• 제목/요약/키워드: Value-based health care

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문재인 케어 정책에 대한 미디어 프레임 분석 (Analysis of Media Frames of Moon Jae-in Care policy)

  • 이근찬
    • 보건의료산업학회지
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    • 제12권3호
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    • pp.13-26
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    • 2018
  • Objectives: This study investigated how Korean daily newspapers frame the present government's health insurance coverage expansion policy, Moon Jae-in Care. Methods: A contents analysis was conducted to construct news frames represented in the four Korean daily newspapers' editorials and columns on Moon Jae-in Care during from April 2017 to April 2018. News text was classified into three different layers of frames: expressive element, narrative structure, and implied values. Results: The analysis revealed that the frequency of narrative frames was as follows: health system improvement (20.8%), public burden (14.6%), opposition by doctors (14.6%), and populism (12.5%). The financial sustainability accounted for 41.7% of the value frame, followed by procedural legitimation (18.8%), and coverage expansion (16.7%). The results also revealed that reported frames were different among newspapers: Chosun Ilbo tended to report in a negative tone, while Hankyoreh shinmun and Kyunghyang shinmun used a positive tone. Conclusions: This finding suggests that there are salient framings in reports on Moon Jae-in Care. Based on the results, the government needs to present a detailed financing plan on Moon Jae-in Care in detail. I discussed another implication of media frames results.

의료기술평가 기반으로서의 데이터 연계 (Data-Linking Infrastructure for the Health Technology Assessment)

  • 박종연
    • 보건의료기술평가
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    • 제6권2호
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    • pp.81-87
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    • 2018
  • With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

방문간호센터 경영효율성 개선 사례 분석: 경영 컨설팅 적용을 중심으로 (Case Analysis of Visiting Nursing Center for Improving Efficiencies: Based on Business Management Consulting)

  • 임지영;김주행;김선희
    • 가정∙방문간호학회지
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    • 제28권2호
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    • pp.111-123
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    • 2021
  • Purpose: This study aimed to present the management strategies necessary to improve the operational efficiency of visiting nurse centers and evaluate their effectiveness. Methods: The subjects of this study were visiting nurse centers registered as long-term care centers. Based on value chain analysis, cost information analysis, and data envelope analysis, the study was carried out according to the Magerison's management consulting procedure, for six months. This procedure comprised eight sub-steps of approach and application. Results: The following management strategies were agreed upon: establishment of a cooperative network with other visiting care centers, creation of high satisfaction of external customers by providing practical training to care workers, and making rehabilitation and exercise services as the core nursing activities to be focused on. Conclusion: The management consulting process and analysis method applied in this study can referred to as a useful methodological framework for revitalizing visiting nursing centers in the future.

국가 암 비용 감소를 위한 환자중심 진료의 적정성 확보 전략 (Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea)

  • 배종면
    • Journal of Preventive Medicine and Public Health
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    • 제50권4호
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    • pp.217-227
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    • 2017
  • In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

방문요양 행위 업무량의 상대적 가치 측정 (Measuring Workload of Home Visit Care Activities Using Relative Values)

  • 한성옥;박은철;강대룡;강임옥
    • Journal of Preventive Medicine and Public Health
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    • 제41권5호
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    • pp.331-338
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    • 2008
  • Objectives : The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. Methods : The participants of this study were 126 home-helpers of 50 home visit care agencies at the 2nd Long-term Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. Results : Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. Conclusions : The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.

병원입원환자가 인지하는 의료서비스 질, 만족도, 서비스가치, 병원 재이용 의사간의 인과관계분석 (The Causal Relationship of Hospital Inpatient's Perceived Quality, Satisfaction, Service Value, and Intention to Revisit)

  • 박재산
    • 한국병원경영학회지
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    • 제7권4호
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    • pp.123-151
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    • 2002
  • The objective of this study is to analyze the causal relationship of hospital inpatient's perceived quality, overall satisfaction, service value, and future intention to revisit. To carry out this objective, first we analyzed the dimensions of inpatient care service quality using SERVQUAL scale. The SERVQUAL scale is based on the gap theory, that is, the difference of patients' expectations and the actually received medical care service in hospital. On the basis of this theory, we measured the inpatient's perceived service quality and overall patient satisfaction. Data was gathered from a self-administered questionnaire at a 980 bed university hospital in Inchon City. These questionnaire measuring the service quality were distributed to 250 inpatients. The response rate was 66.4%. A total of 166 questionnaires was finally analyzed. To categorize medical service quality, the factor analysis was performed on 42 items. The reliability and validity of these items was evaluated. Finally to test 6 hypotheses, we analyzed the causal relationship of service quality, overall satisfaction, service value, and intention to revisit through the structural equation modeling(SEM). The major results of this study are as follows. First, the dimension of inpatient service quality was categorized into 7 dimensions, that is, personal caring, communication, access, physical environment, facilities and equipment, cleanliness, appropriateness and health status. Second, the reliability and validity of inpatient service quality items was satisfied. Third, as a result of structural equation modeling, the effect of inpatient's perceived service quality on overall satisfaction, service value, and intention to revisit was statistically significant. And total effect on intention to revisit as the core endogenous variable was perceived service quality(1.100), patient satisfaction(0.006), and service value(0.605).

