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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 25, Issue 4 - Dec 2015
Volume 25, Issue 3 - Sep 2015
Volume 25, Issue 2 - Jun 2015
Volume 25, Issue 1 - Mar 2015
Selecting the target year
Build Capacity for International Health Agenda on the "Transforming Our World: The 2030 Agenda for Sustainable Development"
Park, Yoon Hyung ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 149~151
DOI : 10.4332/KJHPA.2015.25.3.149
United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (
) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.
A Panel Study on the Effect of Obesity and the Chronic Diseases on the Health Care Expenditures
Kim, Sang-Hyun ; Sakong, Jin ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 152~161
DOI : 10.4332/KJHPA.2015.25.3.152
We analyze the determinants of obesity and the chronic diseases using the Korea Health Panel data. Also we analyze the effect of obesity and the chronic diseases on the health care expenditures. Through this study, to reduce the health care expenditures, we suggest the policy implication that might curb the obesity and the chronic diseases. We estimate the determinants of obesity, the chronic diseases, and the health care expenditures using 2SLS (two stage least squares) estimation method under the simultaneous equations framework. Result says that obesity and chronic diseases significantly have positive effects on the health care expenditures. Also the determinants of the health care expenditures that have positive effects are age, income and health care utilization variables.
The Factors Related to the Non-Practice of Cancer Screening in Cancer Survivors: Based on the 2007-2012 Korean National Health and Nutrition Examination Survey
Yang, Song-Ei ; Han, Nam-Kyung ; Lee, Sun-Mi ; Kim, Tae-Hyun ; Chung, Woojin ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 162~173
DOI : 10.4332/KJHPA.2015.25.3.162
Background: The aim of the current study was to investigate the factors related to the non-practice of cancer screening in cancer survivors, who are at high risk of developing second cancers. Methods: This study is a cross-sectional analysis of 1,125 cancer survivors
years old who participated in the Korean National Health and Nutrition Examination Surveys IV and V (2007-2012). A Rao-scott chi-square test and a survey logistic regression analysis were employed respectively to analyze the difference of cancer survivors in cancer screening by each characteristic and the factors related to the non-practice of cancer screening in cancer survivors. Results: Among total subjects, 33.5% did not participate in cancer screening in the last two years. Results from a fully adjusted logistic model showed that the non-practice of cancer screening in cancer survivors was significantly associated with variables such as sex, age, marital status, education level, monthly income, and drinking a alcoholic beverage Specifically, the odds ratio of non-practice of cancer screening was higher in males than in females, in the younger group than in older group, in the group with no spouse than in the group with a spouse; in a group with a low level of education than in a group with a high level of education; in a group with the lowest income level than in a group with the other levels of income; or in non-drinkers than in drinkers. Conclusion: Health policies to reduce the non-practice rate of cancer screening in cancer survivors should be designed and implemented with close attention to cancer survivors' socio-economic characteristics such as sex, age, marital status, education, and income, along with a health behavioral characteristic as drinking.
A Legal Framework for Improving Patient Safety in Korea
Ock, Minsu ; Kim, Jang Han ; Lee, Sang-il ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 174~184
DOI : 10.4332/KJHPA.2015.25.3.174
This paper reviewed structure and current status of laws related to patient safety using patient safety law matrix to promote systematic approach in legal system of patient safety. Laws related to patient safety can be divided into three areas: laws for preventing; laws for knowing about; and laws for responding. In the case of Korea, gaps are especially prominent in the areas of laws for knowing about and responding. Patient safety law which will be enacted in July 2016 will fill the gap in the area of laws for knowing about. This law will be comprehensive law, covering the full spectrum of laws related to patient safety. However, after reviewing current patient safety law in Korea, the following drawbacks were identified: absence of code for grasping the current patient safety level; absence of code for mandatory reporting in patient safety reporting system; and absence of code for privilege about patient safety work product. Furthermore we need wider discussions about covering issues of open disclosure, apology law, coroners system, and complaint management system in patient safety law.
Refinement and Evaluation of Korean Outpatient Groups for Visits with Multiple Procedures and Chemotherapy, and Medical Visit Indicators
Park, Hayoung ; Kang, Gil-Won ; Yoon, Sungroh ; Park, Eun-Ju ; Choi, Sungwoon ; Yu, Seunghak ; Yang, Eun-Ju ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 185~196
DOI : 10.4332/KJHPA.2015.25.3.185
Background: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. Methods: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. Results: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. Conclusion: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.
