• 보건행정학회지
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• 제6권2호
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• pp.14-42
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• 1996

민간 시장에서의 경쟁의 실패는 일반적으로 정부개입과 규제의 대표적인 근거를 제공한다. 하지만 보건의료분야는 정보의 비대칭성, 의료보험의 보편화, 고가의료기술 및 장비에 의한 비용상승 등과 같은 특수성으로 인하여, 정부가 단순히 충분한 의료공급자나 병원의 수를 보장함으로써 가격의 하락과 서비스 양의 증가와 같은 경쟁의 효과를 기대하기 힘들다. 본 논문은 경쟁과 규제와 관련한 보건의료의 특수성과, 보건의료분야에서 경쟁이 소비자 후생에 미치는 영향에 관한 이론 및 실증분석의 결과들을 고찰한다. 나아가 경쟁과 규제가 조화된 지속가능한(sustainable) 보건의료체계를 위해, 병원설비투자의 직접적인 규제로부터 규제를 통해 경쟁을 촉진시키는 인센티브규제(incentive regulation)로서의 지불보상제도 그리고 필요한 정보의 제공을 통한 시장기능의 회복에 이르는, 정부가 집행할 수 있는 효과적인 정책도구들을 분석한다.

• Journal of Hospice and Palliative Care
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• 제15권4호
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• pp.188-192
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• 2012

Palliative medicine has shown demonstrated benefit for patients with serious illness, their families, and hospital systems. As such, the demand for palliative care services is growing at a fast pace, and health care facilities frequently struggle to develop and implement effective and sustainable methods of providing this care. As with any new system, challenges and barriers naturally exist to instituting palliative care. Undertaking careful assessment, planning, and resource allocation can provide the greatest likelihood of success when developing these novel yet much needed models of care. This summary paper offers a qualitative overview of the potential benefits and the rationale to implement robust palliative care systems. We briefly review the history of palliative medicine in the broadest sense and address several seminal works from the US palliative care literature. Core practices to establish and advance palliative medicine are suggested. Commentary is provided on some of the particular barriers to palliative system development that may need to be addressed in the context of Korean medical culture. Collectively, we hope this overview can contribute to a framework within which such research and development can occur, leading to increasingly effective and sustainable palliative medicine in Korea.

• 보건행정학회지
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• 제24권4호
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• pp.304-311
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• 2014

This manuscript treats a new paradigm for the Korean health care system. We give an account of innovative health care delivery and payment models widely discussed in the contemporary US accountable care organization and coordinated care organization. In doing so, we explore a new health care model amenable to foreseeable changes to the health care system. We propose creating an integrated health care system in which the network of health care providers delivers coordinated and comprehensive care for enrolled patients residing within the geographic boundaries served by the provider network; providers may participate voluntarily in one or more networks and assume shared responsibility for patient care and cost; provider networks compete with each other based on cost and quality; and consumers are allowed to choose a network. We expect that the new paradigm will create a financially-sustainable system that assures quality of care and improves patient experience, minimizing the existing system-wide inefficiency through cross-network competition and within-network care coordination.

• 보건행정학회지
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• 제27권2호
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• pp.103-113
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• 2017

There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

• 보건행정학회지
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• 제32권3호
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• pp.245-246
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• 2022

Concerns about a global economic recession are rising following the coronavirus disease 2019 (COVID-19) pandemic. Accordingly, government entities, which are committed to overcome two barriers to severe inflation and economic recession, are showing high interest in spending management so as not to undermine fiscal soundness. Since the health care sector especially accounts for a large proportion of fiscal expenditure, it should be managed in a manner that the expense is appropriately spent. The National Health Insurance System and Healthcare System have secured international competitiveness and reliability by effectively responding to the COVID-19 pandemic. Likewise, considerable efforts should be made to reorganize the welfare and healthcare systems so that they can be sustainable during the post-COVID-19 era and the recession.

• Journal of Medicine and Life Science
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• 제16권2호
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• pp.52-54
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• 2019

While sustainability is seen in terms of social, economic and environmental dimensions, securing longterm financial costs and planning long-term strategic perspective among policy-makers are needed to maintain a healthcare system sustainability. Thus, the networking and cooperation between policy makers and health care workers should be tightened and strengthened in order to keep and enhance the healthcare system sustainability.

• 보건행정학회지
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• 제21권3호
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• pp.381-396
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• 2011

This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants' disease characteristics, regional service infrastructure, and the certification interviewer's characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.

• 보건행정학회지
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• 제30권1호
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• pp.131-138
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• 2020

The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

• 한국농촌간호학회지
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• 제19권1호
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• pp.25-34
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• 2024

Purpose: This study investigates the relationship between job stress and burnout among primary healthcare practitioners during COVID-19 pandemic through mixed methods study. Methods: Data were collected from October to November 2022 using Qualtrix, a web-based survey platform. 1,082 primary health care practitioners participated in the survey. Quantitative data were analyzed using correlation analysis using IBM SPSS/WIN 27.0. Qualitative data were analyzed using content analysis through open-ended questions. Results: Job stress and burnout among primary healthcare practitioners during COVID-19 were positively correlated. Four categories and seven subcategories were identified. Conclusion: Based on these findings, it is necessary to develop a support system for primary healthcare practitioners according to the type of residential area and the number of peopleto reduce job stress and burnout.

• 보건행정학회지
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• 제30권3호
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• pp.301-310
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• 2020

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion: The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.