• Journal of agricultural medicine and community health
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• v.42 no.3
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• pp.155-167
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• 2017

Objectives: The purpose of this study was to examine the performances and limitations of health community building project of 148 village in Gangbuk-gu, Seoul on community health organization perspective. Methods: we conducted a qualitative study using both a systematic review of this project and in-depth interviews with the operators who had worked for the project from January 2012 to December 2012. Results: In this project, activists worked by gathering the opinions of the residents and focusing on their growth. The residents themselves established a community health care plan. Based on social determinants of health, they continued projects to solve residents' needs. A variety of programs were activated by providing a health cafe, which was an alternative public participation health promotion space that was not a clinic or a public health center. As the various entities gathered, there were difficulties related to interests and role sharing, and there were limitations such as the fact that the performance and limit of the pilot project could not be clearly predicted beforehand. Conclusions: This case suggested that new possibility of health and medical movement, approaching health issues by the way of community organization principle. Through the health community building project as community health organization perspective is expanded, health promotion effect will be created in the whole society.

• Health Policy and Management
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• v.34 no.2
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• pp.196-210
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• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• Journal of the Economic Geographical Society of Korea
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• v.22 no.4
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• pp.405-421
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• 2019

International aid to North Korea remains far below the humanitarian needs of vulnerable people. This paper examines the trajectory of international humanitarian assistance to North Korea over the last two decades with the focus on its decline in the context of the country's nuclear standoff and corresponding stringent sanctions. In so doing, the paper addresses major problems associated with North Korea's reception of foreign aid and operational constraints placed on humanitarian activities in the country. It shows that humanitarian assistance to North Korea has been largely shaped by geopolitical dynamics. A survey of UN reports and statistics also suggests a shifting trend in recent international aid to North Korea. The decline of aid and multiple operational obstacles faced by humanitarian organizations, for instance, have led to a fall in agricultural support and a proportional rise in health and related services. While UN Security Council resolutions include an exemption provision, humanitarian assistance to North Korea has been constrained by stringent sanctions, which have led to adverse consequences for the civilian population. In this regard, the paper suggests some policy directions for international aid to North Korea amidst negotiations over denuclearization, while stressing an urgent need to address the negative impact of sanctions on vulnerable groups in the country.

• Korean Journal of Social Welfare
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• v.55
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• pp.205-230
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• 2003

This article examines the continuity and change of Korean welfare regime during 1990s. Democracy, globalization and the financial crisis changed the landscape of Korean society as a whole and provided a catalyst for the change of the Korean welfare regime. In order to show how and what changed in Korean welfare regime, this study concentrates on the transformations of income maintenance programmes and social welfare services. The changed aspects are as follow: (1) The ratio of social expenditure to GDP has increased during 1990s and now stood at ten percent level. (2)Rather than backing up the company welfare, government strove to build and expand income maintenance devices for all citizens. (3) The poverty and inequality reduction effects of income maintenance programs are very weak in early 1990s, but they are gradually getting stronger impact on poverty and inequality. But, there are also continuance. (1) In spite of the relative development of income maintenance programs, social welfare services are still poorly designed as before. (2) The expenditure level of social welfare services shows sharp contrast to income maintenance programs and lagged behind the other OECD countries. (3) The expansion of social service sector employment are also not so salient. In 2002, social service employment is only at close to 2.5 per cent of the total employment. Accordingly, korean welfare regime is now characterized by a model which is to curb poverty and inequality by engaging in direct government provision of income maintenance programs, but refrain from expanding social service by relying on net welfare which encourage the provision of services within the family. A implication of our analysis is that the expansion of social welfare Korea saw after 1997 was not really an regime shift. According to the arguments of Peter Hall, first and second order changes in policy do not automatically lead to third order changes which imply regime shift. Policy changes which occurred during 1990s was not accompanied by a shift in policy paradigms. Family dependency in welfare is not yet changed.