• Health Policy and Management
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• v.26 no.3
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• pp.195-206
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• 2016

Background: Concentration of patients to large hospitals is serious problem in Korea. The purpose of this paper is to propose appropriate policy direction to relieve concentration of patients to large hospitals. It is focused on evaluation of the possibility of family doctor system as a policy alternative to relieve concentration of patients to large hospital by empirically analyzing the effect of usual source of care (USC) on large hospitals medical care use. Methods: Korea Health Panel conducted 2009, 2012, 2013 by KIHASA (Korea Institute for Health and Social Affairs) and NHIS (National Health Insurance Service) was used for analysis. For dependent variables, first, the ratio of the amount of using large hospital to total amount of using medical care, and second, the amount of using large hospital are estimated. Independent variables are having an USC and type of USC. Panel analysis was done with above variables. Results: Main results are as follows. First, having an USC increases using large hospital. Second, having a domestic clinic type USC decreases using large hospital and ratio of using large hospital. Third, the effect of domestic clinic type USC is greater in older group, less income group, worse health status group, not having private insurance group, and having chronic disease group. Conclusion: These results show that family doctor program can be a policy alternative to relieve concentration of patients to large hospital. Nonetheless, primary care system in Korea is unsatisfied. It is recommended to reinforce primary care system and family doctor system to relieve concentration of patients to large hospitals.

• Health Policy and Management
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• v.23 no.3
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• pp.266-280
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• 2013

Background: Information asymmetry between physicians and patients is one of the most unique characteristics of health care. But as consumerism spreads in health care sector, health care consumers are searching comparative information about quality and cost of providers from many information sources. Providing comparative information to health care consumers not only makes consumers choose hospital rationally, but also invigorates the health care market by providers' competition. However there are few studies regarding information searching behavior of health care consumers, then this study is carried out. Methods: The purpose of this study is to understand the information searching behavior of health care consumers based on their characteristics and the types of medical institutions. For this purpose, 313 spinal patients' data of 11 medical institutions (university hospital, spine specialized hospital, clinic) located in Seoul were collected by self-administered surveys. Results: The results of this study are as follows: 1) t-test/analysis of variance analysis showed that according to various characteristics of health care consumers and the types of medical institutions, the level of information searching of each source and the amount of information searching and searching outcomes are statistically different. 2) Regression analysis showed that influence on searching outcomes are statistically different according to the level of information searching of each source and searching content and the amount of information searching has positive effects on searching outcomes. Conclusion: The significance of this study is to provide empirical basis for establishment of health care policy reflecting information needs and preference of health care consumers.

• Journal of Preventive Medicine and Public Health
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• v.48 no.4
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• pp.195-202
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• 2015

Objectives: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. Methods: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). Results: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model. Conclusions: This study's findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.

• Health Policy and Management
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• v.25 no.4
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• pp.307-322
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• 2015

In most democratic countries, influential professional interest groups often become a part of the iron triangle in the policy making process. One of the typical methods by which professional interest groups participate in policy making process may be by having interest group members in the national assembly, who are sympathetic to the group, implementing policies through legislation. In this study we found that from the Constitutional National Assembly through the 18th National Assembly, 147 members of the National Assembly of the Republic of Korea have been ex health care professionals. The research analyzed the roles of these members in health care law amendments as requested by the professional organizations. This study analyzed 11 major cases that involved nullification or amendment of legislations in favor of the healthcare profession, against the basic policies of the government. The study showed that in the 11 major cases, policies were amended in the direction intended by the National Assembly members and other organizations with similar interests, which was against the policy stance of the government. However, these cases did not unilaterally imply that the National Assembly has been captured by the interest groups through the legislators with health care professional background; rather, they should be perceived to be influenced by the exhibited loss of governability by the government in respect to healthcare policy decisions, loss of initiative due to lack of controllability, and reversals and inconsistencies of the policies.

• Health Policy and Management
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• v.31 no.1
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• pp.17-23
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• 2021

With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

• Health Policy and Management
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• v.27 no.2
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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.

• Safety and Health at Work
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• v.10 no.2
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• pp.132-140
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• 2019

Background: Increasing workplace health-care perception has become a major issue in the world. Most of the health-related problems are faced because of the lack of health management instruments. The level of health care can be improved through workplace health well-being regulations. The aim of the present study is to formulate a conceptual model of physical checkup. Methods: This study applied conceptual theories and figures and used secondary data from articles and relevant websites for evaluating the validity of the study. Results: Annual health checkup increases health-care awareness perception of states, organizations, employees, and their families and manages the annual health record of employees, organizations, and states. Conclusions: Health care and awareness perception of states, organizations, employees, and families improves with annual health checkup, and annual health checkup also prevents unhealthy acts.

• Health Policy and Management
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• v.17 no.2
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• pp.33-51
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• 2007

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

• Health Policy and Management
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• v.29 no.4
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• pp.496-501
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• 2019

Background: In this study, wage status and wage determinants of care workers were analyzed. Methods: The analysis used database (DB) of long-term care institutions, DB of long-term care institutions, DB of long-term care workers, DB of health insurance qualification, and contribution possessed by National Health Insurance Services. We analyzed the wage status of the care workers from 2009 to 2016 through basic analysis and estimated the factors affecting the wage of the long-term care facilities' care workers using pooled ordinary least squares. Results: The monthly average wage of care workers was raised from Korean won (KRW) 1.37 million in 2009 to KRW 1.52 million in 2016, and the working hours were shortened by 20 hours from 207 hours to 187 hours. Hourly wages increased by KRW 1,329 from KRW 6,831 in 2009 to KRW 8,160 in 2016. The average monthly wage of care workers was affected by gender, age, years of employment, monthly working hours, establishment type, city size, institutional size, the grade of the institution, and management status. In particular, the wage level of the care workers was high when the larger the size of the institution, the better the management status (fill rate), the establishment type is "government and local government" and "corporation," the institutional rating is high, and the facility manager has the first grade of the social worker license. Conclusion: The government should consider aggressive policies to improve the treatment of care workers as well as the quality of long-term care services so that there will be more long-term care facilities that are guaranteed social publicity above a certain level.

• Health Policy and Management
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• v.8 no.1
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.