizational effectiveness. For this purpose, the types of leadership, organizational commitment and turnover intention were evaluated among hospital members. A survey was conducted with 827 respondents working in a general hospital in Sungnam-shi. For the data analysis SPSS 10.0 was utilized. To verify the reliability and validity of variables, Chronbach`s
and confirmatory factor analysis were processed. After descriptive analysis, regression analysis was conducted. In these progresses all the statistical significant levels were set at
Cancer Survival and Status of National Health Insurance in a Community
Kweon, Sun-Seog ; Choi, Jin-Su ; Shin, Min-Ho ; Kim, Hye-Yeon ; Choi, Seong-Woo ; Lee, Young-Hoon ;
Health Policy and Management, volume 19, issue 2, 2009, Pages 127~134
DOI : 10.4332/KJHPA.2009.19.2.127
It is known that socioeconomic status(SES) of the cancer patient is associated with survival in recent studies, performed in other countries. The purpose of this study was to determine whether the association between status of national health insurance and survival is also present in a community in Jeonnam province, South Korea. The Gwangju-Jeonnam Cancer Registry, a population-based cancer registry, provided information to identify the cancer cases of study community diagnosed from 1998 to 2007. Total of 2,046 cases were identified during the period. There were significant associations between the status of national health insurance and survival for total cancer after adjusted by age, geographic accessibility to health care, and stage at diagnosis. However, this differences were not found in the analysis using only stomach and colorectal cancer cases. Despite of some limitations, this results suggest that the policy for reducing the difference according to the SES is required in national cancer management program.