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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
Trend analysis of the number of nurses and evaluation of nursing staffs expansion policy in Korean hospitals
Park, Bo Hyun ; Lee, Tae Jin ; Park, Hyeung-Keun ; Kim, Chul-Woung ; Jeong, Baek-Geun ; Lee, Sang-Yi ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 297~314
DOI : 10.4332/KJHPA.2012.22.3.297
Purpose : The purpose of this study was to analyze the trend of the number of nursing staffs and skill mix and to assess the effectiveness of hospital nurse expansion policies in Korea. Methods : The trend of the number of nursing staffs and skill mix were analyzed using time series data, which composed of yearly series data from 1975 to 2009. The impact of hospital nurse expansion policies was estimated by autoregressive integrated moving average(ARIMA) intervention model. Results : The number of general hospital and hospital nurses per 100 beds was decreased in late 1980s and late 1990s due to rapid growth of beds. As a result of the number of nurse aids per 100 beds decreased, skill mix became high in general hospital but nurse ratio among hospital nursing staffs was about 50%. Expansion of new nurse and revised differentiated inpatient fee were only effective in expansion of hospital nursing staffs. But they had no effect in general hospitals. Conclusion : In Korea, a few policies related to expansion of hospital nurses have an effect on increasing the number of hospital nurse. Nevertheless, level of hospital nursing staffs is inferior to that of general hospital.
The Rights of Patients as Consumers
Kwon, Yong Jin ; Son, Sang Sik ; Lim, Young Deok ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 315~346
DOI : 10.4332/KJHPA.2012.22.3.315
The legal relationship between patient and physician is legally equal relationship. But, in times past, patients be compelled to sign an unequal contract, substantially. Because of the imbalance between supply and demand in the health care market. Today, the law of supply and demand in the health care market is running well. And as the cognition of citizens' rights grows, the relationship between patient and physician can also get a lot of changes. Patients have the right to know the information about medical care, and to decide whether or not to get treatment including invasions against their own bodies. In other words, Doctors have an obligation to explain to their patients. If doctors did not provide patients sufficient explanation or information, it violates the right of patients. This is a tort, or a breach of contract. To improve the remedy for violation of patient's right, patient is able to be protected by status as consumer. If patient is a kind of consumer in terms of medical consumption, he/she as consumer can enjoy supplementally the consumer's right. The patient as a consumer can exercise now a consumer's right as a constitutional right. In addition, with respect to consumer's rights, Framework Act on Consumers was enacted. This Act is based on constitutional provisions of Article 124 and the Act can be seen as a law that embodies consumer right because the provision of the constitutional law delegates specific contents. In the health care field, patients need to win recognition the statue of the consumer to hold the sovereignty of the consumer. In particular, if patients are consumers, they may be able to make good use of the quickly and efficiently collective dispute resolution and association lawsuit to rescue their damage, the Alternative Dispute Resolution(ADR) of Framework Act on Consumers.
The Effects of Preceptors' Transformational Leadership on Job Stress and Clinical Performance among New Graduate Nurses
Kim, Hee Young ; Park, Jong ; Ryu, So Yeon ; Choi, Seong Woo ; Han, Mi Ah ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 347~364
DOI : 10.4332/KJHPA.2012.22.3.347
Objective : The purpose of this study was to investigate the effect of preceptors' transformational leadership on job stress and clinical performance among new graduate nurses. Methods : The study subjects were 180 new nurses in three University Hospitals. General characteristics, leadership, job stress and clinical performance were collected using self-reported questionnaires. Transformational leadership consisted of charisma, intellectual stimulation and individual consideration. T-test, ANOVA, pearson correlation and multiple regression analysis were performed to access the effect of leadership on job stress and clinical performance. Results : Of 180 subjects, 94.4% were female. The mean scores of transformational leadership, charisma, intellectual stimulation and individual consideration were
, respectively. In multiple regression analysis, overall transformational leadership(
=.154, p=.006) and charisma(
=.388, p=.008) significantly increased the job stress. On the other hand, individual consideration significantly decreased the job stress (
=-.671, p=.048) and increased the clinical performance(
=2.472, p=.024). Conclusions : Charisma of preceptors was associated with the increase of job stress, and individual consideration was associated with the decrease of job stress and improvement of clinical performance. Therefore, the preceptors' leadership focusing on individual consideration rather than charisma may reduce job stress and improve clinical performance in the University hospital organization.
