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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 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
Public Participation in Healthcare Decision Making : Experience of Citizen Council for Health Insurance
Kwon, Soonman ; You, Myoungsoon ; Oh, Juhwan ; Kim, Soojung ; Jeon, Boyoung ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 467~496
DOI : 10.4332/KJHPA.2012.22.4.467
Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public`s understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public`s preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants` perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.
The effect of social capital, health risk behavior and health status on medical care utilization by the elderly
Woo, Kyung-Sook ; Seo, Jae-Hee ; Kim, Gye-Soo ; Shin, Young-Jeon ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 497~521
DOI : 10.4332/KJHPA.2012.22.4.497
Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.
Cognitive Function and Activity of Daily Living of Older Adults Using Long-term Care Service
Chang, Hyun-Sook ; Lee, Hung Sa ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 522~537
DOI : 10.4332/KJHPA.2012.22.4.522
The purpose of this study was to analyze the level of the cognitive function and activities of daily living of the beneficiary older adults at home based on Korean Long-term Care Insurance System. A cross-sectional descriptive survey was conducted from November 2010 to May 2011, the final respondents were 1,026 beneficiary older adults taking home visit care covered in Korean long-term care insurance system. The questionnaire included general characteristics of subjects, cognitive function, ADL(Activity of daily living). The data was analyzed using the SPSS 20.0 version. There was significant difference in cognitive function and ADL between 1st Grade, 2nd Grade and 3rd Grade of long-term care classification. The correlated factors of cognitive function were ADL, long-term care grade, disability of arm and leg, limitation of joint, bed sore and tube feeding. The correlated factors of ADL were cognitive function, long-term care grade, disability of arm and leg, bed sore and tube feeding. This study suggests that cognitive functions have to be mainly considered in long-term care grade. It is necessary to make an effort to develop long-term care grade in Korean long-term care insurance system an cognitive function improvement program for the beneficiary older adults. Above all things government will be seriously contemplating of revise contents for long-term care grade to provide quality of care for the older adults.
Analysis on the Level of National Health Expenditure and Associated Factors in the OECD Countries
Park, Inhwa ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 538~560
DOI : 10.4332/KJHPA.2012.22.4.538
This study tried to find out the level of national health expenditure and associated factors in the OECD countries and then to derive lessons for Korea`s health financing based on the cross-national comparison. As a result, Korea`s health expenditure in 2010(7.1% of GDP) accounted for 74.7 percent of the OECD average and ranked as countries to spend less on health. At the same time, the socio-economic indicators such as GDP per capita, elderly population ratio and the total tax revenue to GDP also remained between 72 ~ 82 percent of the OECD average. The public share of health financing(58.2%) was relatively lower than those of other countries. However the health expenditure and the public share have grown 1.9 ~ 2.4 times higher than the OECD average over the past decade. According to the quantitative analysis, countries with relatively high income and elderly population turned out to have high health expenditure. Whereas, an inverse relationship was found between the total health expenditure and the public funding. It was estimated that the value of national health expenditure to GDP decreases 0.083 when the rate of public funding increases 1 percent point. Further, the share of public funding was affected positively by the total tax burden. Based on these findings, this study suggests that the sustainable spending on health and alleviating households` direct burden could be ensured by enhancing the share of public funding along with adjusting the tax burden of the people.
Factors associated with changes in pharmaceutical expenditures of outpatient care in clinic setting : Focusing on the incentive scheme to reduce total prescribed drug expenditure and the drug utilization review system
Yi, Myung-Hyun ; Chung, Woojin ; Cho, Eun ; Kim, Roeul ; Lee, Sunmi ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 561~578
DOI : 10.4332/KJHPA.2012.22.4.561
This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor`s autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.
