• Title/Summary/Keyword: Medical reform

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Direction of Healthcare Reform for Sustainability (지속 가능한 보건의료의 혁신 방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.4
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    • pp.379-381
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    • 2019
  • Korea's healthcare is in great danger of sustainability. In 2020, the baby boomer will begin to be older, and there is no promise that the total fertility rate of 1.0 or less will rebound, and Korea's economic growth rate is predicted to be less than 2%. Together with these phenomena, Plan for Benefit Expansion in Nation Health Insurance (Moon Jae-in Care) will seriously threaten the sustainability of health insurance finance. In addition, health care in Korea has many problems: excessive medical utilization, rapidly increasing elderly medical costs, concentrating patients into big hospitals, low healthcare personnel but many healthcare facilities and equipment, bad quality of primary and mental care, and fast-growing health expenditure. For sustainability, healthcare of Korea should be reformed. The direction of the reform is people-centered and integrated healthcare in the community which is composed of empowering and engaging people, strengthening governance and accountability, reorienting the model of care, coordinating services, and creating an enabling environment.

The Effect of Reform of New Diagnosis-Related Groups on Coverage of National Health Insurance (신포괄수가 시범사업 모형개선이 건강보험 보장률에 미친 영향)

  • Choi, Jung-Kyu;Kim, Seon-Hee;Chang, Cheong-Ha;Yoon, Jong-Min;Kang, Jung-Gu
    • Health Policy and Management
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    • v.30 no.2
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    • pp.178-184
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    • 2020
  • Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

A study on problem solution method for works improvement and advancement quality of life on Job analysis of Emergency Medical Technicians (응급구조사의 직무분석에 따른 업무개선과 삶의 질 향상을 위한 문제점 해결 방법에 관한 연구)

  • Kim, Jae-Gab;Koh, Jae-Moon;Kim, Kyung-Wan;Jung, Young-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.1
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    • pp.73-80
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    • 2007
  • This study is a descriptive survey research to know the levels of job satisfaction and influential factors for emergency medical technicians(EMT). This study sampled Level 1 and Level 2 Rescue Members from fire stations and EMT from general hospitals in the Gwangju City and JeollaNamdo area. Interviews for the 75 participants of this convenience sample were conducted for a two month period from July to September 2006. Data was collected on interviewing questionnaires. When looking at the results above internal factions were most influential towards satisfaction and self-responsibility, fulfillment, displays of Aptitude were highest for satisfaction. However, organizational factors were the lowest. There is a need for reform in promotion term periods and policy as well as promotion opportunities. Influential factors for job satisfaction were Role Performance Ability, Intentions for Changing Jobs, and Job Selection Motivation. Therefore, the more insufficient your ability to perform your job the less satisfied you are with it and the more fear you feel from experiences on the job the less satisfied you are with your job. Henceforth, there is a need to reform the educational programs offered to EMT for job training emphasizing job performance ability and the ability to judge for oneself on emergency situations, and reform the promotional system. Finally, there is a need for psychological consultation to offer stability to those after treating an emergency situation and encouragement for personal religion.

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Establishment of Healthcare Delivery System through Improvement of Health Insurance System (건강보험수가제도 개선을 통한 의료전달체계 확립방안)

  • Oh, Youngho
    • Health Policy and Management
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    • v.29 no.3
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    • pp.248-261
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    • 2019
  • Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

Premedical Curriculum in Seoul National University College of Medicine (서울대학교 의과대학 의예과 교육과정 개발과 편성 사례)

  • Yoon, Hyun Bae;Lee, Seung-Hee;Hwang, Jinyoung
    • Korean Medical Education Review
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    • v.19 no.3
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    • pp.134-137
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    • 2017
  • The main points of issue with the former premedical curriculum of Seoul National University College of Medicine (SNUCM) were the absence of educational objectives, decline in student motivation caused by uniform education, students' lack of a sense of belonging, and lack of humanistic education. In accordance with these issues, there were five aspects considered for the improvement of the premedical curriculum: reform based on the newly established educational objectives that corresponds with the 6-year medical school curriculum as a whole, expansion of elective courses and the development of personalized curriculum for the improvement of students' learning motives, expansion of social sciences and humanities curriculum for the development of students' capabilities as good doctors, active participation of medical professors in premedical education, and expansion of informal education and the student support program. According to the assessment done after the implementation of the reformed curriculum, premedical students were gratified with its establishment and management of multifarious liberal arts and major subjects. In preparation of the more rigorous entrance quota of the premedical school at SNUCM, there is ongoing reform of required major subjects and establishment of new subjects in the premedical curriculum in pursuit of unity with the 6-year medical curriculum. Moreover, there is ongoing development of an e-portfolio system for the association of premedical and medical education, integration of formal and informal curriculum, and reinforcement of student observation and formative evaluation. Further discussion on the assessment and betterment of premedical curriculum is needed.

