• Health Policy and Management
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• v.11 no.1
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• pp.107-130
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• 2001

During the last year, we had a very severe situation with the strike of physicians working in medical facilities. From that time, many politicians and scholars insisted on the expansion of public hospitals to enhance the public role in the medical care sector. They think that private medical facilities work for profit motivation and that the high proportion of private to whole facilities is an obstacle to the public function of medical care under social insurance system. They found that one of the reasons for failing to prevent the physicians' strike was the high proportion of private facilities. Others insisted that the strike was not a good reason for the expansion of public hospitals. The physicians' strike was a very rare case, and it is not a good basis for generalization of the discussion of public hospitals. Last year almost all apprentice physicians in public facilities took part in the strike, and consequently the public hospitals also lost the role of public function. They view this increasing involvement of government in the medical sector as improper and the cause of inefficiencies. In this paper we review the debate over the expansion of public facilities. To clarify the debate, we review traditional criteria for the role of government in a market system and to apply these criteria to medical care. There are two traditional areas where government Is acknowledged to have a role in a market system: market imperfections and market failure. Where market imperfections and market failure exist, there may be a role for government. The justifications for government intervention are consumer protection and the existence of externalities. One of externalities is to provide medical care for the poor. The appropriate measures to provide medical owe to the poor can be sought in both demand and supply side subsidies. National health insurance is a method of demand subsidies and establishment of public hospitals is a method of supply side subsidies. Under the National Health Insurance System, the expansion of public hospitals is not an appropriate subsidy policy.

• Journal of Home Health Care Nursing
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• v.13 no.1
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• pp.33-45
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• 2006

Purpose : The purpose of this study is to present the desirable level of home health care services by identifying the roles and activities by task of home health nursing specialists as well as to raise the level of professionalism in home health care services. Method : This is a methodological study. The roles and activities by task were identified through a review of literature and a state-of-the-practice survey, and were structured into a questionnaire after being reviewed and modified through a consensus of experts. The field survey was conducted on 136 home health nursing specialists at medical institutions, public health centers. public medical institutions, non-governmental organizations, and religious institutions in Seoul, Gyeonggi Province. Incheon, Busan, Daegu, and Gwanggju from June 4 to August 4. 2004. Seven roles. 34 tasks and 130 activities were identified in association with home health nursing specialists. Result : The roles of home health nursing specialists were identified as professional nursing service provider, advisor, educator, administrator, case manager, researcher and leader. Under these roles. 34 tasks and 134 task-specific activities were identified. Conclusion : The the roles and activities of home health nursing specialist identified in this study can be used in various home health care settings. These the roles and activities should provide the evaluation criteria of home health care services for institutions with existing home health care programs. An evaluation tool should be developed in order to ensure the hish quality of home health care services.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.418-427
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• 2015

Purpose: Focus group interviews were conducted to explore the current status and barriers of health care services in nursing home from the viewpoint of staffs taking care of nursing home residents. Methods: A qualitative thematic analysis using the focus group interview method was used. A total of 32 health care professionals (19 nurses and 13 social workers) from thirteen nursing homes in South Korea attended (5 focus groups) in 2014. Results: The two main themes were identified: 'minimal health care services that left personal care needs unmet' which has three subthemes of 'stereotyped and fragmented care by types of care providers', 'medically-oriented health care services' and 'health care services mixed with social or recreational programs'; and 'barriers to proper and timely care in nursing homes' with four subthemes including 'unmet care needs due to cognitive dysfunction or lack of expression', 'care guides or tools not suitable for long-term care facilities', 'health care needs that are beyond the facility's care boundary', and 'care delay due to lack of understanding on the older adult's status'. Conclusion: The findings from this study should help health care policy makers to recognize the factors that influence health care services and provide direction for nurses and other staffs involved in supporting health care services for nursing home residents.

• Journal of Korean Public Health Nursing
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• v.17 no.1
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• pp.5-16
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• 2003

