• International Journal of Advanced Culture Technology
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• 제4권3호
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• pp.39-47
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• 2016

The state adopts the policies based on the goals pursued by the state and provides a basic policy for administrative activities related to early childhood education. Therefore, early childhood education policy should be established organically in consultant with the social consent in advance. In most countries will bear the costs of child care and early childhood education can reduce the financial burden of parents and early childhood education consumers are able to understand the will of the government to support the child care services, which they need in a variety of way. The conflict is deepening - among policy officials, front-line institutions participating in policy implementation, and parents - surrounding the infant and early childhood education. And the conflict has caused the difference between this policy and claims that cannot find hardly a solution. In this study, we argue how the policy differences between groups involved in the policy to analyze the influence, to find the policy conflict resolution strategies.

• 보건행정학회지
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• 제31권2호
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• pp.180-187
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• 2021

Background: This study analyzed the effect of applying the diagnosis-related group (DRG)-based payment system, which was implemented in July 2012 for hospitals and clinics nationwide, on the cesarean section rate. Methods: The subjects of the study were divided into new groups that participated in the payment system after July 2012 and maintenance groups that participated in the payment system before July 2012. As an analysis method, a difference-in-difference analysis, which is a quasi-experimental design, was used. The risk-adjusted cesarean section rate was used as a dependent variable. Results: Seven risk factors (malpresentation of fetus, eclampsia, multiple pregnancies, problems in the placenta, previous Cesarean section, cephalopelvic disproportion, problems in amniotic fluid) were included in the final risk-adjustment model, and found to have a statistically significant relationship with the cesarean section rate. Results showed that the risk-adjusted cesarean section rate increased significantly in new groups after the application of the DRG-based payment system. Conclusion: Study results provided policy implications for the reorganization of the DRG-based system should that reflects the demands of obstetricians, such as organizing a consultative body with obstetricians and establishing a reasonable fee.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.347-353
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• 2001

Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

• 보건행정학회지
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• 제10권4호
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• pp.20-56
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• 2000

The purpose of this article was to evaluate the effects of reimbursement system on the basis of diagnosis-related groups(DRGs). We searched articles which was published from 1970 to 2000 using MEDLINE ； Key words "diagnosis-related groups, DRGs, prospective payment system, PPS. Then we reviewed 97 articles on classifying them into several categories of contents. It seems that the effects of DRGs in controlling hospitals cost in the U.S. was not clear cut. The U.S. Medicare PPS using DRGs remains vulnerable to compensatory increases in ambulatory care and long-term care facilities utilization despite cost per case and cost per admission being reduced. Also some research indicated the possibilities of deterioration in health care service quality. So putting theses results together, much more consideration is needed before the application of DRGs reimbursement system in Korea. Particularly there is the crucial difference between U.S. health care system and Korean, we must be aware of the limitations of DRGs and revise the DRG system to applicable in Korea.orea.

• Journal of Preventive Medicine and Public Health
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• 제36권2호
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• pp.147-152
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• 2003

Objectives : To develop a Diagnosis-Related Group (DRG) fraud candidate detection method, using data mining techniques, and to examine the efficiency of the developed method. Methods ; The Study included 79,790 DRGs and their related claims of 8 disease groups (Lens procedures, with or without, vitrectomy, tonsillectomy and/or adenoidectomy only, appendectomy, Cesarean section, vaginal delivery, anal and/or perianal procedures, inguinal and/or femoral hernia procedures, uterine and/or adnexa procedures for nonmalignancy), which were examined manually during a 32 months period. To construct an optimal prediction model, 38 variables were applied, and the correction rate and lift value of 3 models (decision tree, logistic regression, neural network) compared. The analyses were peformed separately by disease group. Results : The correction rates of the developed method, using data mining techniques, were 15.4 to 81.9%, according to disease groups, with an overall correction rate of 60.7%. The lift values were 1.9 to 7.3 according to disease groups, with an overall lift value of 4.1. Conclusions : The above findings suggested that the applying of data mining techniques is necessary to improve the efficiency of DRG fraud candidate detection.

