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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
Editor in Chief :
Volume & Issues
Volume 20, Issue 4 - Dec 2010
Volume 20, Issue 3 - Sep 2010
Volume 20, Issue 2 - Jun 2010
Volume 20, Issue 1 - Mar 2010
Selecting the target year
The Determinants of Population Health in OECD countries
Tchoe, Byong-Ho ; Nam, Sang-Ho ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 1~18
DOI : 10.4332/KJHPA.2010.20.1.001
This article examines social determinants of population health in OECD countries, where life years, infant mortality, and PYLL are used as proxy variables of health. The unit of analysis is a country which is the OECD affiliate. A panel regression estimation is chosen as a method, using OECD Health Data. The results are: the increasing national health expenditure affected positively to improve population health. Education was rather a significant determinant of health than income level. The government direct investment for public health did not contribute positively to enhance population health. The expansion of health care coverage was working positively for improving health, but with a time lag. The supply of doctors was a most influential determinant of health. In case of Korea, the coverage expansion of health care was the most important determinant of health. The supply of doctors was, however, not a positive factor for better health, which is different result with the case of OECD countries.
Difference in Resource Utilization according to Beneficiary Characteristics of the Long-term Care Facilities
Lee, Sue-Hyung ; Shin, Ho-Sung ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 19~36
DOI : 10.4332/KJHPA.2010.20.1.019
Fee for long-term care insurance in Korea are determined in proportion to resources utilized according to severity rather than based on categorization of beneficiaries in consideration of the characteristics of resource utilization. This adoption is based on the assumption that as beneficiaries of long-term care insurance, characteristically, demands social services rather than needs medical treatments, the characteristics of beneficiaries and the quality of utilized resources are comparatively homogenous. Therefore, the proposition is that the size of resource consumed by beneficiaries in the same grade is identical. However, even in the same grade, the level of utilized resources is different depending on the characteristic of beneficiaries. In this regard, this study is to examine whether there are differences in the volumes of utilized resources depending on the characteristics of beneficiaries even in the same grade. We analyzed time study data for 2003, 2005, 2006 which conducted by the Korea Institute for Health and Social Affairs. To look at differences in the volumes of utilized resources, we identified characteristics of beneficiaries that influence utilized resource volumes and categorized services provided by facilities into the rehabilitation treatment category, the problematic behavior category, and the physical malfunction category. Then, we examined each service in consideration of service difficulty levels and wage weights. The result of examination showed that differences in utilized resource volumes exist in all three grades depending on the characteristics of beneficiaries. Especially, in the first grade with a high level of seriousness, utilized resource volumes were different for those three service categories and the problematic behaviour category considered dementia was found to consume the largest volume of resources. Moreover, there was the inversion phenomenon of utilized resources volumes between the grades. This result indicates that utilized resource volumes are different even in the same grade depending on the characteristics of beneficiaries and it is required to consider case-mix for reflection of the volumes of utilized resources depending on the characteristics of beneficiaries.
Projecting Public Expenditures for Long-Term Care in Korea
Yun, Hee-Suk ; Kwon, Hyung-Joon ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 37~63
DOI : 10.4332/KJHPA.2010.20.1.037
Public expenditures on long-term care are a matter of concern for Korea as in many other countries. The expenditure is expected to accelerate and to put pressure on public budgets, adding to that arising from insufficient retirement schemes and other forms of social spending. This study tried to foresee how much health care spending could increase in the future considering demographic and non-demographic factors as the drivers of expenditure. Previous projections of future long-term expenditure were mainly based on a given relation between spending and age structure. However, although demographic factors will surely put upward pressure on long-term care costs, other non-demographic factors, such as labor cost increase and availability of informal care, should be taken into account as well. Also, the possibility of dynamic link between health status and longevity gains needs to be considered. The model in this study is cell-base and consists of three main parts. The first part estimated the numbers of elderly people with different levels of health status by age group, gender, household type. The second part estimated the levels of long-term care services required, by attaching a probability of receiving long-term care services to each cell using from the sample from current year. The third part of the model estimated long-term care expenditure, along the demographic and non-demographic factors' change in various scenarios. Public spending on long-term care could rise from the current level of 0.2~0.3% of GDP to around 0.44~2.30% by 2040.
