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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
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Volume & Issues
Volume 24, Issue 4 - Dec 2014
Volume 24, Issue 3 - Sep 2014
Volume 24, Issue 2 - Jun 2014
Volume 24, Issue 1 - Mar 2014
Selecting the target year
Health Insurance Benefit Criteria and Quality Assurance Policies of Diagnostic Ultrasound Services in Other Countries
Chung, Seol Hee ; Lee, Hye Jin ; Kim, Han Sang ; Oh, Ju-Yeon ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 109~119
DOI : 10.4332/KJHPA.2014.24.2.109
In accordance with the government's plan to expand the national health insurance (NHI) coverage for severe diseases such as cancer, heart disease, cerebrovascular disease, and rare and incurable disease, the diagnostic ultrasound services have been covered by NHI from October 1, 2013. The quality is very important factor in providing diagnostic services because they influence on the diagnosis, treatment, and outcome of diseases. In particular, equipments and health care providers plays an important role in providing qualitative services. The purpose of this paper is to examine the major feature of ultrasound services covered by health security system and to review quality assurance policies in other countries such as Australia, Japan, the USA, and Canada. In addition, we assessed the implication of those policies. We especially put emphasis on the types and qualifications of healthcare professionals and measures to manage equipments. All countries have reviewed on policies to promote the quality such as educational requirements of professionals or restrictions on the duration of equipment usage. Various measures should be implemented to assure the qualitative ultrasound service.
The Effect of Korean Prospective Drug Utilization Review Program on the Prescription Rate of Drug-Drug Interactions
Kim, Dong-Sook ; Park, Juhee ; Jeon, Ha-Rim ; Park, Chanmi ; Kang, Hyeun Ah ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 120~127
DOI : 10.4332/KJHPA.2014.24.2.120
Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.
Regional Difference in Outpatient Service Utilization for Chronic Diseases among the Elderly
Yun, Heesuk ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 128~135
DOI : 10.4332/KJHPA.2014.24.2.128
Background: With ageing and growing importance of disease management system, it is necessary to investigate the extent of regional difference in service utilization for chronic diseases among the elderly and to reflect it in designing the system. Methods: A multiple regression analysis and descriptive statistics analyses were employed using patient survey, which covers nationwide health facilities and their users. Results: While the differences in the rate of service utilization/utilization outside living area between urban and rural areas or between income levels are not large, considerable variations are observed within urban or rural areas and within income groups. Conclusion: This results suggest that it is important to subsidize economically disadvantaged segments of the population and residents of less-favored areas to be better-equipped for chronic disease management in order to prevent the development of severe ailments and the need for treatment at higher-level medical institutions. Improvements to the service infrastructure in vulnerable regions are essential.
The Effects of Adherence on Hypertension Control among Newly Diagnosed Hypertension Patients
Han, Jin-Ok ; Oh, Dae-Kyu ; Yim, Jun ; Ko, Kwang-Pil ; Lee, Hee Young ; Park, Jong Heon ; Im, Jeong-Soo ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 136~142
DOI : 10.4332/KJHPA.2014.24.2.136
Background: This study is to research on how hypertension control is associated with adherence in newly diagnosed hypertension patients. Methods: The study is based on 255,916 patients who were diagnosed with hypertension in 2009 and didn't have any previous medical history of hypertension or associated complication for the past year using data collected by National Health Insurance Corporation. Newly diagnosed hypertension patients are divided into two group by visiting medical center numbers (more than 300 days was adherence group, if not non-adherence group). Patients are considered to have successfully controlled their hypertension based on blood pressure measured by health examination. Chi-square test and logistic regression, repeated measured analysis of variance was used to analyze. Results: The relations between adherence and hypertension control show that 1.12 times of patients in adherence group was able to control their hypertension. The additional analysis proves that adherence group are more decreased level of blood pressure than non-adherence group except for patients who are over 70. Comparison of the average of systolic blood pressure and diastolic blood pressure between adherence and non-adherence groups shows that the blood pressure has been significantly among the adherence group. Conclusion: The study proves that constant treatment for hypertension could control the blood pressure and encourages patients to put more effort for persistent treatment. It also shows that hypertension treatment are more effective in younger patients than the elderly and strategies of approaching are different depending on age.