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건강원에서 제조한 건강음료에 대한 주부의 인식, 관심 및 소비에 관한 연구 (A Study on Housewives' Perception, Interest and Consumption of Health Drinks Made in a Health Food Stores)

  • 김현아;박복희
    • 대한지역사회영양학회지
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    • 제3권1호
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    • pp.107-115
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    • 1998
  • This study was conducted to investigate housewives' perception, interest and consumption of health drinks made in a health food stores, and to assess the relationsh- ip between nutritionally-related-variables and the consumption of health drinks. Data was collected from 518 housewives in Chonnam province. Among many items which housewives perceived about health drinks, three factors of 'preference·health-care', ' quality·convenience' and 'price' were found to be represented. Housewives' perception of 'preference·health-care' was negatively correlated with nutritional knowledge. However, a positive correlation between the 'quality·convenience' and eating habits was found. Consumption of health drinks was positively correlated with the diet management score, the perception and interest in health drinks. However, the inverse relationship between consumption of health drinks and nutritional knowledge was observed. Multiple regression analysis showed that the interest and factors of perception of health drinks. Consumption of health drinks was not based upon accurate knowledge concerning nutrition, but was based upon the consumers' perception of taste preference and healthful quality. Therefore, there is a need to educate consumers about the nutritional value of health drinks and how to use nutritional supplements.

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Trend of Occupational Injuries/Diseases in Pakistan: Index Value Analysis of Injured Employed Persons from 2001-02 to 2012-13

  • Abbas, Mohsin
    • Safety and Health at Work
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    • 제6권3호
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    • pp.218-226
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    • 2015
  • Background: The present study aimed to analyze the index value trends of injured employed persons (IEPs) covered in Pakistan Labour Force Surveys from 2001-02 to 2012-13. Methods: The index value method based on reference years and reference groups was used to analyze the IEP trends in terms of different criteria such as gender, area, employment status, industry types, occupational groups, types of injury, injured body parts, and treatment received. The Pearson correlation coefficient analysis was also performed to investigate the inter-relationship of different occupational variables. Results: The values of IEP increased at the end of the studied year in industry divisions such as agriculture, forestry, hunting, and fishing, followed by in manufacturing and construction industry divisions. People associated with major occupations (such as skilled agricultural and fishery workers) and elementary (unskilled) occupations were found to be at an increasing risk of occupational injuries/diseases with an increasing IEP trend. Types of occupational injuries such as sprain or strain, superficial injury, and dislocation increased during the studied years. Major injured parts of body such as upper limb and lower limb found with increasing trend. Types of treatment received, including hospitalization and no treatment, were found to decrease. Increased IEP can be justified due to inadequate health care facilities, especially in rural areas by increased IEP in terms of gender, areas, received treatment, occupational groups and employment status as results found after Pearson correlation coefficient analysis. Conclusion: The increasing trend in the IEP% of the total employed persons due to agrarian activities shows that there is a need to improve health care setups in rural areas of Pakistan.

보건의료산업 글로벌화 정책의 성과 및 향후 과제 (Achievement and Future Tasks of Healthcare Industry Globalization Policies)

  • 정기택;최훈화
    • 보건행정학회지
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    • 제28권3호
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    • pp.288-293
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    • 2018
  • In 1994 Korea government began to develop the healthcare industry, since then the government has tried to create opportunities to promote the industry through various political efforts and policies. The biggest achievement was attracting foreign patients from 2009 to 2016 with a cumulative 1.56 million and total revenue of 3 trillion won. But Korea still loses the opportunity to become a global leader in the health care industry due to regulations and various ideological disputes. Accordingly, it is necessary to facilitate policy understanding and present a practical road map so that Korea's healthcare industry become a new growth engine that will lead the trend of global market in the future. It also suggests a national economic development paradigm, the health economy as health and economic value are rotated through a shift in view of health care. At this point, 20 years after the beginning of the healthcare industry development, it is necessary to evaluate the related policies and discuss effective future directions. In this sense, the purpose of this study is to examine the policies and limitations of the healthcare industry by each government division, and based on it, to propose political tasks for the future.

Academic Medicine은 환자 중심 의료이다 (Academic Medicine Is Patient-Centered Medicine)

  • 안신기
    • 의학교육논단
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    • 제21권2호
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    • pp.80-91
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    • 2019
  • The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.