• Health Policy and Management
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• v.13 no.4
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• pp.48-65
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• 2003

Detailed analyses of total health expenditure and its sub­categories are essential for the evidence­based health policy(EBHP). These analyses, again, should be based on timely and reliable data that are comparable across countries. The System of Health Accounts (SHA), published by the OECD in 2000, provides an integrated system of comprehensive and internationally comparable accounts. The author has implemented the SHA manual into Korean situation, and examined overall expenditure estimate and its basic functional breakdown following the manual. This study explains how pharmaceutical expenditure is estimated. The results are, then, analyzed particularly from the international perspective. Both administrative data in Statistical Yearbooks (National Health Insurance, Medical Aid, Industrial Accident Compensation Insurance) and survey data on Health and Nutrition are used for the estimation. Per capita pharmaceutical expenditure in Korea (183 US$ PPPs) was far less than the OECD average (308 US$ PPPs) in 2001, but pharmaceutical expenditure share in total health expenditure (20.3％) was higher than the average (16.7％). This can be explained by the fact that there is a statistically significant correlation between pharmaceutical expenditure share and per capita GDP of each country. Korean people follow the tendency of relatively low­income countries to spend less than OECD average for health care, but follow again their tendency to spend more on drugs than on other health care services. In consideration of results and analysis as above, per capita pharmaceutical expenditure in Korea is expected to grow in the future, but the growth rate of the pharmaceutical expenditure is expected to be less than that of overall health expenditure.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.1
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• pp.1-13
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• 2019

Backgrounds : The market of Complementary Alternative Medicine(CAM) in the United State(U.S.) accounts for a large proportion of the global CAM market and has a high growth rate. The recent introduction of Obama Care has brought the change in the health insurance system for CAM, and we need to analyze it for its implication to Korean system. Objectives : The purpose of this study is to investigate the current status of acupuncture and chiropractic health insurance in the U.S., and to draw implications for expanding the health insurance coverage for Korean traditional medicine through the comparison between the U.S. and Korean health insurance systems. Methods : We examined the data through the literature search and from the websites of both U.S. government departments and related organizations for the health insurance policy. Based on the collected data, we analyzed its CAM health insurance system in Korea. Results : The acupuncture covered by public health insurance in the U.S. has a limit in the number of treatments and a range of applied diseases compared with Korea. In addition, the practice of acupuncture is not subdivided. However, the chiropractic in the U.S. which also has a limited number of coverage and only three categories of practices are similar to that of Korea. Conclusions : Although the use of CAM by public health insurance is not active in the U.S., but the organizations such as Veterans Health Administration in Vermont is already discussing the use of acupuncture to solve the problem of opioid overuse. Thus Korea also needs to discuss to promote the expansion of the insurance system for CAM.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.1-12
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• 2002

This study, aimed to categorize pattern of impatient's families in the ICU and to provide useful data for development of family-supportive program was conducted from June, 12 to Aug., 28, using Q-method. After reviewing the literature the researcher proceeded to interview 4 impatient's families in the ICU, developed the statement from consisting of 38 items, and then 30 impatient's families in the ICU were sampled. The collected data were coded after having been scaled from 1 to 9 points, and analyzed using the PC QUANL program. Three types were identified; The first type focused on self-regret about the impatient, the second type of families had some concerns for their health, and the third type was thinking of preparing for their future-lives, such as insurance and savings. It was common to feel powerlessness, regret, compassion, grief and anxiety in all types. They wanted to be given some information, the prognosis of patient and the way to overcome. The study will offer better understanding for family-centered approach and be useful for the system of orientation about impatients and their families.

• Journal of Korean Dental Hygiene Science
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• v.3 no.1
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• pp.15-24
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• 2020

Background: The program aims to enable the participants to receive oral health care with sustainability and give them the choice and prior autonomy of dental practitioners while enhancing the benefits of sustainability. The purpose of this study is to investigate the necessity, awareness, and satisfaction of the implementation of the registered dentist program for children and adolescents, and to promote the introduction of RDPCA. Methods: The survey targeted adult residents in their 20s or older who live in Seoul, an area that continuously implements the RDPCA system, especially in the cities of Cheonan and Asan Results: 79.7% were the most unaware. However, RDPCA participants were significantly more aware than non-participants. When surveying the desire to participate in RDPCA, 96.6% of the respondents said they would 'participate' in the non-RDPCA participate group. The analysis of the satisfaction level of the RDPCA received by their children indicated that 48.6% expressed their satisfaction, and 47.3% said they were healthy. There was a high percentage of people who said they would recommend RDPCA to others as well as a high rate of those who said they would continue to use RDPCA. Conclusions: The reality is that the awareness and implementation of RDPCA are low. For the development of oral health care programs for all children and adolescents in Korea, and the improvement of the satisfaction level of the dental care system, there should be an active consideration of high-quality programs and.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.145-152
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• 2015

Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta-synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• Journal of East-West Nursing Research
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• v.18 no.1
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• pp.25-30
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• 2012

Purpose: The purpose of this study was to verify the influence of health point system on the lifestyle among the patients with chronic diseases listed in iCDMS, a project of the Incheon Metropolitan Center for Chronic Disease Control and Prevention. Methods: The data were collected 1,000 persons among the patients listed in iCDMS from March 16, 2009 to December 21, 2010 by telephone survey. The data were analyzed by descriptive statistics, ${\chi}^2$-test, odds ratio and logistic regression with the SPSS 18.0 program. Results: The higher the percentage of the accumulation of the points of necessary medical examinations they have, the better the lifestyle the participants practice moderation in drinking, exercise, and diet (p<.05). Also the higher the percentage e accumulative points of education and visit, the stronger the intention to improve the lifestyle such as for example, receiving the guidance of no smoking, giving up drinking, or being conscious of nutrition and obesity (p<.05). Conclusion: This study suggests that the motivation through an incentive system can increase self-care make an effect on the care of patients with chronic diseases.