Medication use among adults in Korea: focusing on prescription drugs and lifestyle drugs
Byeon, Jinok ; Jung, Youn ; Chung, Haejoo ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 579~596
DOI : 10.4332/KJHPA.2012.22.4.579
The purpose of the study is to examine the use of medication among adults by comparing the pattern of outpatient prescription drug use with the pattern of long term taking lifestyle drug use. Furthermore, the study investigates factors associated with the use of medication, particularity focusing on socioeconomic factors. Korea Health Panel data of 2008 was used to conduct the study analysis. By performing four different logistic regression models, the study noticed different patterns of the medication use between prescription drugs and lifestyle drugs. More specifically, the study showed that adults with lower education level tend to more frequently receive prescriptions while adults with higher education as well as income level tend to more use lifestyle drugs than their counterparts. Furthermore, other control factors such as age and gender were statistically significant for the use of both prescription and lifestyle drugs in different patterns. The study findings expect that reimbursement structure of drugs may be significantly associated with the different patterns and accordingly the accessability of medicine in particularly vulnerable population. Therefore, these policy factors should be considered in future study to more comprehensively understand about the diverse patterns in the medication use.
Perception of Korean Hospital CEOs on Organizational Accountability : Findings from In-Depth Interviews
You, Myoungsoon ; Lee, Geunchan ; Kwon, Soonman ; Yoon, Hyejung ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 597~627
DOI : 10.4332/KJHPA.2012.22.4.597
As misalignments among images, identity, and legitimacy of health professionals and institutions have been on the rise, CEOs of health care organizations have been required to enhance organizational accountability. Despite the accumulation of literature on the conceptual discussions of accountability, only a few studies empirically investigated key barriers to accountability and its facilitators. To identify perception on accountability with key barriers and facilitators of organizational accountability, a semi-structured interview with 11 CEOs of Korean hospitals was conducted. A short survey was taken to get quantitative data on CEO`s perception on organizational accountability. To CEOs, accountability was very complex and unfamiliar concept, but understood as physician`s code of ethics by nature and basic principle of hospital management. CEOs thought accountability could be improved through ethical leadership, financial stability and learning climate of hospitals. Distrust of the government, which failed to provide economic incentives for hospitals to increase accountability activities, was emphasized as a serious barrier to hospital accountability. There was consensus among hospital CEOs as to the importance of accountability in management. However, there were concerns that, without policy instruments to motivate hospitals toward increasing community benefits as well as collective efforts among health professionals to rebuild moral climate for being accountable, greater accountability would not be achieved in hospitals.
A Study on the Relationship between Nursing Officer`s Leadership Style and Knowledge Transfer - Focused on Moderating Effect of Job Characteristics -
Roh, Myoung Hwa ; Lee, Jung Ok ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 628~653
DOI : 10.4332/KJHPA.2012.22.4.628
Purpose : This study attempted to find out the relationship between leadership style, knowledge transfer in nursing officers` job, considering the task characteristics. Methods : The data were collected from the military hospital during November 1st to November 17th, 2008 using a structured questionnaire and analyzed with the statistical method of frequency, correlation, and regression analysis, in SPSS 12.0 program package. Results/Conclusion : The results of empirical analysis shows that the levels of job tension and job focused task domain affect the job characteristics of the nursing officers` organization. The job characteristics have a moderating effect on the relationship between leadership style and knowledge transfer. The research is very useful in finding out the job characteristics which well depict military nursing organizations. This research suggests that a desirable leadership styles affect the knowledge transfer in the job characteristics type.
Workplace Friendship and Organizational Effectiveness of Hospital Employees
Hwang, Jae-Moon ; Seo, Youngjoon ; Kim, Sungho ; Kang, Jung-Kyu ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 654~675
DOI : 10.4332/KJHPA.2012.22.4.654
This study purports to investigate the relationship between workplace friendship and organizational effectiveness in general hospitals. Organizational effectiveness was represented by the level of job satisfaction, organizational commitment, stress, and intent to leave. Data were collected from 372 workers at 6 hospitals in Chungbuk Province using self-administered questionnaires from May 1 to 20, 2009, and analysed using t-test, ANOVA, correlation analysis and multiple regression analysis. The major findings of the study are as follows: First, friendship level of hospital employees is highest in the friendship with colleague, followed by the friendship with subordinates and with superiors. Second, the group of higher level of workplace friendship showed significantly higher level of organizational effectiveness than the group of lower level of workplace friendship. Third, the level of the workplace friendship with superiors and colleagues was found to have a significant positive impact on the job satisfaction and organizational commitment. The level of the workplace friendship with superior was found to have a significant negative effect on the intent to leave and work stress. These results imply that hospital managers should make an effort to create the organizational climate and systems which improve the workplace friendship.
