• Health Policy and Management
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• v.28 no.1
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• pp.35-47
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• 2018

Background: The purpose of this study is to elucidate the context of medical experience and the perception of unmet healthcare of elderly people with chronic diseases based on in-depth interview data. Methods: We carried out in-depth interviews with 10 elderly people with chronic diseases using semi-structured questionnaires based on literature review. The in-depth interview data were analyzed using thematic analysis; one qualitative research methodology, three core meaning categories, and four attributes associated with unmet healthcare were ultimately derived. Results: The context of the medical experience were based on the following three categories: (1) discomfort due to diseases and high medical needs, (2) the poor community medical environment and difficulties in accessing to metropolitan medical institutions, and (3) inconvenience caused by long waiting time and side effects of medicine. In addition, the elderly with chronic disease realized the unmet healthcare as (1) the availability related to the desired medical institutions at the right time, (2) the affordability related to their economic capacity, (3) the effectiveness of the medical services they experienced, and (4) the appropriateness related to receiving medical services in a pleasant environment. Conclusion: The perception of unmet healthcare among the elderly with chronic disease is the result of interaction of multi-level and multi-dimensional factors related with their medical experience.

• Journal of Society of Preventive Korean Medicine
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• v.18 no.1
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• pp.103-111
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• 2014

Objective : Understanding the state of sanitation policy during the period of Japanese colonization of Korea. Method : Analyze 'Slang on hygiene practices' found in Korean medical journal "ChoSunEuiHakGye" that published in the period of Japanese colonization. And analyze articles that were same theme. Results : Japanese colonial policy regards the colony people's old adage of health as outrageous things. Japanese colonial police demands don't use old adage of health because it is obstruction to colonial hygiene policy. Conclusion : The Japanese occupation health administration led by the Japanese police considered Korean people as significant. And they regarded old adage of health as harmful habits. In addition, the knowledge derived from traditional Korean medicine was turned away outrageous things. Traditional Korean medicine knowledge lost the chance of renewal.

• Health Policy and Management
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• v.31 no.2
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• pp.148-157
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• 2021

Background: Based on that the key function of health technology is improving the quality of healthcare services, our study purports to explore the process of medical device development in detail and to discuss its policy implications. Methods: A total of 12 in-depth interviews were conducted with four groups of industry, hospital, academia, and civil society. All of the interviewees except those from civil society were involved in the new medical device development between 2009 and 2018. We performed a text network analysis and content analysis of the interview data. Results: The frequency and the degree centrality rankings suggested a close association between the utilization issue and the technology development. Similarly, the results of the content analysis showed that the appropriate intervention in the utilization of technology has a direct impact on the progress of development. Under the continuous industrial effort to boost profits by developing new technology, service providers and citizens should be knowledgeable of and make good use of the new technology for the provision of better services. Conclusion: As the development itself would not guarantee the improvement of service quality and better health outcomes, health technology policies should take a more comprehensive view to serve the unmet needs and even to facilitate the technology development.

• Health Policy and Management
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• v.3 no.2
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• pp.27-80
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• 1993

It is widely known that patients' utilization pattern for medical care facilities and the patientflow are influenced by multi-factors, such as demographic characteristics, structural characteristics of society, socio-psychological characteristics(value, attitude, norms, culture, health behavior, etc.), economic characteristics(income, medical price, relative price, physician induced demand, etc.), geographical accessibility, systematic characteristics(health care delivery system, payment methods for physician fees, form of health care security, etc.), and characteristics of medical facilities(reliability, quality of medical care, convenience, kindness, tec.). This study was conducted to research the mechanism of patient-flow according to changes of health care system(implementation of national health insurance, health care referral system and regionalization of health care utilization, etc.) and characteristics of medical facilities(ownership of hospital, characteristics of medical services, non-medical characteristics, etc.). In this study, the fact could be ascertained that the patient-flow had been influenced by changes of health care system and characteristics of medical facilities.

• Health Policy and Management
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• v.30 no.3
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• Health Policy and Management
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• v.32 no.3
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• pp.317-322
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• 2022

Background: Limited access to medical services causes problems in patients' health and life. Also, hospital closures cause concentration towards general hospitals, which leads to worsening National Health Insurance finance. Therefore, hospital closure is an important topic to be analyzed. Methods: This paper analyzed the factors that affect hospital closures using survival analysis with the data of 970 hospitals opened between 2010 and 2019 in Korea. The number of medical personnel, hospital rooms, sickbeds, and medical departments were used as explanatory variables. Results: The number of medical personnel and hospital rooms increased the survival probability while the number of sickbeds and medical departments decrease the survival probability. Conclusion: The results suggest that hospitals have economies of scale and diseconomies of scope in management.

• Journal of Korean Medical Science
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• v.33 no.47
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• pp.302.1-303.10
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• 2018

Background: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors. Methods: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model. Results: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ${\geq}9$ correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ${\leq}4$ correct answers). Interestingly, among current smokers, only those who correctly responded to ${\geq}9$ of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation. Conclusion: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking.

• 대한예방의학회:학술대회논문집
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• 1999.10a
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• pp.204-205
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• 1999

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.347-353
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• 2001

Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

• Journal of Radiation Protection and Research
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• v.49 no.1
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• pp.40-49
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• 2024

Background: This study aimed to prioritize policy measures to improve radiation safety management in medical institutions using the analytic hierarchy process. Materials and Methods: It adopted three policy options-engineering, education, and enforcement-to categorize safety management measures, the so-called Harvey's 3Es. Then, the radiation safety management measures obtained from the current system and other studies were organized into action plan categories. Using the derived model, this study surveyed 33 stakeholders of radiation safety management in medical institutions and analyzed the importance of each measure. Results and Discussion: As a result, these stakeholders generally identified enforcement as the most important factor for improving the safety management system. The study also found that radiation safety officers and medical physicists perceived different measures as important, indicating clear differences in opinions among stakeholders, especially in improving quality assurance in radiation therapy. Hence, the process of coordination and consensus is likely to be critical in improving the radiation safety management system. Conclusion: Stakeholders in the medical field consider enforcement as the most critical factor in improving their safety management systems. Specifically, the most crucial among the six specific action plans was the "reinforcement of the organization and workforce for safety management," with a relative importance of 25.7%.