• Proceedings of The Korean Society of Health Promotion Conference
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• 한국보건교육건강증진학회 1999년도 3rd International Symposium
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• pp.149-163
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• 1999

Department of Health Services, under the Ministry of Health, Nepal has adopted the five year plan and Primary Health Care service as the main strategy to provide basic health service at the rural areas. However, development of the Specialized Services in the Urban areas, Human Resource Development, Management Strengthening and Investment of Private and External Sector are also highly entertained through its Liberalization Policy. But due to, Early Marriage, Superstitious Traditional Beliefs ＆ behavior, Poor Sanitation of living, Poverty, Illiteracy, Lack of Supervision and Monitoring, High Density population in relation to arable land and Lack of Private and External Sector Investment, the Country is still suffering from high Fertility, Malnutrition, Infectious diseases and so high Death Rates. So Primary Health Care Services should be more emphasized than before; Community Financing, Private and External Sector should be highly involved; Manpower Development and Specialized Services should be most taken care; Management Skills be more strengthened and Evaluating the previous work and avoiding the mistake for the future program implementation should be well done. If these are improved, then the health will be definitely promoted to meet the Health Target of Nepal.

• The Southeast Asian review
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• 제28권1호
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• pp.173-218
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• 2018

This study focuses on the healthcare sector in Vietnam which is promoting universal health insurance for the achievement of Universal Health Coverage (UHC) under Sustainable Development Goals (SDGs). The purpose of this study is to examine the characteristics of the reform process of the health care system and the law on health insurance through the historical and cultural contexts and its implications from the perspective of development. Based on the three dimensions of UHC - extension of protection for population, provision of various medical services, and financial protection, the current status of the Vietnam healthcare sector is summarized respectively as follows. First, according to the revised Health Insurance law which came into effect in 2015, the mandatory health insurance premiums are calculated based on household units. Second, there is a medical network that can provide preventive and healthcare services centered on primary health care facilities, for example commune health stations (trạm y $t{\hat{e}}$ $X{\tilde{a}}$). Third, out-of-pocket expenditure is still a large proportion although public spending has increased and private spending has decreased since the enforcement of the health insurance law and various schemes. Vietnam is currently striving towards a universal health care system. The development of institutions and systems should be designed in a way that is appropriate for the members of the society rather than efficiency. This article findings shed light on the role of social values, family culture, and informal institutions.

• Korea Journal of Hospital Management
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• 제9권3호
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• pp.18-48
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• 2004

Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.

• The Korean Journal of Health Service Management
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• 제12권4호
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• pp.85-102
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• 2018

Objectives: In order to cope with the quality and the substantiality issues in long-term care for the elderly, we should have a wider view of long-term system components based on the understanding of health care organizations, management services, support for care providers and beneficiaries, education of the workforce, and management of finance and resources. Methods: For resolving the issues raised and offering guidance in the area of long-term care, we reviewed 20 reports and documents of the government and government-related institutions using the Internet home pages of the Australian government and the related organizations in the health care sector. These organizations are undergoing a huge system reform to implement consumer-directed care since 2015, in the areas of service, resources, finances, organization, and management. Results and conclusions: The study outcomes can have some implications for the long-term care system in Korea based on the differences in the service components. The results can provide basic information for improving the long-term care service, and can have several other implications for long-term care in Korea.

• The Journal of Korean Medicine
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• 제35권1호
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• pp.145-156
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• 2014

Objectives: Korean medicine hospitals, since they first emerged in the early 1970s, have rapidly become a new member of the hospital population. As it was a new organizational frame for traditional medicine, we tried to analyze the changes of Korean medicine hospitals coping with institutional environment and their relative positioning in the whole health care sector. Methods: On the basis of Scott and his colleagues' identification of the three components of institutional environments, changes in organizational logics, actors, and governance of Korean medicine hospitals during the period from 1971 to 2010 were analyzed. Results: First, Similar to previous literature on institutional eras of Korean health sector, three distinct periods were characterized: the foundation of Korean medicine hospitals to consolidate the legal status(1971~1986), a rapid increase of entrepreneurial hospitals through cultural-cognitive legitimacy(1987~2001), and the reinforcement of specialization and competition(2002~present). Conclusions: Results suggested that: (1) changes in institutional environments hada heavy impact on structural and behavioral changes among Korean medicine hospitals, but the pace was slower than that of western medicine hospitals. (2) In structure, Korean medicine hospitals have positioned themselves as unofficial long-term care hospitals, focusing on chronic diseases(e.g. cerebrovascular disease). Our study demonstrated that organizational theories can provide useful framework for the analysis of Korean medicine and related policies. Indeed, one of the most important implications of this study is that understanding changes in institutional environments is important to understand the process of how members of the health care sector live, grow, change, decline and survive.

• Health Policy and Management
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• 제2권1호
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• pp.147-166
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• 1992

The purpose of this study is to analyze the effects of the health center hospital on the health service utilization pattern of the rural population in a county. Two field studies had been conducted in Yonchon County, Kyunggi Province, on February 1989 and on August 1991 before and after the establishment of the Yonchon health center hospital. This study revealed that Yonchon health center hospital occupied 7.3% of total outpatient visits and 16.8% of hospitalization of the county population and the self-sufficient rate of the outpatient visit and hospitalization of Yonchon County between two field studies increased by 1.7% and 20.9% each. Yonchon health center hospital contributed to the growth of the public health sector but it weakened the role of health sub-centers. For the efficient health service utilization of the population in that County, more investment to health center hospital would be needed and the primary health activities of the health subcenter should be enforced.

• Health Policy and Management
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• 제32권1호
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• pp.3-13
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• 2022

Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

• Health Policy and Management
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• 제20권3호
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• pp.36-57
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• 2010

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea's health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high, compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage, income inequality after deduction of health care expenditure should be continuously monitored.

• Korean Journal of Health Education and Promotion
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• 제7권2호
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• pp.78-88
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• 1990

The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

• KDI Journal of Economic Policy
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• 제12권3호
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• pp.47-69
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• 1990

The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.