• Health Policy and Management
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• v.32 no.2
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• pp.137-153
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• 2022

In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as 'large or small,' and the government's regulation and management policy on private health insurance was classified as 'strong or weak.' Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government's management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries' cases.

• Korean Journal of Occupational Health Nursing
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• v.26 no.3
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• pp.151-159
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• 2017

Purpose: The purpose of this study was to identify the effects of service orientation on the organizational commitment and management performance of public health center workers. Methods: A cross-sectional survey design was used. A convenience sample of 280 workers was recruited from six public health centers in J province, South Korea. Data were collected by self-report questionnaires, including general characteristics, service orientation, organizational commitment, and management performance. Data were analyzed with descriptive statistics, Pearson correlation coefficients, independent t-test, one-way ANOVA, and hierarchical regression using the SPSS 22.0 program. Results: The service orientations explained 34.1%of the variance in organizational commitment and explained 31.4% of the variance in management performance. The service orientation was a significant predictor of organizational commitment and management performance. Conclusion: The results of this study suggest that better strategies for service orientations will be helpful to enhance organizational commitment and management performance in the public health center.

• Research in Community and Public Health Nursing
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• v.10 no.2
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• pp.455-466
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• 1999

Western missionary nurses practiced in Korea from 1891. and the first trial to begin missionary public health nursing service in 1909 could not put into practice for short of nursing staff and budget. The main focus of missionary medical practice was not in public health program but in the management of missionary hospitals. A few of missionary western R.N. tried district nursing in 1910s. but their activities were personal and focused on the rescue of poor and sick patients. In 1917 the North American Methodist Church dispatched R.N. Elizabeth S. Roberts to begin district nursing in Korea. Roberts began maternal and child district nursing service. Her service was focused on teaching the method of bringing up children. bathing service, and home visiting for delivery. She could not but stop district-nursing service in 1918 to serve for a hospital in Siberia. The North American Methodist Church dispatched a few of R.N. to Korea in early 1920s and the missionary public health nursing of Korea could be activated. R.N. E. T. Rosenberger began public health nursing program in Seoul with Korean graduate nurse, Shin-gwang Han, and missionary M.D. Hall. Their public health nursing program was focused on maternal and childcare. They did home visiting in the morning, and served at a well baby clinic in the afternoon. The first baby competition began in 1925. and contributed to the teaching the method of bringing up children. They expanded public health nursing activity to school health nursing and milk station. Their public health nursing program was such a success that In 1929 Severance hospital. Eastgate Hospital. Taehwa Social Evangelistic center organized Seoul Child Health Union. Maren P. Bording, another missionary R.N. and midwife dispatched by the North American Methodist Church began public health nursing program at Kongjoo in 1924. Her program was focused on the maternal and childcare and close to that of Seoul. She started the first milk station in Korea in 1926. As she was a midwife and could get M. D. license in Korea, her program was more focused on maternal care than that of Seoul. The first day nursery school in Korea and the first graduate course for public health nursing in Korea began at Kongjoo in 1930. As the city of Choongcheongnam Province moved from Kongjoo to Daejeon in 1932, missionary public health nursing service in Kongjoo extended to Daejeon. There were lots of public health nursing program in Korea in 1920s and 1930s by missionary western nurses and Korean nurses. There were 13 missionary public health-nursing center in Korea in 1932. But in the late 1930s. Japan extended colonial war and drove out western missionaries. The missionary service in Korea was daunted. and the missionary public health nursing service could not but shrink.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.199-207
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• 2014

Family type is not only an important sociodemographic variable for health studies but also influences the health behavior and health condition of individuals. This study assessed a representative sample to see whether family type is associated with health behavior in Korean adults age 65 and older. This is a cross-sectional study of 9,535 Korean elderly who participated in the 2010-2012 Korean National Health and Nutrition Examination Survey. The subjects were classified as couple cohabitation, couple-offspring cohabitation, alone, or alone-offspring cohabitation. We assessed the relationship between family type and six health behaviors (smoking, high risk drinking, walking, oral examinations, health screenings, and influenza vaccinations) after controlling covariates. The "alone" classification had a significantly higher risk of no health screening, but was more likely to have an influenza vaccination than couples. Significant interactions between family type and healthy behavior were observed with oral health screening, influenza vaccination, and smoking {Odds ratio (95% confidence interval), 1.452 (1.066-1.980), 1.375 (1.083-1.747), 2.246 (1.604-3.146)}. There is a significant association between family type and healthy behaviors.

