• Title/Summary/Keyword: Medical reform

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A Study of the History of Medical Administration in Qing(淸) Dynasty (청대(淸代) 의정사(醫政史)에 관한 연구)

  • Kim, Ki-Wook;Park, Hyun-Kuk
    • The Journal of Dong Guk Oriental Medicine
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    • v.10
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    • pp.98-118
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    • 2008
  • Basic summary of the medical administration : Due to Qing dynasty being the last of the dynastic era, it revealed overall extreme political traits in politics, economy, phenomenon, and cultural aspects. Few emperors of the early Qing dynasty adopted appeasement policy that mitigated ironies to a certain extent and showed growth in various business related fields. Even the medical administration had freshness during that period. United medical administrative system was generally formed, chicken pox was effectively prevented, shamanistic treatment was banned, medical journals were complied by the government, medical relief was more intensely done. However, actions on restoring Ming dynasty and against Qing dynasty as well as the reform power grew against Qing government threatening it. The drastically grown forces from the western region dan1aged Qing dynasty that the governors had to adopt despotic measures in politics, economy and culture. Social chaos began to arise, economy stagnated and weakened that the medical field also dwindled to the point where it could not be restored to the original point. The era of Qing dynasty was the period that had scientific culture at its fast growing pace, but for Chinese medicine, by contrary, due to autocracy and other factors, was faced with barriers in the medical development.

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The Change of Basic and Postgraduate Medical Education after Intern Training System Dismantling (인턴수련제도 폐지에 따른 기본의학교육-졸업 후 의학교육의 변화)

  • Kim, Byung Soo
    • Korean Medical Education Review
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    • v.15 no.2
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    • pp.69-74
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    • 2013
  • This study aimed to review the expected changes in the medical educational environment and to evaluate approaches to coping with the abolition of the postgraduate intern training system. It is expected that after the intern training system is dismantled, postgraduate medical students will be deprived of the opportunity to practice opportunity for clinical practice and to inquire into their medical specialization. Therefore, major improvements in the clinical education curriculum must be made so that students can do so through the clinical education program. Offering students the opportunity to perform clinical practice through the clinical education program might require a revision in the laws and regulations on clinical education as well as the standardization of the clinical education curriculum in line with international practices. Reform measures to provide students the opportunity to inquire their specializations might be the introduction of a medical curriculum containing diverse fields and the establishment of a matching program to assign medical students to their residency programs after medical school. Finally, the fact that the basic concern of postgraduate medical education is the cultivation of primary care physicians must not be forgotten even after the dismantling of the postgraduate intern training system.

Survey on the Education System and National Licensing Examination for Fostering Competent Medical Technologists (우수한 임상병리사 양성을 위한 교육제도 및 국가면허시험제도에 대한 설문조사 분석)

  • Kim, Hong Sung;Kwon, Pil Seung;Kang, Ji-Hyuk;Yang, Man-Gil;Park, Jong O;Kim, Dae-Joong;Kim, Won Shik;Joo, Sei Ick;Kim, Eun-Joong;Lee, Sun Kyung;Lee, Sang Hee;Jekal, Seung-Joo
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.161-170
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    • 2017
  • This study aimed at characterizing policy directions to foster competent medical technologists by analyzing the opinions of professors and medical technologists regarding university education and national licensing systems. An online survey questionnaire was distributed to 255 professors and 4,000 medical technologists in August of 2016. Fifty-nine professors (23%) and 1,099 medical technologists (27.7%) responded to the survey. The results were evaluated using descriptive statistics and comparative analysis. Professors and medical technologists agreed that there needs to be an improvement and standardization in both education at universities and practical training at hospitals. Moreover, both groups also thought that it was necessary to reform practical examinations and make improvements in the current licensing system. According to the survey results, professors and medical technologists thought that, the improvement of the quality of university education and hospital practical training should be essential, and the reform of existing national licensing examination should be necessary.

Efficiency Evaluation of General Hospitals using DEA (DEA를 이용한 종합병원의 효율성 평가)

  • Park, Byung-Sang;Lee, Yong-Kyoon;Kim, Yoon-Shin
    • The Journal of the Korea Contents Association
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    • v.9 no.4
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    • pp.299-312
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    • 2009
  • Unlike profit-seeking businesses, hospitals provide medical services to promote the public good in a way, and they need a reform of management to ensure sustainable growth in fast-changing medical environments. The key to the managerial reform is enhancing efficiency, and inefficient managerial practices and factors affecting that should be grasped first of all to boost the efficiency of hospital management. But evaluation methods that are prevalent in the private sector are hardly applicable to hospitals. The purpose of this study was to assess hospital efficiency by using a data envelopment analysis(DEA). The 2006 data on 74 residency training hospitals with 500 beds or more were analyzed. The selected input variables included the number of bed, the number of doctors, the number of nurses, the number of medical technicians, personnel expenses, management cost and materials cost. And the selected output variables were the yearly number of outpatients, the yearly number of inpatients, the number of operation cases and earnings. In addition, the influence of the type of hospital establishment, location, the year of foundation and the type of hospital on hospital efficiency was checked as well.