The Effect of the Regional Factors on the Variation of Suicide Rates: Geographic Information System Analysis Approach
Park, Seong-Yong ; Lee, Kwang-Soo ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 143~152
DOI : 10.4332/KJHPA.2014.24.2.143
Background: Previous studies showed that the characteristics of population and regions were related to the suicide rates. This study purposed to analyze the relationships between regional factors and suicide rates with spatial analysis model. Methods: This is a cross sectional study based on the statistics of 2011 which was extracted from the 229 City Gun Gu administrative districts in Korea. Cause of death statistics on each district was used to produce the age-, sex-adjusted mortality rates resulting from suicide. Regional characteristics were measured by the number of doctors engaged in medical institutions per 1,000 population, divorced people's rate per 1,000 population, number of marriages per 1,000 population, and percent of welfare budget in general accounting. Statistical analysis was performed by using SAS ver. 9.3 and ArcGIS ver. 10.2 was used for geographically weighted regression (GWR). Results: In ordinary least square (OLS) regression, divorced people's rate per 1,000 population had a significant positive relationship with the standardized mortality rate per 100,000 population. Marriages per 1,000 population and the proportion of welfare budget in the general accounting had significant negative relationships with the mortality rates. Meanwhile, GWR provided that the directions of variable, divorced people's rate per 1,000 population, were varied depending on regions. The adjusted
was improved from the 0.32 in OLS to the 0.46 in GWR. Conclusion: Results of GWR showed that regional factors had different effects on the suicide rates depending on locations. It suggested that policy interventions for reducing the suicide rate should consider the regional characteristics in obtaining policy objectives.
The Effects of Quality of Care, Image, Role Performance Perceived by Community Residents on Medical Service Satisfaction to Public Hospitals
Hwang, Eun Jeong ; Moon, Jungjoo ; Sim, In Ok ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 153~163
DOI : 10.4332/KJHPA.2014.24.2.153
Background: This study aims to explore the effects of quality of care, image, and role performance perceived by community residents on medical service satisfaction to public hospitals. Methods: The subjects of this study were selected in the community residents around 39 district public hospitals. The questionnaire were included 4 factors and 16 items. The data were collected utilizing call-interview by a survey company. Results: The community satisfaction was positively correlated with quality of care, image, and role performance of public hospitals (p<0.001). As the results of multiple logistic regression, the significant variables of community satisfaction were quality of care (odds ratio [OR], 1.353; 95% confidence interval [CI], 1.211 to 1.511), image (OR, 1.487; 95% CI, 1.280 to 1.727), role performance (OR, 1.240; 95% CI, 1.085 to 1.416) among subjects having use experience of public hospitals. The significant variables of community satisfaction were quality of care (OR, 1.240; 95% CI, 1.175 to 1.309), image (OR, 1.328; 95% CI, 1.232 to 1.432), age (OR, 3.051; 95% CI, 1.385 to 6.724), monthly incomes (OR, 0.420; 95% CI, 0.198 to 0.892) among subjects not-having use experience of public hospitals. Conclusion: Public hospitals have to effort to improve image and satisfaction of community through providing quality of care, and role performance. It is possible to support them by the central and local government.
Awareness of Adverse Drug Reaction Reporting System in General Population
Ahn, So Hyeon ; Chung, Sooyoun ; Jung, Sun-Young ; Shin, Ju-Young ; Park, Byung-Joo ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 164~171
DOI : 10.4332/KJHPA.2014.24.2.164
Background: Safety of drugs has become a major issue in public healthcare. Spontaneous reporting of adverse drug reaction (ADR) is the cornerstone in management of drug safety. We aimed to investigate the awareness and knowledge of spontaneous ADR reporting in general public of Korea. Methods: A total of 1,500 study subjects aged 19-69 years were interviewed with a questionnaire for their awareness and knowledge related to spontaneous ADR reporting. Computer assisted telephone interview was performed from 27th February 2013 to 4th March 2013. Target population was selected with quota sampling, using age, sex, and residence area. Healthcare professionals such as physicians, pharmacists, and nurses were excluded. The survey questions included awareness of spontaneous ADR reporting, opinions on ways to activate ADR reporting, and sociodemographic characteristics. Results: Overall awareness of spontaneous ADR reporting system was 8.3% (
) among general population of Korea. Major source from which people got the information regarding ADR reporting was television/radio (69.9%), followed by internet (19.3%), and poster/brochure (6.1%). Awareness level differed between age groups (p<0.0001) and education levels (p<0.0001). Upon learning about the ADR reporting system, 88.5% of study subjects agreed on the necessity of ADR reporting system, while 46.6% thought promotion through internet and mass media as an effective way to activate ADR reporting. Conclusion: The overall awareness of spontaneous ADR reporting should be enhanced in order to establish a firm national system for drug safety. Adequate promotions should be performed targeting lower awareness groups, as well as various publicity activities via effective channels for the general population.
