This study is designed to estimate an appropriate level of patient's cost-sharing for oriental medical services in the Korean National Health Insurance. The findings of this study can be summarized as follows: 1) The current co-payment system for oriental medical services does not reflect its cost structure in clinical practice due to inconsistency of cost-sharing plan in the NHI. 2) Both oriental medical institutions and their patients, as a result, are at a relative disadvantage in financial burden, compared with other services. 3) The substantial proportion of patients' cost-sharing depends on the amount of co-payment and the range of medical cost that a flat rate is applied to. 4) The extension of the range doesn't make any substantial decrease in patient's cost-sharing. 5) The fixed amount of co-payment is more sensitive than a range to total variations of patient's cost-sharing. Based on the above, the budget impacts of a new co-payment system were estimated for each co-insurance rate, according to given scenarios. The results range from -59 billion Won (-8.5%) to 16 billion Won(2.3%).

Organizational culture has been, by and large, regarded as one of the most significant factors to manage organizations. Especially the understanding of empowerment is pivotal, leading to explain organizational cultures. For hospital workers whose services are closely related to quality and performance of their hospitals, empowerment is now called upon more than ever before. This study is intended to investigate the relationship between organizational culture types and hospital workers' empowerment levels. The data were collected from 589 hospital workers at one university hospital and two general hospitals using the self reported questionnaire from Jan.9 to Jan.20 in 2004. The findings were as follows: 1. Empowerment levels were significantly different among the four organizational culture types. Developmental culture group showed the highest empowerment score(3.74), and next were group culture(3.64), rational culture(3.62), and hierarchial culture(3.46). 2. There was a significantly positive correlation between group culture and empowerment(r=.298, p<.000), between developmental culture and empowerment(r=.295, p<.000). But there was not a significantly correlation between hierarchial culture, and between rational culture. 3. According to the multiple regression analysis, self-esteem(${\beta}$=.417, p<.001), position (${\beta}$=-.190, p<.001), self-control(${\beta}$=.185, p<.001), and age(${\beta}$=.169, p<.01) were significant among general properties for organizational empowerment. As for organizational cultures, developmental culture(${\beta}$=.165, p<.001), group culture(${\beta}$=.099, p<.01), and rational culture (${\beta}$=.063, p<.05) were significant other than hierarchial culture. In conclusion, it is necessary to promote group culture and developmental culture to enhance hospital worker's empowerment level, and this article elucidates that understanding the organizational culture embedded in each organization is important for efficient management of organization.

The purpose of this study was to identify a determent of mastery approach goal and performance approach goal using a basic concept of goal orientations and goal setting theory, and to evaluate a preference of goal achievement index as a balance score card (BSC). The study model proposed had a adoptable level of goodness of fit index(.94) and root mean square residual(.08). The meditating variable, goal contribution, totally mediated the impact of goal commitment, Y-theory human behavior, and self-efficacy but organizational resource contribution for pursuing goal orientation. Moreover, goal contribution significantly determined mastery approach goal(p<.01) and performance approach goal(.05). In standardized effects, the most powerful antecedent of mastery approach goal and performance approach goal were in order of organizational resource contribution(.27/.28), goal contribution(.21/.17), self-efficacy(.07/.06), and Y -theory human behavior and goal commitment(.05/.05), respectively. Moreover, goal contribution had a more powerful impact on mastery approach goal(.21) rather than performance approach goal(.17). In the preference of BSC, all job types preferred learning and growth index in first. In the second preference, medical doctors and pharmacists chose financial results, nurses customer service, and office managers internal processes. Each job type reflected its' own preferred BSC index to that of the other job types. In comparing a preference of four BSC index of each own job type, it was statistically different at p<.001. In conclusion, one who emphasize organizational goal contribution in pursuing goal orientation has a more strong orientation toward mastery approach goal rather than performance approach goal. A hospital should overcome and harmonize the different preferences of four BSC index since the differences might cause organizational conflicts among job types with having each unique professional norm.

This research purposed to analyse the diversity of the long-term care system based on the dependency/independency of the aged. For this purpose, we divided the long-term care systems to three components; form of benefit, generosity of benefit and delivery system. Form of benefit is whether the benefit is cash or in-kind, and the generosity of benefit is related to the level and coverage of benefit. The last concerned to focus on provider and user selection. According to this, we tried to make an ideal type of long-term care in the perspective of citizenship and consumerism. As a result, we established four types of long-term care system; active citizen type, passive citizen type, latent citizen type, and family dependent type. And we investigated Austria, Sweden, Germany and Korea for each type empirically.

This paper critically reviews three decades of research on geographic variations. in health services utilization in the United States, thereby drawing policy and research implications for Korea. The recent renewed interest in variations research in the United States, precipitated by studies on regional variations in Medicare expenditures, stems mainly from the policy implication that a substantial amount of Medicare expenditures could be saved without compromising quality and access. From the research perspective, this policy implication was made tenable by integrating micro- and macro-level analysis of variations in health services utilization. Still, theoretical limitations inherent in the research pose great challenges to developing effective strategies at the health system level. Variations research in the United States can serve as a case study as to how health services research has responded to efficiency and quality issues in an ever expanding health system Considering the current health policy and research environment in Korea, the following implications can be drawn. Variations research will help formulate a national policy agenda for health care quality and also advance the framework of approaches to health policy issues. For such purposes, both relevant descriptive and hypothesis-testing studies are needed. Further advancement in variations research will require interdisciplinary explorations and methodological sophistication. To the extent that Korean health policies will strive to achieve complex goals, variations research will increasingly prove to be useful.