A Study of relationship between high performance-HRM system of medical doctor and the effectiveness of hospital
Park, Seung-Ho ; Cha, Jong-Seok ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 676~695
DOI : 10.4332/KJHPA.2012.22.4.676
This study purposes to examine the relationship between high performance-HRM system of medical doctor and the effectiveness of hospital. The high performance-HRM practices were derived from reviewing the literature of SHRM(Strategic Human Resource Management) and investigating some cases of Korean leading hospitals. The result reveals that the high performance-HRM system of medical doctor is significantly related with subject measurement such as financial performance, employees` turnover, and customer(patient) satisfaction. Moreover, it is positively related to objective performance such as hospital`s profit growth, yearly patient growth. Based on the result, the academic and practical implications are suggested and then the limitation and further research directions are discussed.
Has Disabled Access in Healthcare Institutions been Increased? - A Case Study of Jongno-gu in Seoul, Korea -
Lee, Jin Yong ; Jeong, Jaeyoung ; Kim, You Kyung ; Jun, Eun-Kyung ; Kim, So Yun ; Kim, Hyun Joo ; Lee, Bo Woo ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 696~702
DOI : 10.4332/KJHPA.2012.22.4.696
The purpose of this study was to evaluate the improvement of disabled access to healthcare institution located in Jongno-gu, Seoul in 2011 compared to 2003 since disabled access has been mandatory in healthcare institutions located in new buildings by the amended law in 2004. We had investigated 10 assessment items for disabled access in 166 healthcare institutions located in Jongno-gu, Seoul and the results were compared with those of 2003 survey. On average, 74.1% of the healthcare organizations has equipped with items for disabled access. However the adequately equipped rate for those items was only 39.2%. Compared with the results of 2003 survey, these rates showed a little increase by 4.1% and 8.0%, respectively. There were only 10 healthcare institutions located in new buildings which were constructed after July, 2005. Their average equipped rate(84.4%) and adequately equipped rate(46.8%) were higher than those of the other organizations because the Korean government ruled that healthcare institutions in new buildings must have facilities for the disabled. In conclusion, we confirmed that the accessibility of the disabled to healthcare institution slightly increased. In particular, the healthcare institutions in newly constructed building showed the significant increase of accessibility of the disabled. However, it is founded that disabled access is still not enough for the disabled.
Creation of a central public healthcare human resources management department to coordinate existing agencies
Yoon, Seok-Jun ; Seo, Hye-Young ; Park, Yoon Hyung ;
Health Policy and Management, volume 22, issue 4, 2012, Pages 703~710
DOI : 10.4332/KJHPA.2012.22.4.703
Purpose : The aim of this study is to review the current status of healthcare provision and its human resources administrative management and propose a coordinated human resource management plan for the more efficient operations of healthcare organizations. Methods : We reviewed the literature and held discussions with officials from the United States Department of Health and Human Services to survey United States Public Health Service Commissioned Corps operations. In addition, we surveyed the literature to analyze the current structure and responsibilities of governing bodies involved in public healthcare in Korea. Results : In Korea, there are several administrative offices involved in public health: the Ministry of Health and Welfare, the Ministry of Defense, the Environment Ministry and others. Since these diverse agencies don`t integrate their operations, it is difficult to grasp their management of both public healthcare services and their personnel. A potential model is the United States Public Health Service Commissioned Corps, a sub-group of the Department of Health and Human Services and an elite team of highly qualified, public health professionals, which coordinates and manages the overall work and personnel of diverse healthcare organizations. Conclusion : We suggest the establishment of a federal level, public health administrative department of human resource management to centralize and coordinate the existing, disparate healthcare administrative agencies.