• 보건행정학회지
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• 제22권4호
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• pp.467-496
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• 2012

Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

• 보건행정학회지
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• 제3권1호
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• pp.102-123
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• 1993

This study investigates effcts of HMO internal structural arrangements on performance, specially cost reduction measured by hospitalization rate. This study formulates formalization, centralization measured by decision-making participation, differentiation, and coordination as structural factors, considering coordination as an intermediate factor between the rest of structural factors and hospitalization rate. The commonly used HMO types is assumed not effective in explaining performance differences. For the empirical test, I use bootstrap regression analyses with 48 HMOs. The results of the analyses show that HMO types fail to explain differences in hospitalization rate. However, dicision-making participation and differention effectively reduce hospiatalization rate, while frmalization increases hospitalization rate and coordination has nonessential effect on hospitalization rate. And, formalization and decision-making participation positively contribute to achieve coordination in HMO. These findings suggest that the theoretical framework derived from rational-citingency theory of formal organization better explains performance differences of HMOs than HMO types.

• 한국건축시공학회지
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• 제13권2호
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• pp.148-158
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• 2013

Generally, building construction projects have a complex decision-making process because of the participation of various agents. In this situation, a final decision is arrived at by relying on subjective judgments based on the experience of project participants. For this reason, a method of assessing the objectivity of opinions is needed. In previous studies, the multi-criteria decision making method was applied to arrive at a final decision objectively, but this method has a limitation, in that the experience of each decision maker is not considered differently in the decision making process. Therefore, this study proposed a theoretical model using the S-shaped growth curve and regression analysis by building construction project type to quantitatively estimate decision-making reliability according to the experience of individual project participant`s. The developed model could be added to the Multi-criteria decision making method, and secure the objectivity and reliability of project participants' final opinion.

• 지역사회간호학회지
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• 제12권1호
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• pp.239-246
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• 2001

This paper attempts to identify the occupational stress-related factors among the workers at the manufacturing industry and to provide the basic data concerning development of stress management program focused on the manufacturing industry. The subjects exhibit significantly highest level of 'the characteristics of task and participation in decision making factor'. And the mean score of 'the avoid coping strategies' was higher than 'the control coping strategies'. The main factor that affected the occupational stress responses was 'the physio-environmental factor' and it was explained 15.6% out of the total variance of the stress responses. Also, it would be explained 29% out of the total variance of the stress responses with 'the characteristics of task/participation in decision making factor', sex, social support, and 'extra-organizational stressor'. In conclusion. For developing the stress management program in workplace, 'the physical environmental factor' and 'the characteristics of task and participation in decision making factor' should be considered. Also, It should be identified the direct and indirect paths among factors that significantly related factors to the occupational stress of workers further more.

• 한국융합학회논문지
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• 제12권9호
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• pp.361-371
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• 2021

본 연구의 목적은 공유의사결정과 의료진 신뢰 간의 관계에서 환자활성화의 조절효과를 규명하기 위함이다. 연구 대상은 대전광역시에 소재한 상급 종합병원 내분비대사내과에서 당뇨병 치료를 받고 연구 참여에 동의한 환자 186명이다. 연구결과, 의료진 신뢰(β=0.32, p=.045)와 환자활성화(β=0.32, p=.024)는 공유의사결정에 영향을 미치며, 의료진 신뢰와 공유의사결정 관계에서 환자활성화는 조절효과가 있는 것으로 나타났다(β=0.25, p=.019). 연구결과를 기반으로 공유의사결정의 활성화를 위해 환자의 의료진 신뢰 정도를 사정하여 의료진에 대한 부정적 인식을 개선하고, 신뢰를 강화할 필요가 있다. 또한 공유의사결정에 참여를 촉진하기 위한 환자활성화에 초점을 맞춘 융합적 프로그램을 개발하여 교육할 것을 제안한다.