Trends and Factors Affecting Participation Rate in Korean National Health Screening among People with Disabilities
Yun, Ji Eun ; Lim, Borami ; Ho, Seung Hee ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 172~180
DOI : 10.4332/KJHPA.2014.24.2.172
Background: People with disabilities have higher prevalence rates and earlier onset of chronic disease than the non-disabled; therefore, their participation in health screening is important. This study evaluates the participation rate and trends in health screening of people with disabilities, and examines the association between their participation rate and disability characteristics, and socioeconomic status. Methods: Data on disability-related characteristics were collected from the National Disability Registry, and participants' corresponding health examination data were taken from the Korean National Health Insurance Corporation between 2002 and 2011. A total of 873,819 participants aged
years were analyzed in this study. Results: The rate of participation of people with disabilities in health screening has increased each year, but their participation rate is lower than that of the total population. The participation rate was lower in females than in males; the elderly group than in the younger group; those who live in city areas than rural areas; self-employed for health insurance than employees; those with an internal organ disability than those with an external physical disability; those with a severe disability than those with a mild disability; and those with a short-term disability than for those with a long-term disability. Conclusion: The factors associated with participation rate are age, sex, socioeconomic status, and disability characteristics. These findings indicate that health check-ups of people with disabilities should be promoted using an approach that takes into account the large individual differences in socioeconomic status and disability characteristics in this population.
Analytic Hierarchy Process-Based Prioritization in Expanding Health Insurance Benefit Package: in Case of Four Major Serious Diseases
Jeong, Hyoung-Sun ; Cho, Jae-Young ; Ko, Hey-Jin ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 181~190
DOI : 10.4332/KJHPA.2014.24.2.181
Background: Demands are recently rising for the securement of procedural justification of policy decision-making. This study aims to improve the procedure of making a decision to expand health insurance benefit package from the perspective of building a social consensus. Methods: Major priority principles were firstly derived through literature search. Weights for such principles were calculated through an analytic hierarchy process, based upon the survey conducted for the health policy experts. Priority for 11 non-covered services was assessed by applying the weights as above to the results of the questionnaire survey targeted at people including members of related committees or societies. Results: Weights for priority principles were in the order of 'severity/urgency (0.428)', 'cost-effectiveness (0.318)', 'substitutability (0.164),' and 'accountability (0.090)'. What was obtained by applying these weights to the results of the questionnaire survey was considerably in line with what health experts classified those items into 3 groups depending on their own judgement of service necessity (consistent with 9 services out of 11). Conclusion: Results of the study are suggestive as to how far a brief assessment by experts could be utilized in case there are constraints on time and expenses in implementing all the process to secure procedural justification. Various attempts and endeavors need to be made to secure procedural justification that will not mar efficiency of decision-making in the days to come.
The Organizational Citizenship Behavior and Organizational Effectiveness of Hospital Employees
Kim, Sung Ho ; Kim, Jang Mook ; Seo, Young Joon ;
Health Policy and Management, volume 24, issue 2, 2014, Pages 191~202
DOI : 10.4332/KJHPA.2014.24.2.191
Background: The organizational citizenship behavior is generally known as the important factor relevant to the organizational effectiveness. This research examined the mediating effect of the organizational citizenship behavior of hospital employees on the organizational effectiveness. Methods: Data were collected from 1,112 employees located in city of Seoul, Kyunggi and Chungnam province through self-administered questionnaires. Collected data were analyzed using IBM SPSS ver. 20.0, frequency analysis, t-test, analysis of variance, regression analysis, and path analysis. The main findings of the study are as follows. Results: First, it was found that many characteristics variables of personality, job, and relationship together affected organizational citizenship behavior of hospital employees. Especially, the following variables of negative affectivity, desire for growth, job value, job significance, and job security were found to have significant effect on the organizational citizenship behavior of hospital employees. Second, the results of path analysis showed that, through the mediating effect of organizational citizenship behavior, personality variables of positive and negative affectivity, and desire for growth, job characteristics variables of job value, job significance, and job security, and relationship variables of organizational support and task interdependence, had significant total effects on the level of job satisfaction of hospital employees. Conclusion: As a result, the organizational citizenship behavior seems to have both direct and indirect effects on the organizational effectiveness of hospital employees. Based on above findings, some theoretical and practical implications were discussed.