• Health Policy and Management
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• v.23 no.1
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• pp.3-18
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• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.8
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• pp.325-333
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• 2020

This study compares the rapidity and subjective convenience of T-AED and SC-AED for health care providers and the general public. Subjects were randomly allocated to T-AED (n=77) and SC-AED (n=79) groups. Each group conducted defibrillation, with subsequent measurement of the rapidity of defibrillation in peri-shock pause, pre-shock pause, hesitation pause, and post-shock pause. Defibrillation and chest compression delay times for both equipment were analyzed by t-test. On conclusion of the experiment, subjects answered a questionnaire on the subjective convenience of defibrillation, as measured for confidence, convenience, and clear decision. Comparisons of subjective convenience analyzed by t-test revealed significantly shortened peri-shock pause (11.22s), pre-shock pause (11.04s), and hesitation pause (2.15s) in the SC-AED group, as compared to the T-AED group (p<0.001). However, no significant differences were observed for post-shock pause values. Comparing subjective convenience, confidence (T-AED: 7.62±1.25VAS vs. SC-AED: 7.80±0.98VAS, p=0.358) was not significant, whereas convenience (T-AED: 7.05±1.36VAS vs. SC-AED: 8.95±0.89VAS, p<0.001) and clear decision (T-AED: 6.58±1.73VAS vs. SC-AED: 9.08±0.98VAS, p=0.001) showed statistically significant differences. Our results indicate that compared to T-AED, SC-AED has significantly shortened pauses. Moreover, it is more convenient for the user, and significantly aids in clear decisions.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5773-5779
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• 2014

Background: Since cervical cancer can be prevented and controlled through human papillomavirus (HPV) vaccination, it is important to train health care providers and provide them with appropriate knowledge. This study aimed to understand the level of HPV related knowledge among medical students and correlates in Southwest China in order to address any potential gap in their knowledge base. Methods: We conducted a cross-sectional survey among medical students in six selected universities across Southwest China based on a pretested questionnaire regarding HPV infection, cervical cancer, and HPV vaccines. Results: We successfully surveyed 1, 878 medical students, of whom 32.1% were males and 67.9% were females. Their mean age was 20.8 (standard deviation: 1.3) years. 91.8% of them were ethnic Han Chinese, and 43.8% were students in clinical medicine. While 76.5% had heard of HPV only 48.8% knew that the prevention of cervical cancer was possible through HPV vaccination. Only 42.9% of the male and 49.2% of the female students correctly answered over 10 out of 22 questions on HPV related knowledge. Female students appeared to know more about HPV and HPV vaccination (OR: 1.39; 95% CI: 1.11-1.75). In addition, the student knowledge improved with the grade (p<0.001). University courses were the most selected source of knowledge about HPV vaccination (66.4%). 83.6% of males and 91.4% of females were willing to have more HPV related education by experts (p<0.001). Only 10.1% of the students acknowledged that people had asked for their advice regarding HPV vaccination. Conclusions: Our survey indicates that medical students from Southwest China have poor knowledge of HPV and HPV vaccination, but are willing to receive more relevant information. Targeted education should be incorporated into school courses to inform these future health care providers and ensure success of programs for cervical cancer control and prevention.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.4
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• pp.201-209
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• 2020

In this study, issues related to changes in base year, which have controversial effects on fees in service contracts, were reviewed. In this regard, sensitivity analysis was conducted on the effects of changes in base year on conversion factor by type. The benefits and disadvantages of each specific type of medical institution were examined. Main conclusions are as follows. First, changing the base year to be closer to the present time had a beneficial effect on the conversion factor of hospitals. Second, changing the base year to be closer to the current point of time had an adverse effect on the conversion factor of pharmacies and clinics and had a significant adverse effect on clinics. Third, assuming that a single conversion factor is collectively applied to all types, a favorable effect occurred in all cases when the base year was changed to be closer to the present time. Base year changes can bring about conflicts of interest between insurer and providers, and within providers. Therefore, changing the base year should be pursued upon mutual agreement on a reasonable basis for resource allocation. In addition, it is necessary to provide incentives for temporary compensation for the types of losses incurred.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.1
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• pp.109-121
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• 2006

The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.504-516
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• 2018

Many countries have tried to reform financing systems toward UHC and paid attention to the function of strategic purchasing. This study was performed to examine theoretical foundations and the function of strategic purchasing. And we examined the functions of strategic purchasing in Korea based on the framework proposed by Preker(2005). For this purpose, we reviewed literature related to purchasing. we defined the strategic purchasing as strategic activities to provide health care services people need within a given budget, which is carried out by certain organizations, purchasing organizations. These activities include selecting appropriate providers, designing and operating the payment system, setting the price, and determining the target populations and their needs etc. The relationships among government, purchasers and healthcare providers can be explained by the principal-agent theory. In addition to Preker's framework, we emphasized the importance of the infrastructure such as decision making support systems, information systems, health care resource management systems, or expenditure monitoring systems. The National Health Insurance Service and the Health Insurance Review & Assessment Service play major roles in performing strategic purchasing.

