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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 21, Issue 4 - Dec 2011
Volume 21, Issue 3 - Sep 2011
Volume 21, Issue 2 - Jun 2011
Volume 21, Issue 1 - Mar 2011
Selecting the target year
Unmet Health Care Needs and Associated Factors among Patients with Hypertension and Those with Diabetes in Korea
Huh, Soon-Im ; Lee, Sue-Hyung ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 1~22
DOI : 10.4332/KJHPA.2011.21.1.001
This study investigated unmet health care needs and associated factors among patients with hypertension and those with diabetes. Patients were identified by medical professionals. Patients who did not take pharmaceuticals to treat their disease(s) were defined as those with unmet health care needs. Using data from 2005 National Health and Nutrition Examination Survey, 3,635 hypertension patients and 1,431 diabetes patients were analyzed. A multivariate logistic regression analysis was employed to examine factors associated with unmet needs. Overall, 16.6% of hypertension patients, 20.3% of those with diabetes presented unmet needs. Common factors associated unmet needs for both hypertension and diabetes were sex, insurance type, self-reported health status and length of disease. Study findings suggest that hypertension and diabetes should be treated in early stage and further study is needed to examine the reasons for unmet needs to improve patient's status effectively.
Factors Affecting Spatial Distance to Outpatient Health Services
Shin, Ho-Sung ; Lee, Sue-Hyung ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 23~43
DOI : 10.4332/KJHPA.2011.21.1.023
Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA
11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.
The effect of surgical site infection on the length of stay and health care costs
Chang, Jin-Hee ; Kim, Kyoung-Hoon ; Kwon, Soon-Man ; Yeom, Seon-A ; Park, Choon-Seon ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 44~60
DOI : 10.4332/KJHPA.2011.21.1.044
Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.
Factors Affecting Beneficiary Satisfaction on Financial Aid Program for Cancer Patients in Korea
Sim, Ju-Ho ; Park, Jong-Hyock ; Lee, Jung-A ; Kim, So-Young ; Park, Bo-Ram ; Park, Eun-Cheol ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 61~76
DOI : 10.4332/KJHPA.2011.21.1.061
Limited research has investigated the satisfaction of patients with cancer. This study was performed to explore patients' satisfaction and the related factors. The data were collected by telephone survey for the participants who were beneficiaries on the national financial aid program for cancer patients between January and October in 2009. Student's t-tests and analysis of variance were performed first to determine if the mean satisfaction score differed by the characteristics of study objects, followed by stepwise multiple regression analyses to examine the factors affecting satisfaction. When comparing the relating factors with patients' satisfaction according to the sociodemographic characteristics, the male, old-aged, higher educated, lower cancer stage, lung cancer group showed a significantly higher level of recognition for satisfaction. A public health center, better public relations, recognized more helpful, don't have expectation, put a person to expense, and don't feel pressured for medical cost groups were showed a higher level of recognition for satisfaction. The result of the multiple regression analysis, short waiting time, well known program policy, recognized helping of policy and had the financial burden had significantly influence on the satisfaction of patients with cancer.
Assessment of Needs and Accessibility Towards Health Insurance Claims Data
Lee, Jung-A ; Oh, Ju-Hwan ; Moon, Sang-Jun ; Lim, Jun-Tae ; Lee, Jin-Seok ; Lee, Jin-Yong ; Kim, Yoon ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 77~92
DOI : 10.4332/KJHPA.2011.21.1.077
Objectives : This study examined the health policy researchers' needs and their accessibility towards health insurance claim datasets according to their academic capacity. Methods : An online questionnaire to capture relevant proxy variables for academic needs, accessibility, and research capacity was constructed based on previous studies. The survey was delivered to active health policy researchers through three major scholarly associations in South Korea. Seven-hundred and one scholars responded while the survey as open for 12 days (starting on December 20th, 2010). Descriptive statistics and logistic regression analysis were carried out. Results : Regardless of the definition for operational needs, the prevalent needs of survey respondents were not met with the current provision of claim data. Greater research capacity was shown to be correlated with increased demand for claim data along with a positive correlation between attempts to obtain claim datasets and research capacity. A greater research capacity, however, was not necessarily correlated with better accessibility to the claim data. Conclusions : The substantial unmet need for claim data among the healthcare policy research community calls for establishing proactive institutions which could systematically prepare and make available public datasets and provide call-in services to facilitate proper handling of data.
