• 한국보건간호학회지
• /
• 제19권1호
• /
• pp.148-160
• /
• 2005

Presented here are policy alternatives for understanding home health care for the long-term health care insurance system which is being developed for elderly people starting 2007. The summary of issues concerning home health nursing care under the long-term care insurance system include; 1) absence of comprehensive and systematic policy in home health care deliverly systems; 2) absence of community based home health agencies that are considered as the community residents in general. In order to overcome these problems and Issues, policy alternatives of home health care should 1) establish a comprehensive home health care policy for homebound persons; 2) establish the foundations for home health care nurses and community based home health care systems; 3) establish home health care facilities and infrastructure; and 4) promote research and development concerning home health care. Conclusively, a home health care system should be built on a comprehensive policy vision based on health policy, especially long-term care insurance system in the near future. Every homebound residents service has to be constructed systematically under suitable facilities considering the consumer characteristics and health conditions. By doing this, the consumer based comprehensive community home health care delivery system can be constructed in view of the long-term health care insurance system for elderly people.

• 보건행정학회지
• /
• 제32권3호
• /
• pp.247-257
• /
• 2022

The presidential election and the inauguration of the new government are a period of the policy window opening. The newly launched government is expected to improve the quality of life of the people. The Yoon Suk-yeol Government is also launched with new expectations with a transitional period in health care. The sustainability of health care in Korea is threatened. The environment of health care and the main policy issues of health care are difficult to secure the necessary finance for health care in spite of the increasing health care burden. Accordingly, the Yoon Suk-yeol Government's health care policy aims to provide intensive support to those in need of health and welfare and to improve the health of the people through investment in health. And for integrating fragmented health care and welfare services and creating people-centered community-based health care, a health care innovation center will be established for the evaluation platform of new delivery and payment systems, a health care development plan will be established for the blueprint of health care, and reorganizing the central & local government should be reviewed. Although we are facing unfavorable situations such as the distribution of the National Assembly, inflation, and the possibility of economic recession, we expect that announced health care policies will be implemented, recognizing that health care innovation is the only way to improve health care sustainability.

• 보건행정학회지
• /
• 제16권4호
• /
• pp.86-111
• /
• 2006

Either ways of understanding health care as a commodity or public work are at opposite ends of health care spectrum. These two rival conceptions reflected by viewpoint(ideology) would lead to different directions in policy-making for health care reform. The purpose of this study is to access the value differences of experts' policy views about health care issues by analyzing the extent of consensus among experts in the field of health care. Using primary data obtained through a mail survey of 558 experts in the field of health care, we analyzed the differences of experts' opinions about characteristics of health care market, policy issues and values Gdeology). The study represents from 50-50 split analysis, entropy index, and factor analysis that the wide spread disagreements over health policy, which is a major barriers to effective policy-making, could be caused by the ideological perception differences among experts. This implies that, if values play an important role in policy-making, we should identify the differences in value and seek ways to balance among the diverse values such as efficiency, equity, freedom, and security. For this, the policy issues debated on differences in values should be reconciled for narrowing gaps of experts' perceptions through various ways.

• 한국보건간호학회지
• /
• 제17권1호
• /
• pp.5-16
• /
• 2003

This policy alternatives for establishment of rehabilitation health care delivery system for the disabled in the community were developed based on the data of current health status and situations of health care management for disabled persons in Korea. This research was conducted with secondary data analysis for identifying health status and current situations of managing health of disabled persons, and discussed current issues for establishing rehabilitation health care delivery systems in the community. Observing the health status and current situations of managing health of disabled persons, scope and target population of disabled person extended. so prevalence rates increased. and the severity of disability intensified and specified. The summary of issues of health management for disabled persons included; 1) absence of comprehensive and systematic policy in rehabilitation health care systems. 2) absence of consumer based rehabilitation health care facilities and delivery systems that are considered as the characteristics of disabled persons 3) fixed form of projects based on the provider and lack of variety in the programs. Hereafter. to overcome these problems. policy alternatives should 1) establish a comprehensive rehabilitation health care policy for disabled persons. 2) establish comprehensive and specific community based rehabilitation health care delivery systems that can promote preventing disability. providing medical care for disabled persons, establishing rehabilitation management for disabled persons and health care when returning to society. 3) provide training and secure manpower for rehabilitation, but the training case managers who will take the roles as an expert rehabilitation nurse mediators for multidisciplinary team work are needed immediately. and 4) include efficient connection and provision of independent services for welfare rehabilitation service and health care. Conclusively. a community based rehabilitation health care delivery system should be comprehensive policy vision of the government on rehabilitation health care delivery System rehabilitation service has to be constructed systematically under suitable facilities con consumer characteristics and rehabilitation health care policy. By doing this, consumer comprehensive community rehabilitation health care delivery system could be constructed disabled person.

• 가정∙방문간호학회지
• /
• 제7권1호
• /
• pp.15-25
• /
• 2000

This article was trying to suggest an agenda and alternatives of home health care policy for the future home care growth and development and examine the significance of new health care law and regulations. In addition. It was to analyze and drive the home care system problems. of which was made an announcement on the 11th of April. that home health care project must be centered from the nationwide general hospital. As we have learned from the developed countries, the home health care have been closely related health care policy among the field of nursing area. Therefore. we need to understand our national health care policy and need to predict the future direction and goal of our home health care policy in order to enhance the growth and activation of health care system. Additionally. we also need to have a vision and ability to develop under our own health care policy with systematic and rational home care business escaping from past perspective and standpoint. We must create a master plan of home care system to fulfill one part of system of the function and an important role in order to pursue an advanced health care plan under our system. For instance. in the 21th century as we establish a master plan for the growth of our country home care plan with improving plan systematically and also we need to produce many highly qualified researching and good personal who can develop and maintain the system efficiently. Specially. based on the unique characteristics of our health care system and the direction of development of plan, we need to find and correct the problems which we have faced the present time, so that we can provide and reach the goal of advanced health care system which our government want to pursue. Finally. we have to strive our best effort to make our home health care system can be positioned and stand the right direction to have the benefit for every individual citizen in our country.

• 한국보건간호학회지
• /
• 제8권2호
• /
• pp.71-82
• /
• 1994

The article reviewed the elderly health care management problems in policy development issue of the nation. Policy of Korean government on elderly health care has still not yet developed. The main stream of policy which is effective on elderly welfare policy is 'Elderly care are responsible by their families'. Now only those aged whose family members are not able to take care of their parents are receive custodial care at the non-profit nursing homes. This article examined the main stream policy in pro and cons aspects in relation to social changes such as: demographic changes. family structure changes. attitude changes. health care delivery system. and political settlement view points in connection with medical insurance program. Finally. a model for the elderly health care management was proposed which will provide chronic care services at the community level. such as nursing homes. day care centers. day hospitals, respite care units, and special care institute for dementia.

• Journal of Periodontal and Implant Science
• /
• 제46권6호
• /
• pp.405-414
• /
• 2016

Purpose: This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods: A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results: Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions: The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

• 보건행정학회지
• /
• 제18권3호
• /
• pp.90-109
• /
• 2008

Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.

• 보건행정학회지
• /
• 제28권3호
• /
• pp.197-201
• /
• 2018

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

• 보건행정학회지
• /
• 제24권4호
• /
• pp.396-412
• /
• 2014

Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.