• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.185-197
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• 2002

Today, the basic problem of functional safe management of Korean Disaster Control system was separately administrated 33 acts that are relating to safe management in 13 ministries. Because of the facts that the fire service is not provided practically, the control system and risk management for safe administration are not operated, the information can not be shared with each other, and the various laws have the lacks of linkage, the National Safe System was appeared unsteady. The roles and functions of fire service have started with restriction to operate structurally and institutionally, which operational structure of fire service is becoming weak. As a result, the federal and local fire organizations have not reached yet to the institutionalization and the local fire service agencies have bias with the task regarding the fire service because of the relation between organizational structure and the local fire agency. With the enforcement of the federal and local fire system, professionality and autonomy for making policy, and dealing with changes of fire service positively, the national fire service on the policy performance can be established. Promotion of research and development and education training to strengthen innovation in technology and competition in fire industry will contribute to the firmly establishment of control system to prevent from fire, flood, terror and national disaster. This article proposed that (a) the established law and administration, agency are required efforts to effectively operate fire service system; (b) the national fire service agency, national college of fire, national institute of science fire, and national fire service hospital should be early established to make firmly policy to operate effectively and practically. These kinds of innovational acts are known the best ways of operating solid policy of national fire service system.

• The Journal of the Korea Contents Association
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• v.13 no.10
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• pp.365-374
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• 2013

The purpose of this study is to find out the differences in between national and private medical institutions' perception towards aging, and to analyze how their different perceptions effect each of their later life preparation. A total of 783 questionnaires were distributed among national and private medical institution workers. Frequency analysis, t-test, hierarchical regression analysis was conducted from the collected data via SPSS 21.0. The results were the following. Firstly, there was a partial difference in their perception of aging, government policy satisfaction and later life preparation. National medical institutions were better than private medical institutions in all three terms. Also, perception of aging and government policy satisfaction were higher-than-average in both institutions, but in later life preparation, both scored lower-than-average. Secondly, the factors affecting preparation for aging were significantly different between these two institutions. Also, how each factors affected later life preparation was partially different. In conclusion, effects of factor was difference in aging preparation between national and private medical institutions workers. We need to provide as basic data for education and policy making for aging preparation.

• 대한예방의학회:학술대회논문집
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• 1998.10b
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• pp.86-87
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• 1998

• Health Policy and Management
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• v.3 no.1
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• 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.23 no.2
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• 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.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Health Policy and Management
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• v.24 no.3
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• pp.205-218
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• 2014

Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.

• International Journal of Computer Science & Network Security
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• v.22 no.7
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• pp.320-326
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• 2022

The main purpose of the article is to determine the role of the digitalization phenomenon (its positive and negative sides) as a means of anti-corruption policy in the healthcare sector of Ukraine and provide practical recommendations for transforming the domestic healthcare sector based on digitalization through the implementation of organizational and legal measures. The definitions of such concepts as: corruption in the healthcare sector; digitalization; digitalization of the healthcare sector; e-medicine. A typology of reasons for promoting the development of corruption in the healthcare sector of modern Ukraine is given. As a result of the study, a number of scientific tasks were implemented. The negative side of the introduction of digitalization in the healthcare sector has been identified and illustrated. The types of e-services in the healthcare sector are systematized, each of them is characterized and the fundamental directions of their development are indicated. The existing problems of technostress are characterized (techno-overload; techno-invasion; techno-complexity; techno-insecurity; techno-uncertainty). In the context of considering digitalization as a means of anti-corruption policy in the healthcare sector, practical organizational and legal measures are proposed for implementation.