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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
The relationship between the new-building of rural public health centers and outpatient medical utilization - review of confounding effect by IMF economic recession
Park, Sun-Hee ; Lee, Su-Jin ; Soh, Un-Ki ; Na, Baeg-Ju ; Lee, Jin-Yong ;
Health Policy and Management, volume 21, issue 3, 2011, Pages 349~364
DOI : 10.4332/KJHPA.2011.21.3.349
Objectives : The purpose of this study was to evaluate the relationship between new-building of rural public health centers and the outpatient medical utilization. Methods : The study subjects were 141 public health centers in rural area. The data were collected from 1995 to 2001, medical utilization and local population, healthcare resources, and economic characteristics were included. In order to evaluate new-building effects, we performed paired t-tests and multivariate regression analyses. Results : The following variables are significant affecting the medical utilization of rural public health centers: urban side location of public health centers(p<0.05), pre- and post-IMF economic crisis(p<0.001), number of medical aid recipients(p<0.01), number of private clinics(p<0.05), workers of public health centers(p<0.001), financial independent level of local governments(p<0.001). In contrast, the existence of new-building and number of the aged 65 and over were not significant variables. Conclusions : We could not find out the positive relationship between the existence of new-building and the volume of medical utilization in rural public health centers. In particular the medical utilization of rural public health centers is significantly affected by IMF economic recession and number of the poor strata, the economically depressed area.
Consumers' knowledge and attitudes toward antibiotic resistance
Chae, Su-Mi ; Park, Eun-Ja ; Park, Sylvia ;
Health Policy and Management, volume 21, issue 3, 2011, Pages 365~380
DOI : 10.4332/KJHPA.2011.21.3.365
This study was conducted to investigate the association between socio-demographic factors and attitudes toward antibiotic resistance and consumer's knowledge on antibiotic use for common cold. Telephone survey was conducted between June 24 and July 2, 2009, among 1,015 adults who were randomly stratified by age, sex and area. A total of 921 respondents were included in the analysis. Logistic regression was used to analyze the influence of socio-demographic factors on knowledge and attitudes. A total of 452 respondents(49.1%) recognised that they knew about antibiotic resistance and 769 respondents(83.5%) worried that antibiotic resistance is a serious problem in Korea. A total of 577 respondents(62.7%) had adequate knowledge on antibiotic use and resistance. Multiple logistic regression showed that younger age and higher education level were associated with adequate knowledge. The odds ratio of appropriate knowledge among persons with college degrees was 5.25(95% CI, 2.78-9.90) compared to those with elementary or less education. Sex and income variable were not predictors of adequate knowledge on antibiotic use and resistance. This study showed that consumers with less education had inadequate knowledge on antibiotic use for common cold. Even though consumers in their 40s and 50s thought they knew about antibiotic resistance, there is a need to improve their knowledge. Education campaigns for appropriate antibiotic use have to be differentiated among consumers with different socio-demographic characteristics.
Factors affecting regional rate of certification in Korean Long-term Care Insurance
Kang, Im-Oak ; Han, Eun-Jeong ; Park, Chong-Yon ;
Health Policy and Management, volume 21, issue 3, 2011, Pages 381~396
DOI : 10.4332/KJHPA.2011.21.3.381
This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants' disease characteristics, regional service infrastructure, and the certification interviewer's characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.
Relationship between Income and Healthcare Utilization in Cancer Patients
Kim, Jin-Hee ; Kim, Kyung-Joo ; Park, Jong-Hyock ;
Health Policy and Management, volume 21, issue 3, 2011, Pages 397~413
DOI : 10.4332/KJHPA.2011.21.3.397
Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the
-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.
