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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 22, Issue 4 - Dec 2012
Volume 22, Issue 3 - Sep 2012
Volume 22, Issue 2 - Jun 2012
Volume 22, Issue 1 - Mar 2012
Selecting the target year
Establishment and Functions of World Health Organization: With a Functionalism Perspective
Ko, Han-Soo ; Kim, Chang-Yup ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 1~28
DOI : 10.4332/KJHPA.2012.22.1.001
Since its establishment in 1948, World Health Organization (WHO) has tried and facilitated international cooperation of public health under the goal of "the highest attainable health," and gained outcomes like the eradication of smallpox and polio, turning itself into the representative of international public health. However, there was discord between member nations during the cold war era, and the status of WHO experienced rise and fall after its establishment. WHO, the representative international health organization, also has not been freed from influences from international regime changes, which means that the discussion on the internal causes of WHO functionings should be expanded more. In this study, functionalism was tested as one of international relations theory that tries to explain the establishment and role of WHO. Especially, this study analyzed the problems and problem-solving process that WHO had to face by using Imber's five steps theory that arranged chronologically the theory of Mitrany. We mainly investigated the secondary source that described historic facts on the rise and fall of WHO in terms of roles and functionings during establishment of WHO, the cold war era, and international cooperation of public health. The roles of WHO were analyzed by selecting the gains of WHO in the post cold war era. The functionalism arrangement of Imber was appropriate to some extent in explaining the establishment and role of WHO. The first step was International Sanitary Conference in 1851 that made nations to recognize international cooperation of public health, and the second step was the establishment of WHO that handles public health as an international organization. Recent cases of the Framework Convention on Tobacco Control and International Health Regulations showed that each nation agreed with an international norm that they had to cooperate each other to tackle infectious diseases and smoking, and this implies that these were emergence of global governance. This process was the third step of Imber's theory (nations had a gain from international cooperation would agree with the expansion of authority of international organization). However, the last two steps of the theory are still not realized. The partial success of WHO was based on the functional elements that WHO deals with non-political elements, human resources centering on professionals, and democratic decision making process. This essential and non-political characteristics mean that necessity of international cooperation catalyzed by WHO would continue despite of the global governance era when global health governance get faced more challenges.
The cost of end-of-life care in South Korea
Shin, Hyun-Chul ; Choi, Mi-Young ; Tchoe, Byong-Ho ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 29~48
DOI : 10.4332/KJHPA.2012.22.1.029
The purpose of this study is to analyze medical expenses by decedents in their last year of life and compare them with those by survivors during the year 2008. This study is conducted firstly in Korea, except some studies focusing on medical cost of decedents from specific diseases. To study this, national health insurance(NHI) claims data was used with medicaid claims data. The study group(decedents) was selected from the insurance entitlement file who were dropped out from January to December of 2008. The control group(survivors) was selected from the entitlement file by stratified sampling with keeping age-sex composition of the study group. The medical expenses of decedents during one year before death were measured and compared with those of survivors by sex and age. And the medical expenses were analyzed by causes of death, and also the expenses were examined by each item of medical services. On average, the medical expense amounted to 11 million Korean Won per decedent during their last year of life in 2008. The medical expense per decedent was 9.3 higher than that of survivor. The death-related expense of under the age 35 was about 16 million Won, compared with 4 million Won in the case of over the age 95, in average. The death-related expense is higher in younger ages. This means that more medical resources are put in to save life in younger ages. Total death-related expenditure took 8.3 percent in total NHI expenditures. Of the death-related medical expenses, the largest one was injection-related cost which shares twenty five percent, and the second largest one was hospitalization charges, and then the third one was surgery cost. The results of this study suggested that we should pay attention to the medical expenses in the last of year of life when we study health care expenditure in Korea. In addition, we have to deliberate health care policy to cope with medical expenditures before death in more efficient way.
Determinants of health screening and its effects on health behaviors
Yeo, Ji-Young ; Jeong, Hyoung-Sun ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 49~64
DOI : 10.4332/KJHPA.2012.22.1.049
With the burden of chronic diseases mounting among the population as a result of its aging, the importance of health examination is being stressed in order to identify and manage diseases in the early stage. Health examination in Korea is divided largely into periodic health examination provided as a national health screening program and individual physical checkups. The advantages of the former include little economic burden on the examined and those of the latter include the freedom of the individual to select various examination headings depending on the individual's characteristics and preferences. With both examinations now being expanded, empirical analyses from various standpoints are needed. This study proposes to analyze traits of the examined and non-examined as shown in the facts and figures of the 1st and 2nd Korean Longitudinal Study of Ageing (KLoSA), thereby make the determinant factors clear leading to the acceptance of the examinations, and analyze the effects of the examinations upon maintaining or moving to healthy lifestyle. It was confirmed that demographic features such as gender and age, socioeconomic features such as the level of education, place of residence and household income, physical and mental state of health such as chronic disease and dementia, and daily living habits are significantly related with whether to accept physical examination. It is also confirmed that physical examination leads to non-smoking, regular physical exercises and regular dietary habits. It is suggested that, to enhance effects of health examinations, follow-up management programs making use of results of health examinations be further expanded, and the national health screening program be more actively put into operation for the bracket lying in the blind spot of the program.
Development of efficiency indicators for medical resources use using Delphi technique
Choi, Yoon-Jung ; Kwon, Young-Dae ; Kim, Chang-Soo ; Kim, Yoon ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 65~84
DOI : 10.4332/KJHPA.2012.22.1.065
Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.