Compulsory Licensing as a price control and supply policy of patented drugs : Is it a possible alternative in South Korea?
Byeon, Jin-Ok ; Chung, Jung-Hoon ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 64~86
DOI : 10.4332/KJHPA.2010.20.1.064
Korea has had problems with the price and supply of essential drugs such as Gleevec for leukemia, Fuzeon for HIV/AIDS, and Tamiflu for both avian flu and swine flu. The shortage or refusal of patented drugs supply is imposing a heavy burden in not only developing countries but also developed countries. Thinking over the serious results, we need to concern about the limited access to patented drugs by multinational drug companies' patent monopoly especially for pandemic and life threatening diseases. The effective response regarding to pandemic and life threatening diseases. The effective response regarding to pandemic situation requests collaborative and unbiased provisions of all countries in the world, however, sometimes patent monopoly may hinder the efforts. Compulsory licensing has been considered to be a useful alternative to the abuse of patent rights. However, the Korean experiences of compulsory licensing have left some controversial issues in connection with the availability of it in Korea. 'Flexibility' allowed in TRIPS and Doha Declaration has not come into effect in Korea for several reasons. Although the situation shows the limitations of compulsory licensing as a pharmaceutical supply policy, it is clear that compulsory licensing still has the possibilities of enhancing the access to medicines of all countries in need. Through searching the institutionalization process and experiments of compulsory licensing in Korea, this article explores the possibilities and the limits.
The Impact of Medicaid Expansion to include population with low income on the preventable hospitalizations
Shin, Hyun-Chul ; Kim, Se-Ra ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 87~102
DOI : 10.4332/KJHPA.2010.20.1.087
The objective of this study were to examine the impact of medicaid coverage expansion policy aimed at improving access to primary care. The case-control study was conducted to compare preventable hospitalization(PH) rate in new medicaid recipients versus national health insurance(NHI) enrollees form 1996 to 2001. Rates of preventable hospitalization associated with ambulatory care sensitive conditions(ACSC) were calculated and standardized by age and sex. Multinomial logit regression model was used to control the confounding factors such as age, gender and charlson comorbidity index Annual PH rates in the new medicaid increased 1.64 times after medicaid expansion, with controling confounding factors. Meanwhile, annual PH rate in the NHI increased 1.68 times during the same period, with adjusting confounding factors. Current findings suggest that the new medicaid PH rate was less likely to rise than NHI PH rate after implementing medicaid expansion. This study is expected to provide policy-relevant evidence of medicaid expansion to include population with low income.
Incidence and magnitude of out-of-pocket payment and factors influencing them in Industrial Accident Compensation Insurance
Park, Bo-Hyun ; Lee, Tae-Jin ; Lim, Wha-Young ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 103~124
DOI : 10.4332/KJHPA.2010.20.1.103
Objectives: The out-of-pocket payment (OOP) of the Industrial Accident Compensation Insurance (IACI) in Korea was investigated empirically in terms of its incidence, magnitude and factors influencing them. Methods: The subjects were sampled with stratified, randomized methods among medical institutions of which the number of monthly IACI claims exceeded its median as of May 2008. Out of 204 institutions selected, 118 institutions (57.8%) responded to this survey. A total of 24,826 episodes(2,457 inpatient and 22,369 outpatient episodes) were included in this analysis. The incidence and magnitude of OOP of IACI were calculated by characteristics of institution as well as patient. Factors that affected the incidence and magnitude of OOP were investigated through multi-level analysis. Results: The overall incidence of OOP of IACI was 9.9% (25.6% for inpatient and 8.2% for outpatient) and the percentage of OOP among total expenditures was 8.3% on average (7.6% for inpatient and 26.8% for outpatient); 25.2% at traditional oriental medicine hospitals, 9.5% at general hospitals and 2.5% at the industrial-accident-designated medical institutions. The incidence of OOP of IACI was influenced by hospital size, ownership, longer duration of designation (over 5 years) and length of stay. On the other hand, its magnitude was influenced by medium-sized hospital, public hospital, location of large city and length of stay. Extra charges for upper grade room which accommodates less than 4 patients and treatment by specialists were the leading contributors to the magnitude of OOP of IACI. Conclusion: The incidence and magnitude OOP of IACI varied in institution type and were influenced by both institutional and patient's factors. In order to achieve the goal of Industrial Accident Compensation Insurance, appropriate level of compensation, that is, no incidence of OOP, for accident and disease of workers, it is necessary to take measures to reduce incidence and magnitude of OOP.