Predictors of Participation in Hypertension Management Education Programs Using Data From the 2008 Korea National Health and Nutrition Examination Survey
Kang, Kyung-Hee ; Yim, Jun ;
Health Policy and Management, volume 21, issue 3, 2011, Pages 414~424
DOI : 10.4332/KJHPA.2011.21.3.414
The purpose of this study is to describe the characteristics associated with the hypertension educated population, and to develop and analyze a simple predictive model of the hypertension management education status. Based on the Korea National Health and Nutrition Examination Survey in 2008, a cross-sectional design was used in this study. An effective 1.165 adults(
) sample was divided into a participation group (n=66) and a non-participation group(n=1,099), and to compare demographic, socio-economic and health characteristics between two groups. Moreover, predictors associated with participation in hypertension education programs were identified by the logistic regression analysis. The participation rate in hypertension education in Korea is only 5.7% which is vastly low given the various programs were provided, and there are statistically significant differences between a participation group and a non-participation group in age(p=0.050), marital status(p=0.002), education level(p=0.000), and residence area(p=0.037). Furthermore, age for 40-49 years(OR : 0.207), education level of high school(OR : 2.579) and college(OR : 6.417), duration of hypertension(OR : 1.044), CVA(OR : 2.463), and blood pressure(OR : 1.041) are statistically significant predictors associated with the participation in hypertension education programs. To increase the participation of hypertension education program, variables such as age, education level, duration of hypertension, CVA, and blood pressure are more concerned. And, high-risk patients and family members need targeted outreach programs.
Institutional Change and Organizational Change: A Multicase Study on the Organizational Adaptation to the Introduction of Pharmacoeconomics
Lee, Hye-Jae ; You, Myoung-Soon ; Lee, Tae-Jin ;
Health Policy and Management, volume 21, issue 3, 2011, Pages 425~456
DOI : 10.4332/KJHPA.2011.21.3.425
Background: Organizations in the pharmaceutical industry are highly dependent on the institutional environment. The introduction of pharmacoeconomics to the decision-making on the price and reimbursement decisions became strong constraints to pharmaceutical companies in Korea. As little is known about the issue on organization-environment interaction in the healthcare field, this study aimed to figure out how pharmaceutical companies adapted to the environmental changes. Methods: A multicase study method was used, selecting eight cases among multi-national pharmaceutical companies in South Korea. In-depth interviews were conducted with the managers of these organizations, and secondary data were reviewed to complement the interviews. Results: Pharmaceutical companies viewed the new policies as a big threat and sought for actions against them. One of the most distinguishing organizational changes was to construct a Market Access department. Other strategies managing the environment such as co-optation, forecasting, and bargaining were also implemented. These changes were consistent with the predictions of Resource Dependency Theory and Institutional Theory. Conclusions: The interactions between pharmaceutical companies and institutional environments in healthcare were first explored. This study presents a new perspective on how organizations change and the motives for the changes. The findings of this case study will form the basis of further empirical studies.
An Institutional and Ecological Analysis of the Healthcare Environment in Korea: Focus on Institutional Logics, Actors, and Governance structures
Kim, Su-Jin ; Kwon, Soon-Man ; You, Myoung-Soon ;
Health Policy and Management, volume 21, issue 3, 2011, Pages 457~492
DOI : 10.4332/KJHPA.2011.21.3.457
The primary goal of our study was to investigate the vast transformations of the healthcare sector in Korea during the past half century. Official data reported in the Korean statistical yearbooks and secondary data suggested by previous studies were used for institutional analysis of healthcare environment. Information on hospital released by the Korean Hospital Association was also used for ecological analysis. Institutional analysis: We identified three distinctive eras based primarily on changes in institutional logics, institutional actors, and governance structures : 'professional dominance (1952-1976)', 'government involvement (1977-1999)', and 'coexistence of competing institutional logics (2000-present)'. During the first era, physician association supported by Korean government comprised the primary governance regime. During the second era, the government became a major actor as a regulator and purchaser in health care sector, introducing of the 'mandatory national health insurance'. During the third era, making healthcare system sustainable and providing health care efficiently was overarching goals although it was hard to find a single central logic dominating this period. Ecological analysis: Evidence from the analysis of hospital population suggested that the expansion of the bed capacity was made from different processes, shifting from the ecological process in 1980s to the adaptive process in 1990s. And Korean hospitals had changed following both 'directional process' and 'stabilizing process' over time. Based on our results, we concluded that more studies to compare more organizational populations other than hospitals and to empirically test the effects of institutional changes on organizational changes and vice-versa, need to be conducted.