University Students' Recognition of Family Support and Care's Socialization in the Elderly
Jung, Hye-Sun ; Lee, Jong-Ryol ; Park, Chun-Man ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 93~114
DOI : 10.4332/KJHPA.2011.21.1.093
This study was conducted to identify college students' supportive attitude toward the elderly and their awareness of the socialization of care for the elderly, since they will have the responsibility for and the support of the aged society in the near future. This study was also conducted to analyze the factors which affect the socialization of elderly care, and to contribute to building a care system which promotes ahealthy and happy lifestyle for the elderly. After conducting a survey of 1,100 students from13 universities around the entire country, I have analyzed 1,089 data forms, and omitted 11 data entries which had errors or were not answered. 1. Those surveyed are 1,089 students from 13 universities around the entire country. Regional distributions are as follows : 263 students from 4 universities in Daegu and Kyongsangbuk Do(24.2%), 291 students from 3 universities in Busan and Kyongsangnam Do(26.7%), 272 students from 2 universities in Jeolla Do(25.0%), 263 students from 4 universities in Seoul and Gyeonggi Do. Males are 51.7% and females are 48.3% of these students. 2. Instrumental supportive sense level is high in men and emotional supportive sense level is higher in women. Also emotional supportive sense is higher in groups of those having more family members and coming from agricultural regions. 3. The sense of living with aged parents is higher in those living with grandparents than those living separate. The sense of living with sons and daughters after aging is stronger in the students from the Science and Engineering Departments than in the Social and Human Sciences Departments; also higher for men than women. 4. Recognition of elderly care socialization is higher in those from Social and Human Sciences Departments than from Science and Engineering Departments; higher in the case of upper classmenand aged groups, groups having fewer family members than more family members, and in the case of living separated from grandparents. 5. The factors affecting the sense of living with grandparents were family cohesion and instrumental supportive sense. The factors affecting the sense of elderly care socialization were family cohesion, instrumental supportive sense, and emotional supportive sense. From the results it is concluded that to insure a healthy and happy lifestyle for aged people, elderly care socialization offered by society and the country must provide desirable, appropriate care services based on the centralized support system of the family. In order to do this, we propose that elderly care needs inter-family and inter-generational fusion programs to improve family cohesion and care recognition. Also, elderly care is in urgent need to build a strong Family and Health Welfare System for care socialization.
Reviewing Efficiency Strategy of Long-term Care System
Shin, Eui-Chul ; Im, Geum-Ja ; Lee, Eunw-Han ; Lee, Yun-Hwan ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 115~131
DOI : 10.4332/KJHPA.2011.21.1.115
Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.
A Study on Rebates in the Pharmaceutical Industry from the Perspective of New Institutionalism
Lee, Ha-Young ; Kwon, Yong-Jin ;
Health Policy and Management, volume 21, issue 1, 2011, Pages 132~157
DOI : 10.4332/KJHPA.2011.21.1.132
The purpose of this article is to examine the cause of policy non-compliance in the case of pharmaceutical rebates from the perspective of rational choice institutionalism. In Korea, there have been rebates practices between pharmaceutical companies and hospitals since the introduction of the Actual Remuneration System for insured medicine in 1999. The government has chosen the policy means of punishment to eliminate pharmaceutical rebates but the illegal practices are still widespread. Institution in rational choice institutionalism usually reflects the incentives and preferences of actors, and the Actual Remuneration System has resulted in a the lack of procedures to ensure savings on drug expenditures. Pharmaceutical rebates are the product of the institutions which reflect their incentives: the Actual Remuneration System, the current pricing policy for generic drugs, the drug distribution system, and so on. In the end, the problem of the rebates is the consequence of policy non-compliance as actors' rational choice because their incentives lead to opportunistic behaviors. We should therefore understand the incentive structure of policy stakeholders, which is derived from the view of new institutionalism; also, the newly designed Korean drug pricing policy reform must be compatible with the incentive structure.