Developing a Hospital-Wide All-Cause Risk-Standardized Readmission Measure Using Administrative Claims Data in Korea: Methodological Explorations and Implications
Kim, Myunghwa ; Kim, Hongsoo ; Hwang, Soo-Hee ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 197~206
DOI : 10.4332/KJHPA.2015.25.3.197
Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.
The User Fee Introduction and Its Effect in the Health System of Low and Middle Income Countries: An Exploratory Study Using Realist Review Method
Son, Kyung Bok ; Kim, Chang-Yup ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 207~220
DOI : 10.4332/KJHPA.2015.25.3.207
Background: The purpose of this exploratory study is to explain where, when and how the introduction of user fee system works in low and middle income countries using context, mechanism, and outcome configuration. Methods: Considering advanced research in realist review approach, we made a review process including those following 4 steps. They are identifying the review question, initial theory and mechanism, searching and selecting primary studies, and extracting, analyzing, and synthesizing relevant data. Results: User fee had a detrimental effect on medical utilization in low and middle income countries. Also previous and current interventions and community participation were critical context in user fee system. Those contexts were associated with intervention initiation and recognition and coping strategies. Such contexts and mechanisms were critical explanatory factors in medical utilization. Conclusion: User fee is a series of interventions that are fragile and dynamic. So the introduction of user fee system needs a comprehensive understanding of previous and new intervention, policy infrastructure, and other factors that can influence on medical utilization.
The Effects of Hospital Resources on the Service Uses: Hospital Service Area Approach
Kwak, Jin-Mi ; Kim, Da-Yang ; Seo, Eun-Won ; Lee, Kwang-Soo ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 221~228
DOI : 10.4332/KJHPA.2015.25.3.221
Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.
Factors Associated with Satisfaction as Surveyor and Reliability of Surveyors in Hospital Accreditation Program
Kim, Kyung-Sook ; Lee, Sun-Hee ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 229~239
DOI : 10.4332/KJHPA.2015.25.3.229
Background: The hospital accreditation program in Korea has been conducted since 2011 in order to improve patient safety and healthcare service quality. This study was conducted to find factors associated with satisfaction as surveyor and reliability of surveyors in hospital accreditation program. Methods: This study was performed targeting 217 responded to the survey among 412 surveyors who had participated in the accreditation survey for acute care hospitals from December 2010 to February 2014. Results: The average number of survey per surveyor is 2.35. We divided surveyors into those who participated in the survey more than 3 times and less than 3 times in order to judge the professionalism of surveyors according to the number of survey participation. Those factors that have an influence on the satisfaction as surveyors include: activity period as surveyor, role in the survey team, experience of survey in other fields, experience as consultant and the useful education and proper composition of survey team (p<0.05). Those factors that have an influence on the reliability for fellow surveyors include: number of beds of hospitals they belong, experience of survey in other fields, useful education, proper composition of survey team and difficulty in leadership interview (p<0.05). Conclusion: It is important to provide useful education and proper composition of survey team to increase the satisfaction as surveyors and the reliability for fellow surveyors.
Factors Associated with Dental Revenue and Income of Self-Employed Dentist by Using a Quantile Regression Method
Choi, Hyungkil ; Kim, Myeng Ki ;
Health Policy and Management, volume 25, issue 3, 2015, Pages 240~251
DOI : 10.4332/KJHPA.2015.25.3.240
Background: Dentist's income is quite variable. We investigate the factors underlying the distribution of dental revenue and dentist income. Methods: Financial and structural variables of private dental practices(N=13,967) were examined with 2010 Economic Census microdata which include non-insurance revenue. We conducted quantile regression method(QRM) and ordinary least square(OLS) in treating skewness and heteroskedasticity of distributions. The effective estimation for the upper and lower range of distribution becomes possible by QRM. Results: Mid-career dentists are shown to have higher revenue and income. Male dentists achieve the higher revenue and income than female dentists in all quantiles. Group practices show lower income per owner than solo practices significantly. The revenue and income are increased with increasing size of clinics. The high cost in renting the clinic office is found to have a big positive effect on the revenue but a little positive effect on the income. Interestingly the density of dentists shows negative effect on the lowest quantile of the revenue but positive effect on the highest quantile. The lowest quantile of the revenue in the capital areas have the relatively high revenue. The lowest quantile of the income in metropolitan city show higher income than those in other areas significantly. Conclusion: The suggested QRM is shown to have more effective and efficient tool in finding out determinants of dentists' revenue and income of our concern. The results of this study are expected to be employed for dentists preparing for the opening practices in their organizational settings and locational selections. The distributional efficiency of dental human resources could be accomplished if policy makers guide dentists with this knowledge.