This policy alternatives for establishment of rehabilitation health care delivery system for the disabled in the community were developed based on the data of current health status and situations of health care management for disabled persons in Korea. This research was conducted with secondary data analysis for identifying health status and current situations of managing health of disabled persons, and discussed current issues for establishing rehabilitation health care delivery systems in the community. Observing the health status and current situations of managing health of disabled persons, scope and target population of disabled person extended. so prevalence rates increased. and the severity of disability intensified and specified. The summary of issues of health management for disabled persons included; 1) absence of comprehensive and systematic policy in rehabilitation health care systems. 2) absence of consumer based rehabilitation health care facilities and delivery systems that are considered as the characteristics of disabled persons 3) fixed form of projects based on the provider and lack of variety in the programs. Hereafter. to overcome these problems. policy alternatives should 1) establish a comprehensive rehabilitation health care policy for disabled persons. 2) establish comprehensive and specific community based rehabilitation health care delivery systems that can promote preventing disability. providing medical care for disabled persons, establishing rehabilitation management for disabled persons and health care when returning to society. 3) provide training and secure manpower for rehabilitation, but the training case managers who will take the roles as an expert rehabilitation nurse mediators for multidisciplinary team work are needed immediately. and 4) include efficient connection and provision of independent services for welfare rehabilitation service and health care. Conclusively. a community based rehabilitation health care delivery system should be comprehensive policy vision of the government on rehabilitation health care delivery System rehabilitation service has to be constructed systematically under suitable facilities con consumer characteristics and rehabilitation health care policy. By doing this, consumer comprehensive community rehabilitation health care delivery system could be constructed disabled person.

• Journal of Korean Public Health Nursing
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• v.33 no.3
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• pp.311-325
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• 2019

Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.

• Journal of Korean Public Health Nursing
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• v.28 no.2
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• pp.258-269
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• 2014

Purpose: This study was conducted in order to present the effects of case management of a home visiting health service for clients with hypertension. Method: One-group pretest-posttest design was used. The subjects were 280 clients who received case management among the first and second registered group. The data were eight-week-case management results from January to December, 2010. In order to evaluate the effect of the visiting nursing service, biological indexes(blood pressure, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, BMI) and self-care abilities(knowledge/attitude of hypertension, management of medication, nutritional care, confidence of self care) were measured. Result: Biological indexes and self-care abilities were improved, except total cholesterol, low density lipoprotein. Conclusion: The case management of home visiting health service by public health centers is considered to be an effective nursing service. Therefore, greater effort is needed for better maintenance of case management, and more research is needed in order to examine a variety of biological indexes.

• 한국보건간호학회:학술대회논문집
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• 2006.06b
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• pp.136-136
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• 2006

• Health Policy and Management
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• v.32 no.1
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• pp.29-44
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• 2022

Background: This study was conducted to analyze the impact of having a usual source of care on health behaviors of the middle aged and the elderly, in order to investigate the potential effect of enhancing primary health care in a Korean context. Methods: This study constructed a balanced panel of middle-aged and elderly samples using the Korea Health Panel 2016-2018, and fixed-effect models were used to analyze the data. Results: Among three sets of dependent variables (physical activity, smoking, drinking), statistically significant results were found only in physical activity. Subgroup analysis showed that this effect was not observed in the late elderly (aged 75 and older) and those without chronic diseases. Conclusion: Results of the study implied that enhancing primary health care among middle age and the elderly may have an effect on improving health behaviors. Moving forward to person-centered primary health care from disease-focused primary health care should be considered in high-risk groups such as the middle aged and the elderly with chronic diseases.

• Journal of Korean Public Health Nursing
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• v.19 no.2
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• pp.177-187
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• 2005

The purpose of this study was to 1) identify the current management status of the Visiting Health Care Services (VHCS) and 2) to analyze the workload of the staff in the VHCS located in the Public Health Centers (PHCs) in the urban and rural areas. Method: A descriptive research design and a prospective, time and motion research design were used. A total of 18 PHCs in Gangwon Province participated in this study. A questionnaire and semi-structured observational sheet were utilized. A total of 650 self report records of the work load from the VHCS personnel were collected for a 10 day period at each of the 18 PHCs. A descriptive analysis was then done. Results: The major results were as follows. 1) The VHCS staff (nurses and nurse aids) was being assigned additional work such as maternal health care, chronic disease care, mental health care and health promotion on top of their VHCS duties. 2) The average number of home visits per client during the past year was 5.8. More specifically, the clients in the severe dependent group received an average of 27.1 visits, those clients in the moderate dependent group received 14.0 visits those clients in the slightly dependent group received 5.0 visits and those clients in the self-care group received 1.6 visits. 3) The time required for the work duties of the VHCS staff totaled 488 minutes per day. The percentage of time for home visits was only 17.4%, and this didn't include travel time. Conclusion: The main problems of VHCS were identified as a lack of personnel and a lack of time for the home visits. Strategies that are directed at the construction of a better infrastructure for VHCS are needed.

• Journal of Korean Public Health Nursing
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• v.20 no.1
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• pp.5-15
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• 2006

Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.