Changing Tendency of the Psychiatric Hospitals' Acute Wards for Return to Society in Japan (사회복귀를 고려한 일본 정신과 급성기치료병동의 변화경향)

  • Ko, Sang-Kyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.4
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    • pp.19-27
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    • 2016
  • Purpose: This study shows a changing tendency of Japanese psychiatric hospitals, presenting "Visions in Reform of Mental Health and Medical Welfare", changed to "Hospitalized Medical Treatment to Living in the Community" and reducing the number of beds since 2004. Methods: This study uses a documentary survey, especially Jananese "Visions in Reform of Mental Health and Medical Welfare System" and a field survey on hospital built for early treatment and return to society after 2004. Results: Change tendencies of psychiatric hospitals are 1) diversification of isolation room and ward, 2) cluster of patient's room, 3) phased organization of space, 4)individualization. Implication: This study will be an important data for researching plan of Korea psychiatric hospital which needs to change by global tendency.

Legal Review of Medical Practice Related to Orthopedic Surgery (정형외과 수술 관련 의료행위에 대한 법적 고찰)

  • Hosik Shin
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.3
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    • pp.87-95
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    • 2024
  • This study examined the levels of satisfaction from medical staff and patients by analyzing 691 Supreme Court precedents on medical practice from legal disputes in Korea, which are developing into a dual medical system. In addition, the issues that can be prevented in the medical field through the flow and judgment of legal disputes in medical practice after the revision of the medical law are discussed. The concept of medical practice not specified in the Medical Law was examined and compared with the medical-legal systems of Germany, Japan, and the USA through international comparative analysis to assess the illegal factors occurring in the medical field by analyzing the legal approach, medical practice, and medical personnel qualifications of each country. An analysis of the Supreme Court's case law revealed the timing analysis of issues in legal disputes related to medical practice, the incidence rate among the subjects of the cases, and medical personnel to be significant. The meaning was studied by finding the law that applied to it. Important cases were identified, and their meaning was reviewed. The legal issues of medical practice in orthopedics were divided into five sections based on precedents, such as problems in consent to information at the start of treatment, problems in prior radiography before treatment, explanation of the consent process for surgical treatment, problems related to the qualification of operators in the operating room, and the responsibility for postoperative results. In the wake of the recent major crisis in the government's medical reform policy (Essential medical package), procedural problems and legal reviews of illegal medical practices and their qualifications in the medical field were conducted because of the lack of medical personnel.

Changes in Japan Healthcare System and New Directions of Hospital Management (일본 의료시스템의 변화와 병원 경영의 새로운 방향)

  • Inoue, Takahiro;Hada, Masashi;Yuzawa, Atsuko;Lee, Sei-Hoon;Kwon, Young-Dae
    • Korea Journal of Hospital Management
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    • v.13 no.4
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    • pp.101-118
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    • 2008
  • Japanese national health expenditure was 8.0% of GDP in 2004, and it was lower than average of OECD countries. But it has increased rapidly in recent years. Japan has relatively many acute care beds and high-price medical equipments, and the average length of stay is long. Japanese government is trying healthcare reform to contain healthcare expenditure, increase the efficiency of management and improve the quality of healthcare. As healthcare policies for hospitals such as DPC (Diagnosis Procedure Combination) for acute care beds, reduction of long-term care beds, and functional differentiation and liaison among healthcare institutions are implemented, the number of hospitals in financial difficulties is increasing. The serious situation urges hospitals to adapt to changes and search new directions of management. They need to establish and implement appropriate positioning strategy, and increase management efficiencies. Korean healthcare system has similarities with Japanese in many aspects. The recent reform and changes in Japanese healthcare system and hospitals give suggestions to Korean hospitals as to how they can prepare for environmental changes and improve management.

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Reform of the Primary Health Care Delivery System in Rural Areas (농어촌보건기관 일차보건의료 서비스 전달체계 개편안 논의의 문제와 대안)

  • Na, Baeg-Ju
    • Journal of Korean Academy of Rural Health Nursing
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    • v.1 no.1
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    • pp.5-10
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    • 2006
  • Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.