• 보건행정학회지
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• 제31권1호
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• pp.1-4
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• 2021

With this as a momentum of approval Pfizer vaccine against coronavirus disease 2019 (COVID-2019), it is changed to the era of vaccine rapidly. Most countries are trying to reserve effective vaccines and inoculate vaccines into high-risk populations for achieving community immunity. I reviewed several vaccine-related issues to be confronted for moving up to the end of COVID-2019: the efficacy and effectiveness of the approved vaccines, the priorities for vaccination into target groups, side effects, and distrust towards COVID-2019 vaccines. Evidence-based decision-making in the policy process and collaboration with professional groups are the most effective strategies for driving successful vaccination policy.

• 지역연구
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• 제33권4호
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• pp.19-28
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• 2017

본 연구의 목적은 기후변화 적응에 대한 공무원 도민들 간의 인식을 비교분석하는 것이다. 기후변화에 대한 두 집단 간의 인식차이를 확인하기 위해 집단별로 설문조사를 실시하였다. 설문조사를 통해 두 집단의 적응 정책의 우선순위 및 분야별 기후변화 피해에 대한 체감도를 조사하였다. 결과적으로, 두 집단 간에는 기후변화 적응 정책에 대한 인식차이가 있음을 확인하였다. 기후변화 적응정책은 정책 수립자와 수용자의 경계가 모호해질 때 정책적 효용성이 크므로, 본 연구는 인식차이를 통해 확인할 수 있는 집단의 특징을 분석하여 두 집단 간 인식격차를 줄일 수 있는 방향을 제시하였다.

• 한국치위생학회지
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• 제12권1호
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• pp.123-133
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• 2012

Objectives : This study was performed to understand smoking condition and to investigate the relations among knowledge regarding smoking and oral hygiene, awareness of anti-smoking policy, and self-esteem, to provide fundamental basis, developing programs for smoking prevention and anti-smoking. Methods : From September 7, 2010 to September 16, 2010, questionaire survey was conducted for 566 female university students studying dental hygienics at a local district in Jeollanam-do. Collected data was analyzed by Chi-square test, t-test, one way ANOVA, Scheffe multiple range test, Perason's correlation test, and stepwise multiple regression test. Results : 1. Smoking condition of study subjects on general characteristics showed 17.1%, where 14.0% of previous smoking history, and 68.9% of currently nonsmoker. 2. Analysis on the knowledge related to smoking and oral hygiene, awareness of anti-smoking policy, and self esteem on the general characteristics of study subjects have shown better awareness of anti-smoking policy in non-alcoholics. Significant difference was found in knowledge about smoking and awareness of anti-smoking policy according to current resident status, but no difference found in self-esteem. Higher academic grade was related to higher awareness of anti-smoking policy and better ics. aalcell. Better health, but no diffeoral hygiene were related to better awareness of anti-smoking policy, and bewhich were statistically significant. Favorable interpersonal self-estehip was related to better awareness of anti-smoking policy. 3. Analysis on knowledge regarding smoking related health and oral hygiene, awareness of anti-smoking policy, and self-esteem showed higher level of anti-smoking knowledge in non-smoking group(60.44) compared to currently smoking group or group with previous history of smoking, and better awareness of anti-smoking policy in non-smoking group(53.54) than other groups, which was statistically significant. 4. Correlation analysis among smoking related knowledge, awareness of anti-smoking policy, and self-esteem has found relatively high correlation between smoking related knowledge and awareness of anti-smoking policy, which was statistically significant(r=0.481, p<0.001). 5. Among factors influencing awareness of anti-smoking policy, higher level of smoking related knowledge and satisfaction to specialty was related to higher awareness of anti-smoking policy which was lower in current smoker than past smoker, and higher academic grade was related to higher awareness of anti-smoking policy. Conclusions : Following results emphasize the need to establish a novel curriculum by which effective programs for smoking prevention and education of anti-smoking specialist could be provided as well as promoting coaching anti-smoking activity.

• 보건행정학회지
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• 제20권2호
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• pp.17-39
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• 2010

This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers' behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions' the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.

• 보건행정학회지
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• 제29권3호
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• pp.277-287
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• 2019

Background: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups. Methods: This study utilized the National Health Insurance Service's National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of 'middle-aged'(45-64 years) and 'old-aged'(${\geq}65years$) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development "Health Care Quality Indicators" project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized. Results: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups. Conclusion: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.