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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 5, Issue 2 - Dec 1995
Volume 5, Issue 1 - Jun 1995
Selecting the target year
Distribution of Private Medical Practitioners' Income from Medical Insurance and its determinants
Health Policy and Management, volume 5, issue 1, 1995, Pages 1~30
This study was conducted to investigate the distribution of private medical practitioners' income from the medical insurance and its determinants. Total amount of the medical service fee paid by the medical insurance to 1,268 private clinics(767 in Taegu and 510 in Kyungpook that had been in practice at least for one year) in 1993 was compared by the characteristics of practitioner, clinic, patient and population. The practitioners in 40-49 years of age and 6-10 years inpractice had the highest income. Total income of a clinic was increased with the number of physicians, employees and equipments. The largest income differentials were observed among obstetrics and gynecology clinics and the least differentials were among pediatrics clinics. The characteristics of practitioner, clinic and population accounted for 41.7% of the total variance of income. The important determinants of income were specialty of the clinic, age of the practitioner and number of the employee and equipments. The large income differentials among clinics imply a skewed distribution of patients and thus long waiting time, inefficient utilization of manpower and inadequate quality of care. Effective measures to reduce the income differentials need to be developed.
Introducing the Insurance Health Care Delivery System and Its Impact on Patients Distribution of Medical Service Organizations
Health Policy and Management, volume 5, issue 1, 1995, Pages 31~58
The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.
A Study on the Evaluation of School Health Policy Performance Process of Korea -Focused on the Secondary School in Pusan City-
Health Policy and Management, volume 5, issue 1, 1995, Pages 59~79
This study intended to grasp the results of performance of school health policy and to provide information for the future policy performance in Korea. As the objects of the study we chose the secondary school(142 middle schools, 111 high schools) in Pusan, 1993. The contents of the study were about school health service and school health education. For the study we collected datum and took statistics through the existing theses, books, various statistics, and interviews with the persons concerned. Therefore the method of the study was basically emperical and demonstrative. The results of the study can be presented as follows : 1. the results of performance of health service proved to be 5.40% for vaccination against hepatitis B, 5.26% for typhoid fever, 6.65% for EH fever, and 9.84% for influenza in middle schools, In high schools' 5.76% for vaccination against hepatitis B, 0.03% for typhoid fever, 0.25 for EH fever, and 0.86% for influenza. 2. The results of policy performance of health education were found out 64.08% in middle schools, and 17.12% in high schools. 3. The factors which affected the results of performance of health service turned out 1) the improper standard of policy performace that applicants should pay their own expenses. 2) the lack of performer's will to carry out the policy owing to the improper standard. 3) the shortage of interorganizational enforcement activities and communications which influence the will of performance. 4. The affecting factors to the will of performance of health education proved to be 1) the improper standard that nurse-teachers can teach students in the classroom in case of need. 2) the lack of nurse-teachers due to the above inappropriate standard. 3) the lack of enforcement activities of supervising organs which employ and direct nurse-teachers. 4) the lack of activities of organs which should communicate one another and allot nurse-teachers of public schools without fail.
Revenue and Expenditure by Alternative Integration Proposals of the Medical Insurance Society for Self-Employed
Health Policy and Management, volume 5, issue 1, 1995, Pages 80~105
Assuming that we introduced integration of medical insurance society for self-employed, this study was conducted to examine effects and results after the integration and to research more effective method for integration. To assess effects and results of the finacial status of 266 insurance societies after intergration, the data were obtained from "The Medical Insurance Program for Self-Employeds Statistical Yearbook in 1992". The major finding are as follows : 1. Three alternative integration proposals were made. First alternative proposal was consisted of 232 medical insurance societies, second was 187, and third was 115. 2. As the results of average number of the insured per insurance societies of medical insurance program for self-employed every alternative proposal, first was 88, 119 persons, second was 108, 576, and third was 178, 967 from 76, 576 persons of present socienties. 3. It was true that the more average size of societies increased, the more average administration expenditure per 1, 000 insured reduced. 4. The average size of societies grew bigger, the rate of general expenditure to general revenue more improved. Also, the rate of benefits to contributions was changed for better. But if not to have had correct analysis and precise preparation for integration, effects and results of integration were always not optiized. 5. According to results of simple regression formulas, it was proved that the more the average size of societies was increased, the more result was advantaged. 6. The law of majority and the economy of scale were applied in this study, and it was necessary to analyze and assess effectiveness and efficiency of integration. Therefore, when the integration of medical insurance societies for self-employeds will be performed, it must be taken into consideration. Among three alternative proposals, third was showed more effective alternative than anothe, second was presented more ineffective result than present system. To achieve more effective and efficient integration of regional medical insurance societies throughout the result of the regression formula on present cost curve, it is necessary to operate well-integrated societies and to know appropriative countermeasures of present situation of each societies. Also, for integrating regional medical insurance societies, it is necessary to continue more deep research through practical model activity and to investigate the effective size and managed method of the societies.societies.
The Age of Medical Malpractice Crisis : Possibility and Limitation of Legal Resolution
Health Policy and Management, volume 5, issue 1, 1995, Pages 106~131
Nowadays there are a lot of medical accidents and medical disputes in Korea. Our government has made efforts to legislate The Medical Disputes Conciliation Law for several years. But this law has many problems. These problems are followings. 1. the problem of going certainly through compulsory screening panels before coming to court. 2. the possibility in making the impartial screening panels for malpractice claims 3. the utilization of a mutual aid association to have low efficiency in paying for damages by medical malpractice and so on. To resolve medical disputes rapidly, we must legislate The Medical Disputes Conciliation Law in a short time. However, all medical disputes are not rationally dissolved by only this law, The Medical Lsw(Arztrecht) is needed to improve the solubility of medical disputes through setting up the decision criteria.
A Study on the Factors of Managerial Performance in General Hospitals
Health Policy and Management, volume 5, issue 1, 1995, Pages 132~160
This study purported to acquire information necessary to improve the management of general hospitals. It tried to determine major indices which represent managerial performance of general hospitals and to identify the managerial characteristics of general hospitals which affect the major financial indices. Eighty-eight hospitals were chosen from 188 hospitals which were subject to standardization audit by the Korean Hospital Association. The results of a discriminant analysis are summarized as followings. First, when a single index was used to measure managerial performance of the sample hospitals, the ration of net profit to total capital was the best index and its discriminant power was 58.14%. The ratio of the number of boardmen((M. D.) and average daily medical cost were highly related to this index. Second, when two indices were used, income growth rte and the ration of net profit to total capital had the highest discriminant distinction ability. Their discriminant power was 61.9%. In this case, the ratio of the number of boardmen(M. D.) was significantly and highly related to the indices. Third, when all three indices-income growth rate, the ration of net profit to total capital and quick ratio - were used together, a discriminant function was statistically insignificant. Therefore, using all three indices was not useful in measuring managerial performance of the sample hospitals. In conclusion, using two indices-income growth rate and the ration of net profit to total capital-was better in measuring manegerial performance of general hospitals than using a single index. The independent variable which affected these indices was the ration of the number of boardmen. The discriminant function was :
*G=growth index(income growth rate) *I=profit index(the ration of net profit to total capital)
Estimating a Causal Model of Job Satisfaction in a Korean Hospital
;;Price, J. L.;
Health Policy and Management, volume 5, issue 1, 1995, Pages 161~191