• Journal of Service Research and Studies
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• v.12 no.4
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• pp.19-29
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• 2022

This study is a descriptive survey using a self-reported survey method to understand the effect of language and non-verbal communication of medical service providers on customer satisfaction through Lapport and to determine the degree of impact on Lapport by adjusting perceived service authenticity. The data collection period was from April 5 to April 30, 2021. Using the convenience sampling method, data were collected from users of medical institutions located in Busan and Gyeongsangnam-do, and a total of 306 valid questionnaires were used as statistical analysis data. The collected data were analyzed using the IBM SPSS statistics version 25.0 and AMOS 20.0 programs through a coding process. In the results of this study, it was found that the language and non-verbal communication of medical service providers influenced customer satisfaction through Lapport, and the perceived service authenticity in the relationship between each variable acts as a moderating effect. Considering that the language and non-verbal factors of the medical service provider are important in the interaction between the medical service provider and the hospital user, the medical service provider should take full account of the language and non-verbal factors and help the medical institution communicate with the hospital user.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.2
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• pp.35-44
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• 2023

Objective : This study sought to explore occupational therapy students' awareness of Developmental Rehabilitation Services (DRSs) and the certification of Sensory Developmental Rehabilitation Service Providers (SDRSPs). Moreover, it also aimed to examine the differences in students' awareness based on general characteristics. The findings were intended to provide a foundation for research on sensory developmental rehabilitation. Methods : An online survey was conducted among 199 occupational therapy students nationwide from October 4 to November 5, 2022. Frequency analysis was used to assess the general characteristics and additional items. Both descriptive statistics and frequency analysis were employed to assess the students' awareness of DRSs and SDRSP certification. Any differences in the students' awareness based on their general characteristics were examined using t-tests and an analysis of variance. Results : The students' awareness of DRSs was moderate (4.50 ± 2.40), while their awareness of SDRSP certification was also moderate (4.22 ± 2.55). The awareness of DRSs varied significantly based on the students' academic year and child-related practice experience. Similarly, the awareness of SDRSP certification differed significantly based on the students' academic program, academic year, recognition by the related department, and child-related practice experience. Conclusion : The occupational therapy students expressed a strong intention to provide DRSs and become certified as SDRSPs. However, their awareness levels were moderate. These findings emphasize the importance of educational efforts and the provision of relevant information about DRSs and SDRSP certification in universities to foster the development of competent SDRSPs.

• Health Policy and Management
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• v.23 no.2
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• pp.152-161
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• 2013

Korea has a single National Health Insurance program and all citizens are covered under this program, accounting 97% of the population, approximately 50 million people. Claims submitted by Health care providers are reviewed by Health Insurance Review and Assessment (HIRA) for the reimbursement. HIRA database contains not only individual beneficiary's information, but also healthcare service information such as diagnosis, procedures, prescriptions and tests for them. HRA database has gained attention as importance source for research due to its rich healthcare information and the demand of HIRA database has increased. Due to its tremendous size, however, researchers have had problems in accessing the database to conduct research. To meet this demand, we conducted a study to develop the inpatient sample data from HIRA database for research. This study has two purposes: 1) to determine a needed sample size; 2) to test reliability and validity of the sample data. We determined an adequate sample size to ensure representativeness and generality with additional consideration for convenience of calculation. The minimum sample size was 729,904 for the generality, and 488,861 for representativeness. After considering the convenience of calculation, our final sample size was 13% of the population, which was about 7.7 million beneficiaries. Age (5 years interval) and gender were used as stratification variables for sampling. In order to examine whether this sample data appropriately reflect population, we tested the reliability and validity of the sample data. From the sample data, we computed average expenditure of total claims per inpatient for 2011, frequency of top 30 disease, estimation of the number of stroke patients from the sample data, and then compared them to those from the population. Results confirmed reliability and validity of the sample data.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7143-7147
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• 2013

Background: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. Objective: This study aimed to explore the decision making experiences of women with early breast cancer. Materials and Methods: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. Results: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. Conclusions: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.