Factors Related to Job Retention of Physicians in Public Hospitals
Oh, Moo-Kyung ; Kwon, Yong-Jin ; Lee, HeyJean ; Lee, Jin-Seok ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 365~382
DOI : 10.4332/KJHPA.2012.22.3.365
Background : Public hospitals suffer worsening shortage of physicians and face great pressure of recruiting doctors. This study is aim to identify the factors associated with retention of physicians who are working in public hospitals. Methods : We conducted a cross-sectional and self-administered questionnaire survey in July, 2011. A total of 333 physicians responded from the 31 public hospitals. We analyzed the difference of job retention across the variables among doctors stratified as salaried and public health doctors. We used chi-square test and multiple logistic regression analysis. Results : To the salaried doctor, longer work period(OR=2.04 in 3rd quartile), professional autonomy(OR=2.69), and positive attitude toward public health(OR=2.39) affect to the higher job retention whereas complain of low income(OR=0.33) and complain of poor clinical environment(OR=0.26) affects to the lower job retention. To the public health doctors, community connections such as hometown(OR=6.27), spouse factors(OR=3.49), and positive attitude toward public health(OR=3.19) affect to the higher job retention. But longer work period(OR=0.17 in 3rd quartile) affects to the lower job retention. Conclusions : Associated factors of job retention vary across physician's status. Professional autonomy has major impact on the job retention to the salaried doctor. And familial factors as well as community relationship have greatest impact to the public health doctor. Positive attitude toward public health is associated with the higher job retention to the both of salaried and public health doctors.
Factors Related to Family Caregiver Financial Burden of Out-Of Pocket Expenses for the Nursing home service under Long-term Care Insurance System
Han, Eun-Jeong ; Lee, Jung-Suk ; Kwon, Jinhee ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 383~402
DOI : 10.4332/KJHPA.2012.22.3.383
The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(
). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.
Comparing standards and guidelines of long-term care facilities based on physical environment and manpower in Korea, Japan, USA, and Australia
Chin, Young-Ran ; Lee, Hyo Young ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 403~426
DOI : 10.4332/KJHPA.2012.22.3.403
The purpose of this study is to compare the standards and guidelines of long-term care facilities based on the physical environments and human resources in Korea, Japan, USA, and Australia. Ultimately, this study suggests the directions for amendments of long-term care service or running of the facilities in Korea. For achieving this purpose, we reviewed the homepage of national health departments, reports and articles of long-term care service, and acts related with long-term care in each country. This comparisons were carried in terms of physical environments, human resources by long-term care related acts and legal sanctions as means of quality control. This study implies that long-term care service guidelines or standards should be revised for developing the quality of our long-term care services.
The factors influencing variation by local areas in antibiotics prescription rate according to the public reporting
Chun, Yu-Jin ; Kim, Chang-Yup ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 427~450
DOI : 10.4332/KJHPA.2012.22.3.427
Objectives : This study examined the factors influencing variation by local areas of antibiotics prescription rate in upper respiratory infections (URI) according to the public reporting. Methods : We used the National Health Insurance Claims Data which the clinics claimed for URI (Korean Standard Classification of Disease, J00 ~ J06) in ambulatory care. The period of analysis was from the first quarter (from January to March) of 2005 to the first quarter of 2007. The number of samples was total 242 local areas that included all clinics (N = 7,942), which prescribed antibiotics for URI in ambulatory care. Results : None of the demographic and socioeconomic characteristic indicators was statistically significant. Among the provider factors, An increase in number of doctors and the average annual antibiotics prescription rate (from 2003 to 2004) for URI by local area were significantly related to an increase of antibiotics prescription rate according to the public reporting. And an increase in number of pediatric clinics, the proportion of clinics less than 5 years since has opened and the average annual fluctuation of antibiotics prescription rate (from 2003 to 2005) were significantly related to a decrease in antibiotics prescription rate by local area according to the disclosure of information. Conclusions : According to the public reporting, the antibiotics prescription rate in clinics had decreased sharply. However, the reduction of antibiotic prescription rate varied in different local areas. The factors influencing variation by local areas in antibiotics prescription rate can be used for establishing effective strategies to reduce variation by region in antibiotics prescription rate.
Factors Affecting Cost-Sharing Charges for Inpatients
An, Byeung Ki ;
Health Policy and Management, volume 22, issue 3, 2012, Pages 451~465
DOI : 10.4332/KJHPA.2012.22.3.451
In order to strengthen assurance of National Health Insurance, co-payment should be reduced. This can happen with collaborative efforts of patients, medical institutes, and government altogether at the same time. This research applied Dutton(1986)'s medical service research model with high R-square, and analyzed 2008 Korea Health Panel Data (Beta Version 1), that was examined by Korea Institute for Health and Social Affairs and National Health Insurance, in order to figure out influential variables on co-payment. In result of Multiple Linear Regression Analysis, R-square was 46.7%, the older the age, the patients who had surgery, the longer days of hospital treatment are, the higher gross income of a household is, the more hospitalized in upper grade general hospitals, and the more upper grade rooms and selecting a doctor are used. The results have statistical significance. When conducting research applying medical service research model, there is a need to apply Dutton(1986)'s medical service research model with high R-square. In order to strengthen assurance of National Health Insurance, first conditions should be that patients are hospitalized in upper grade general hospital, and at the same time, are patients who had surgery with long stay of hospitalization. In addition, if proven that patients used upper grade rooms and selecting a doctor due to lack of regular treatment and rooms, for certain number of days of such hospitalization, it is suggested to be provided with health care insurance in upper grade rooms and selecting a doctor in calculating co-payment limit.