• Health Policy and Management
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• v.33 no.3
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• pp.243-252
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• 2023

This paper aims to introduce Korea's total current health expenditure (CHE) and National Health Accounts of the year 2021 and their 2022 preliminary figures constructed on the basis of the System of Health Accounts 2011. As CHE includes expenditures for prevention, tracking, and treatment of coronavirus disease 2019 (COVID-19) and compensation for losses to medical institutions from 2020, the details are also introduced. Korea's total CHE in 2021 is 193.3 trillion won, which is 9.3% of gross domestic product (GDP). The preliminary figure in 2022, 209.0 trillion won, exceeded the 200 trillion won line for the first time, and its "ratio to GDP" of 9.7% is expected to exceed the average of Organisation for Economic Co-Operation and Development member countries for the first time. Korea's health expenditures, which were well controlled until the end of the 20th century, have increased at an alarming rate since the beginning of the 21st century, threatening the sustainability of national health insurance. The increase in health expenditure after 2020 is partly due to a temporary increase in response to COVID-19. However, when considering the structure of Korea's health insurance price hike, where the ratchet effect of increased medical expenses works particularly strongly, it is unlikely that the accelerating growth trend that has lasted for more than 20 years will stop easily. More aggressive policies to control medical expenses are required in the national health insurance which not only constitutes the main financing sources of the Korean health system but also has the most powerful policy means in effect for changes in the health care provision.

• Journal of Korean Academy of Nursing
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• v.16 no.3
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• pp.108-122
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• 1986

Changing concepts of health care, are stimulating the demand for health care, thereby orienting society to health care rights to such an extent that they are deemed as fundamental ones inalienable to man. Concomitantly, qualitative as well as quantative improvement is being sought in the nursing service field. Today, efforts are being made in various areas, especially to qualitatively improve nursing services. A second issue concerns proper staffing. It is important to study staffing, in as much as it continues to be the most persistent and critical problem facing hospital nursing administrators today. It involves quantity, quality, and utilization of nursing personnel. A great deal of attention has been focused on this problem since mid 1930's when nursing services began to be felt as an important segment of hospital operation representing the largest single item of hospital budgets. Traditionally, the determination and allocation of nursing personnel resources has relied heavily on gloval approaches which make use of fixed staff-to-patient ratios. It has long been recognized that these ratios are insensitive to variations between institutions and among individual patients. Therefore, the aim of this thesis is to point to the urgent need for the development of methodology and criteria suited to the reality of Korea. The present research selected one place, the W Christian Hospital, and was conducted over a period 10 days from January, and nurses who were them on duty in their unit. The total num-her of patients surveyed was 1,426 and that of 354. The research represents many variables affecting the direct patient care time using the result from the direct observation method, then using a calculation method to estimate the relationship between the patients care time and selected variables in the hospital setting. The amount of direct patient care time varies with many factors, such 89 the patients age. diagnosis and time in hospital. Differences are also found from hospital, clinic to clinic, ward to ward, and even shift to shift. In this research, the calculation method of estimating the required member of nursing staff is obtained by dividing the time of productive patient care activity(with the time of patient care observed), by the sum of the productive time that each the staff can supply, i.e., 360 minutes, which is obtained by deducting the time for personal activities. The results indicate a substantial difference between the time of productive patient care observed directing and the time of the productive patient care estimated using calculating method. If we know accurately the time of the direct patient care on a shift, there required number of staff members calculated if the proper method can be determinded should be able the time of the direct patient care be estimated by the patient classification system, but this research has shown this system to be in accurate in Korea. There are differences in the recommended time of productive patient care and the required number of nursing staff depending upon which method is used. The calculated result is not very accurate, so more research is needed on the patient classification system.

• Journal of Digital Convergence
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• v.19 no.12
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• pp.513-521
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• 2021

The purpose of this study is to suggest an anti-aging health care plan through a literature analysis of the life activity system of Oriental Medicine. The source of normal maintenace, development, and change of the natural world and the human body's life activity process is the dynamical cooperative equilibrium of the internal Shen-Ji's discipline that creates, grows, changes, makes differences and stores(生长化收藏) and external Qi-Li's process of change from birth to growth, maturity to old age and ending of life(生長壯老已). Therefore, it was analyzed that the natural and human life activity processes are normally maintained, developed, and transformed. As a result, when the natural healing power of Genuine-Qi, the source of the human vitality, rises with the 'breathing massage' that combines a static breathing method which is anti-aging health care method applying the lifting entering movement of Qi and a dynamic abdominal massage, and it harmonizes the Shen-Ji which is the life process system and Qi-Li so that it is believed to be helpful in prolonging a healthy lifespan.