• Health Policy and Management
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• v.29 no.2
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• pp.206-219
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• 2019

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

• Health Policy and Management
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• v.27 no.3
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• pp.191-198
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• 2017

Moon Jae-in Government announced the Government's 5-Year Plan on July 19, 2017, President Moon directly announced the Government's Plan for Benefit Expansion in National Health Insurance on August 7, 2017. The main contents of the announced expansion include benefit coverage for all medically necessary services with control over non-covered service occurrence, a decrease in the cost-sharing upper limit, and monetary support for catastrophic medical costs. Although past governments have been continuously striving for benefit expansion in the last 15 years, this plan has its breakthrough aspect in that all medical services will be covered by the National Health Insurance. In alignment, there are important tasks to solve: attaining a proper fee schedule, reforming the healthcare delivery system, and improving healthcare quality. This plan is a symptom oriented action in that it is limited in reducing patients' out-of-pocket money, unlike the systematic approach of the National Health Insurance. The sustainability of the National Health Insurance is being threatened due to South Korea's low birth rate, rapidly aging society, and low economic growth, in addition to the unification issue of the Korean Peninsula, medical utilization of the elderly, management of non-communicable diseases, and so on. Therefore, the Government needs to plan the National Health Insurance system reformation including actions addressed toward medical consumers.

• Health Policy and Management
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• v.19 no.3
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• pp.109-124
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• 2009

Background: This study aimed to examine whether cases of punishing false claimants threat general physicians to check their medical cost claims with care to avoid being suspected, and identify empirically general deterrence effects of the on-site investigation system in the Korean National Health Insurance. Methods: 800 clinics were selected among a total of 15,443 clinics that had no experience of on-site investigation until June 2007 using a stratified proportional systematic sampling method. We conducted logistic multiple regression to examine the association between factors related to provider's perception of on-site investigation and high level of perceived deterrence referring to fear of punishment after adjusting provider's service experiences and general characteristics. Results: The probability of high perceived deterrence was higher 1.7 times (CI: 1.13-2.56), 2.73 times (CI: 1.68-4.45) each among clinics exchanging the information once or more per year or once or more for 2-3 months than among clinics no exchanging the information about on-site investigation. Also, the probability of high perceived deterrence was higher 2.27 times (CI: 1.28-4.45) among clinics that knows more than 3 health care institutions having experienced an on-site investigation than among clinics knowing no case. Conclusion: A clinic knowing more punishment cases by onsite investigation and exchanging more frequently information about on-site investigation is likely to present high perceived deterrence. This result will provide important information to enlarge preventive effects of on-site investigation on fraud and abuse claims.

• Health Policy and Management
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• v.21 no.1
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• pp.44-60
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• 2011

Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.

• The Journal of Information Technology
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• v.8 no.2
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• pp.93-101
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• 2005

We implemented an execution health officer system in this research. This system is the execution and can manage the health of the user systematically. A home network standard was not set up yet. The comparison observed geungedda suitable in a health officer system standard. We made efforts to realize the medical treatment network not to be activated yet. We implemented also a remote medical examination and treatment service a former chateu service alimentotherapy service. We will offer different service field and many the gear potent service.

• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.385-395
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• 2022

Purpose: To support implementation of comprehensive, person-centered healthcare, this study aimed to explore immigrant women's public health center (PHC) service experiences and needs while considering Photovoice's feasibility for this purpose. Methods: This qualitative study included 15 marriage-based immigrant women. Participants were recruited from churches and multicultural family support centers using purposive and snowball sampling. Data were collected through four focus group interviews and were subjected to inductive content analysis. Results: Five categories of experiences were identified: language barriers, hectic environment, affordable and practical primary healthcare, feeling ignored and discriminated against, and feeling frustrated. In addition, five categories of needs were identified: language assistance services, ease of access, healthcare across the lifespan, expansion of affordable healthcare, and being accepted as they are. This study provides preliminary evidence that the Photovoice approach can facilitate the interview process in a qualitative inquiry involving participants with limited ability to express their perspectives in the researchers' language. Conclusion: Study findings highlight the need to implement institutional policy and procedural changes within PHCs and to provide culturally competent, personcentered care for South Korea's marriage-based immigrant women and other ethnic minority populations. The findings also provide evidence-based direction for PHC service planning.