Socioeconomic Equity in Regional Distribution of Health Care Resources in Korea
Jeon, Bo-Young ; Choi, Su-Min ; Kim, Chang-Yup ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 85~108
DOI : 10.4332/KJHPA.2012.22.1.085
One of the ways to achieve the principle of equal access for equal needs, availability and geographical accessibility of health care resources regardless of resident sites is important. The purpose of this paper is to measure socioeconomic inequities in distribution of health care resources among regions in the Republic of Korea (hereafter Korea). Data were extracted from regional statistics of National Health Insurance, Community Health Survey, Korea Social Science Data Archive, and Korean Statistical Information Services at the same period of 2009. The dependent variables were the number of health workforce and health care facilities in each region. The proxy indicator of regional socioeconomic status was local tax per person. To identify whether inequalities among regions, we examined the concentration index(CI) and indirectly standardized CI by controlling each region's demographics and need factors. Total observations were 232 districts in nationwide, and we analyzed separately Seoul(25 districts) and non-Seoul areas(207 districts). The standardized CI values of health care resources were positive(favoring the rich region) across the nation in almost all kinds of resources. Especially the number of specialist, dentist, dental clinics, clinics, oriental medical clinics, pharmacists, and pharmacies were statistically significantly favoring the rich region. But the CI for the number of long-term care hospitals, public health centers were negative(favoring the poor region). The tendency of CI presenting positive values were increased in Seoul area. But in the case of non-Seoul, the CI indexes were nearly zero. The results suggest that except the Seoul area, little regional socioeconomic-related inequalities were observed in the distribution of health care resources in Korea.
The Financial Performance of Hospitals Belonging to Multi-hospital System : A Comparative Study
Yoon, Young-Gyu ; Suh, Won-S. ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 109~128
DOI : 10.4332/KJHPA.2012.22.1.109
The purpose of this study is to analyze the performance difference between multi-hospitals and free-standing hospitals. Scholars in industrial economics argue that, due to economies of scale and integration, multi-hospital system may have a better performance compared to freestanding hospitals. The study overturned the hypothesis based on a theory. By analyzing 425 acute-care hospitals in Korea, this research shows that multi-hospital systems and market factors, which have been perceived to be strengths to hospitals, are negatively related to hospitals' financial performance. Specifically, the results showed a better performance of freestanding hospitals compared to multi-hospital systems. Higher labor and administrative cost by multi-hospital system may be the reason for the difference, and it means they are not more effective at cost control. Managers in multi-hospital system, therefore, should pay attention on cost-reducing issues to regain managerial efficiency of organizations.
The Level of Emotional Labor among Workers in One University Hospital
Kim, Hyun-Joo ; Lee, Bo-Woo ; Hwang, Ji-Hye ; Lee, Moo-Sik ; Na, Baeg-Ju ; Lee, Jin-Yong ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 129~144
DOI : 10.4332/KJHPA.2012.22.1.129
Purpose : The purpose of this study was to investigate the level of emotional labor and to identify affecting factors on emotional labor among one university hospital employees. Material and Method : This study was based on cross-sectional, self-administered, and Internet-based survey. The survey was conducted from Mar. 2 to Mar. 28. 2011. Total subjects were 812 employees working in one university hospital. Total response rate was 61.5%. Modified evaluation tool was used, which was originally developed by Morris and Feldman, to measure the level of emotional labor among hospital personnel. In order to identify the affecting factors on high level of emotional labor, we conducted logistic regression. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were 2-sided and a p-value<0.05 was considered statistically significant. Results : Average score of emotional labor was 3.06. Employees(3.39) who are working at the emergency department and hemodialysis room indicated the highest level of emotional labor, followed by wards(3.14), department of administration(3.14), department of ambulatory cares(3.06). The factors affecting on the high level of emotional labor were the highest level of schooling, types of department, and types of personality(p<0.05). Conclusion : The survey results showed that there was significant level of emotional labors among hospital employees. Therefore, the efforts to reduce the level of emotional labors are needed.
Magnitude and its effected factors of non-covered services expenditures among long-term care facilities benefits user in Long-term Care Insurance
Kwon, Jin-Hee ; Lee, Jung-Suk ; Han, Eun-Jeong ;
Health Policy and Management, volume 22, issue 1, 2012, Pages 145~162
DOI : 10.4332/KJHPA.2012.22.1.145
The purpose of this study is to understand magnitude and its related factors of user's cost-sharing for non-covered services in long-term care facilities. We corrected data for 1,016 subjects, based on the long-term care benefits cost specification. Eighteen subjects were excluded from the data analysis due to missing data on family care-givers characteristics. Finally, 998 subjects were included in the study. The average cost of non-covered services per month was 209,093 won and distributed from 0 to 1,011,490 won. There was a significant difference by the characteristics of family care-givers and long-term care facilities. The monthly average cost for meal materials per person was 199,181 won(0~558,000), average cost of additional charge caused by using private bed was 232,992 won (50,000~600,000), and costs for haircut and cosmetics were 8,599 won. For the rest, there were various programs costs(93,328 won), diaper and its disposal cost(109,628 won), purchase cost for daily necessaries(24,435 won) and etc. The related factors for the magnitude of non-covered services expenditures were education level of family care-givers, occupancy rate and location of LTC facilities, and the costs of using private bed, haircut and cosmetics, and various programs among non-covered services. These findings suggest that present level range of LTC facilities users' cost-sharing is wide and it is urgent to prepare the standard guideline for cost and level in non-covered services.