An Evaluation of Accountable Care Organization in USA and Policy Implications for Korean Health Care System (미국의 책임의료조직(Accountable Care Organization) 운영현황 분석과 국내 의료정책에서 정책적 함의 평가)

  • Seo, Kyung Hwa;Jung, Yu Min;Kim, Min Ji;Lee, Sun Hee
    • Health Policy and Management
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    • v.24 no.4
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    • pp.396-412
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    • 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.

Tawian's Health Care Reform and Its Lessons (대만 의료보장개혁과 교훈)

  • 이규식
    • Health Policy and Management
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    • v.8 no.1
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    • pp.232-265
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    • 1998
  • Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

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The Legal System for the Independent Practice of Physical Therapy (물리치료원 독립 개원을 위한 제도적 장치)

  • Bae Sung-Soo;Kim Dae-Young;Nam Sung-Woo;Park Hwan-Jin;Jeon Jae-Kyun
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.253-263
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    • 1998
  • To provide physical therapy service of good quality keeping people healthy and obstain structural reformation coping with the demands of in medical service market to foreign intercourse on 21C, we should make legal system fer the physical therapy practice. Thus we suggest the Ministry of Health and Health and the authorities should, 1. Exclude the provision of physical therapist from the classfication of medical technician on the Medical Technician Law Article 2. and establish the independent Physical Therapist Law 2. Eliminate the provision of physician or dentist's guide the Medical Technician Law Article 1. or reform it to physician or dentist's request so that physical therapists may have a independent practice, or 3. Add the provision of the physical therapy center to the Medical Technician Law, the enforcement ordinances and enforcement regulations, such as the provision of optometrist or dental technician.

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Factors Affecting Perceived Financial Burden of Medical Expenditures (건강보험 입원환자의 주관적 의료비 부담에 영향을 미치는 요인)

  • Choi, Young-Soon;Lee, Kwang-Ok;Yim, Eun-Shil
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.2
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    • pp.147-157
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    • 2011
  • Purpose: This study was done to investigate factors affecting perceived financial burden of medical expenditures. Method: The participants were 2,024 inpatients who were enrolled in a survey on the benefit coverage rate of the National Health Insurance in 2006. The collected data were analyzed using t-test, ANOVA-test, Mann-Whitney-test, Kruskal-Wallis-test, Chi-square test and logistic regression. Results: The crucial factors for perceived financial burden were age, job, equivalence scale, ratio of annual family income vs medical expenditure, and private health insurance. Perceived financial burden was higher for people who were older, who were unemployed, whose medical expenditures were high compared to annual family income, whose index of family equalization was low and for those who had no private health insurance. Conclusion: The results of the study indicate a demand for system reform that will enable management of no-pay hospital bills in the National Health Insurance to decrease the medical expense of people in the low-income bracket.

Regulatory System of Quasi-drugs in Korea (우리나라 의약외품 허가심사제도 고찰 및 개선 방안)

  • Sohn, Hyun-Soon;Shin, Hyun-Taek;Song, In-Sook;Jun, Hyo-Jung
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.123-130
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    • 2006
  • The study was aimed to recommend the ways for improving regulatory system of quasi-drugs in governmental authority by comparing with other countries. According to the regulations, the scope of quasi-drugs includes 3 categories of 1) the health aids made of textile, rubber and paper, 2) the health aids which have very minimal effects or no any effects on humans, and 3) disinfectants and pesticides. In US, these quasi-drugs in Korea are classified into 5 categories of medical device, cosmetics, OTC drugs, dietary supplements and pesticides. To improve quasi-drugs administration in Korea, it is concluded that several measures should be implemented : 1) establish clear criteria for classifying into quasi-drugs and more detailed guidelines on designation of quasi-drugs, 2) reform current regulations to meet 3-categories characteristics, supplement detailed guidelines on quasi-drugs administration for effective application process, and update relevant regulations for efficacy, safety and quality, 3) update quasi-drug monographs, 4) re-evaluate current classification of individual quasi-drugs, 5) develop comprehensive list by ingredients, 6) reform post-marketing management system for safety and quality, 7) strengthen the review agency function by increasing the number of experts, 8) develop the database for quasi-drugs for effective information management.

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Current Status and Reform Tasks in Life Cycle Management of Korean Health Technology for the Fourth Industrial Revolution Era (4차 산업혁명 시대의 대한민국 의료기술 전주기 관리현황 및 단계별 개혁과제)

  • Kim, Arim;Kim, Eun-Jung;Yoon, Seok-Jun
    • Health Policy and Management
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    • v.30 no.3
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    • pp.270-276
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    • 2020
  • Entering the fourth industrial revolution era, health technology is rapidly developing and the people's needs for medical services are gradually increasing. Establishing a life cycle management of health technology has emerged as a new policy agenda to cope with these changes. However, the management of health technology have been conducted without continuity and with several problems pointed out. Therefore, we suggest the reform agendas by stages to establish system for a life cycle management of health technology in the fourth industrial revolution era as follows. In the stage of development, it is important not only to provide research funding, but also consulting by professional about whole cycle of health technologies. In the phase of market entry, there are needs for enhance the system that would expand the early adoption for innovative technology and increase its effectiveness. After the spread of health technology to clinical settings, a reassessment and post management system should be established that have an institutional framework with strong price adjustment and exit mechanism. Furthermore, we hope that discussions will be brisk in macro perspective on the balancing of development in healthcare industry, health of people and national health insurance finance.