• 간호행정학회지
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• 제6권1호
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• pp.19-29
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• 2000

The purpose of this study was to analyze the relationship and the importance of relevant variables among structure, process, and outcome dimensions of nursing department in hospitals. The subject for this study was the registered nurses(N=400) working in medical, intensive care, and surgical units at 5 general hospitals with more than 500beds in Chungnam and Chungbuk. The research design was cross-sectional correlation among the variables based on their self description. The survey instrument was based on eleven structured questionnaires. The data were collected from April 26 to May 26, 1999. The SPSS/PC+ program and LISREL 8.12a program were used to analyze the data. Based on the data collected, the following results were obtained. The relationship among structural, procedural, and outcome dimensions 1. Structural dimension had a relationship with procedural dimension relating to decision-making of caregiving and working conditions, in particular, participation of the problem identification. 2. The extent of participation in decision-making had a relationship with organizational commitment and group effectiveness through the selection process among the total decision-making processes. 3. The structural dimension had a large direct effect rather than indirect effect through decision making processes on organizational commitment and group effectiveness. The relationship of structure, process, outcome dimensions was partially supported by this study. The information obtained from surveys in the field form the basis for the following recommendations for improving organizational effectiveness with in the nursing department in an hospitals. 1) Establishment of decentralized structure, environment, and culture in organizational settings would be desirable so that their members may actively participate in decision-making process. 2) Continuous education and training of nurses with theoretical Knowledge and skill of decision making, practical knowledge, and upright role perception should be highly emphasized for persons in nursing schools and in on-the-job training.

• 간호행정학회지
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• 제9권2호
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• pp.217-232
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• 2003

Purpose : This paper was attempted to identify the job stress related factors among the staff nurses and to provide the basic data concerning development of stress management program focused on hospitals. Method : The subjects were 309 staff nurses at two general hospitals in Seoul. Data were collected with self-reported questionnaires and analyzed by SPSS-PC+10.0 for descriptive analysis, ANOVA, stepwise multiple regression, factor analysis. Results : The subjects exhibit significantly highest level of 'the participation in decision making factor'. The mean score of 'control coping strategies' was higher than 'avoid coping strategies'. The mean scores of social support and stress responses were high. The main factor that affected the stress responses was 'the job characteristic factor' and it was explained 23.0% out of the total variance of the stress responses. Also, it would be explained 42.6% out of the total variance of the stress responses with 'the control coping strategies, work overload factors, social support, and participation in decision making factors'. Conclusion: For developing the hospital- focused stress management program for staff nurses, 'the participation in decision making factors' and 'the job characteristics' should be considered. Also, the organizational efforts and supports should be required to support and use of 'control coping strategies' of nurses

• 보건행정학회지
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• 제27권4호
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• pp.336-346
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• 2017

Background: Due to the asymmetry of information and knowledge and the power of bureaucrats and medical professionals, it is not easy for citizens to participate in health care policy making. This study analyzes the case of the insured organization participating in the Health Insurance Policy Committee (HIPC) and provides a basis for discussing methods and conditions for better public participation. Methods: Qualitative analysis was conducted using the in-depth interviews with the participants and document data such as materials for HIPC meetings. Semi-structured interviews were conducted with purposively sampled six participants from organizations representing the insured in HIPC. The meanings related to the factors affecting participation were found and categorized into major categories. Results: The main factors affecting participating in the decision making process were trust and cooperation among the participants, structure and procedure of governance, representation and expertise of participants, and contents of issues. Due to limited cooperation, participants lacked influence in important decisions. There was an imbalance in power due to unreasonable procedures and criteria for governance. As the materials for meetings were provided inappropriate manner, it was difficult for participants to understand the contents and comments on the meeting. Due to weak accountability structure, opinions from external stakeholders have not been well received. The participation was made depending on the expertise of individual members. The degree of influence was different depending on the contents of the issues. Conclusion: In order to meet the values of democracy and realize the participation that the insured can demonstrate influence, it is necessary to have a fair and reasonable procedure and a sufficient learning environment. More deliberative structure which reflects citizen's public perspective is required, rather than current negotiating structure of HIPC.

• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.298-308
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• 2014

Objectives: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. Methods: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. Results: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. Conclusions: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2007년도 추계학술대회 논문집
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• pp.1787-1795
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• 2007

The objectives of this paper are to introduce the PI(Public Involvement) in railway project and case study about public participation in decision making process for Ko-Yang light rail line development, besides to emphasize the importance of information considering the difference of resident location, regional character and so on are investigated before and after public participation. As the results, it was clarified about PI activities styles that consensus is not achieved in Ko-Yang public participation, the psychological factor such as the knowledge and satisfaction, receptivity about light rail project strongly is affected to making decision.