Factors Related to Fundus Examination in Diabetes Mellitus Patients
Choi, Joo-Hyuck ; Na, Baeg-Ju ; Chun, Sung-A ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 125~136
DOI : 10.4332/KJHPA.2010.20.1.125
Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.
Top Management Team Heterogeneity, Interaction and Organizational Performance in Korean Hospitals
Jung, Moung-Suk ; Lee, Se-Hoon ; Kim, Kwang-Jum ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 137~154
DOI : 10.4332/KJHPA.2010.20.1.137
This study empirically analyzed the effects of the Top Management Team (TMT) on organizational performance. We verified whether the age heterogeneity, job heterogeneity (core career, core function and major), and process (communication and integration) of the TMT affect organizational performance (management performance and healthcare service quality evaluation level). We collected data about 473 members of the 2006 TMT in 81 medical institutions. We also utilized statistics of organizational performance from the Ministry for Health, Welfare and Family Affairs and the Korean Institute of Hospital Management. Results of the study showed that the age heterogeneity of TMT exerted a negative effect on the healthcare service quality evaluation level, while the process exerted a positive effect. However, the age heterogeneity, job heterogeneity, and process had no influence on management performance. We discussed the implications of such outcome of the investigation in comparison with the former studies on TMT and organizational performance, and presented its restrictions and future plans.
An Analysis of Research on Health Care Organizations in Korea
You, Myoung-Soon ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 155~182
DOI : 10.4332/KJHPA.2010.20.1.155
This study reviews 302 articles on health care organizations (HCOs) from 33 Korean Research Foundation registered journals. Articles are classified by criteria, focusing on study topics and methods. Key findings: (1) 'health care' journals are the major source of research on HCOs, (2) there has been a rapid increase in the amount of articles since the 1990s, (3) the majority of the studies deals with micro issues such as job attitude or motivation, (4) approximately 17% of the articles does not provide hypotheses based on theoretical assumptions, (5) few studies attempt to propose a new concept or theoretical framework, (6) most of the studies consider 'individual' as a level of analysis, (7) the use of cross-sectional data collected by survey questionnaire is general, and (8) individuals in a single occupation from multiple organizations are the main data source. Based on the findings, some directions for future research are proposed. Most of all, having more opportunities to introduce theories of organization and organizational behavior in health care need to be made in order to enhance understanding of HCOs. Next, sophisticated methodologies to guide empirical investigations should be developed to reduce deficiencies in research. Finally, efforts to encourage interdisciplinary approaches to the study on HCOs also need to be increased.
An Analysis on the Effect of the Government R&D Subsidies on the Private R&D Investments : in the Case of the Pharmaceutical Industry
SaKong, Jin ; Shin, You-Won ;
Health Policy and Management, volume 20, issue 1, 2010, Pages 183~203
DOI : 10.4332/KJHPA.2010.20.1.183
The purpose of this study is to analyze the effect of the R&D subsidies by the government on the private firms' R&D investments in the Korean pharmaceutical industry, which are supposed to have positive effects on their economic performance. We also estimate the relationship between the private firms' R&D investments and firms' economic outcome. Empirical analysis is done by Error Component 2 Stage Least Squares(EC2SLS) estimation using 43 pharmaceutical firms' 8 years' panel data. The elasticity of the government R&D subsidies on the private R&D investments is 0.021%, which we cannot say 'efficient'. Also R&D investments have positive effects on the economic outcome of the pharmaceutical firms, as we expected. We propose several suggestions in the conclusion for the efficient way of government R&D subsidies to induce more private R&D investments.