• Health Policy and Management
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• v.9 no.1
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• pp.72-109
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• 1999

This study is conducted to investigate the current status on the utilization of health care and plan for solving this problem. The claims data of the fiscal tear 1995 obtained from the regional health insurance society are used for the study. The main findings of the study are summarized as follows. Indexes(The Extremal Quotient(EQ), coefficients of variance(CV's))which represent the regional difference in the admission rate of the tertiary medical diagnosis group report that there is difference in quantity and quality of utilization of health care. The admission rate is lower in the big city areas, Kyoungkido, Kangwondo and Chunlapukdo. Even after age-sex adjustment, the admission rate is still low in Kangwondo, Chunlapukdo and Kyoungsangpukdo. The big city areas tend to have higher rates in the expenses per claim, hospital days per claim, and daily expenses but the rates are still low in some area in Kangwondo, Chunlanamdo and Kyoungsangpukdo. This result remains as same after age-sex adjustment. There is a large regional difference in average utilization rate for the tertiary hospital of the tertiary medical diagnosis group: 57.2%(SD 11.53). The utilization rates for the tertiary hospital in their large catchment area are 96.34%, 83.19% and 73.22% in each Kyoungin, Kyoungnam and Kyoungpuk areas whereas it is lower in a Chungpuk and Chungnam areas. The regional differences of health care utilization of the tertiary medical diagnosis group gave some relationships with their geographical characteristics such as socio-economic characteristics and supply factors of medical services. It is important that many medical policies should be developed in order to minimize and balance out the regional differences of health care utilization. The service allocation policy should include the reconstruction of manpower policy, developing the resource allocating formula, finding the self-sufficient catchment area and reforcing of public health services. Moreover, in order to achieve the balanced development by region, they should investigate and consider each county's microscopic properties under the consistent macrocopic policy. The further studies to find causes of regional difference are needed.

• Health Policy and Management
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• v.13 no.3
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• pp.21-34
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• 2003

Patient revisit to used hospital is a key factor in determining a health care organization's competitive advantage and survival. This article examines the relationship between customer's satisfaction and his/her revisit associated with three different methods which are the Chi Square Automatic Interaction Detection(CHAID) for segmenting the outpatient group, logistic regression and neural networks for addressing the outpatient's revisit. The main findings indicate that the important factors on outpatient's revisit are physician's kindness, nurse's skill, overall level of satisfaction, hospital reputation, recommendation, level of diagnoses and outpatient's age. Among these ones, physician's kindness is the most important factor as guidelines for decision of their revisit. The decision maker of hospital should select the strategy containing the variable amount of the level of revisit and size of outpatient's group under the constraint on the hospital's time, budget and manpower given. Finally, this study shows that neural networks, as non-parametric technique, appear to more correctly predict revisit than does logistic regression as a parametric estimation technique.

• Korea Journal of Hospital Management
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• v.7 no.2
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• pp.37-51
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• 2002

It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

• Journal of the Korean Society of School Health
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• v.17 no.2
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• pp.127-150
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• 2004

Objectives: The purpose of this study is to provide a basic structure for the establishment of the direction of school health programs, an overview of the historical changes of school health programs and their results, and a conceptual framework on school health programs. Methods: The data analysis has been done using a statistical almanac, relevant laws and regulations, operation handbook of the program, theses, reports, records of public hearings, and other reports as a technical research primarily based on evidence. The methodology of this research classifies the development and growth transition of school health programs during a historical period through the investigation of regulations, organization, manpower, and its program via its development process and to provide a basic tool to design a solid school health policy. Results: A The growth and development of school health programs The development of school health programs was classified into three different periods including the forthcoming period (1945~1967), the completion period (1967~1993), and the actualization period based on the establishment of legislation for School Health Law, other relevant legislation, and the contents of school health programs (1993~present). B. Policy direction of school health programs School health programs have reestablished their goals and range based on basic direction, and developed the W1it model of information structure for school health program management and its basic structure. Finally, the stepwise support system through the building of the school health support center is recommended. (1) The basic direction of school health programs has proposed 7 basic goals to reestablish the policy direction of health improvement based on total health. (2) The W1it model of information system and the school health information system for school health program management has been developed to utilize positive management. (3) School health policy through the study of the health laws and systems has been developed. The necessity of school health support center for the policy support, functional support and operation support has also been proposed. Conclusions: It is necessary to build a school health support center that consists of health professionals in charge of policy support, functional support, and program support of school health programs in order to realize and develop new policy.

• Korean Journal of Health Education and Promotion
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• v.16 no.1
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• pp.101-126
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• 1999

As the WTO system launches through the agreement of Uruguay Round, the Government has to revise the office regulations or reform the system. Also, Integrating and Coordinating the like affair in health care (i. e., children's home, industry health, school health, health manpower, the administration of health center, the administration on food hygiene, health environmental education, and so on.) which is now scattered into some government departments like the Ministry of Labor, the Ministry of Education, the Ministry of Home Affairs, the Ministry of Agriculture, and the Ministry of Environment, the Government has to prevent unspecialty, inefficiency, inconsistency, and uneconomy. The Government has to review and adopt above suggested the Proposal 1),2),3),4) of the Health Centers on the basis of the local autonomy law and it will help the successive settlement of the local autonomy system in Korea. According to the suggested proposal, the Central Government mainly takes charge of the Macro affairs as hardware, and transfer the Micro affairs as software into the Local Governments to attempt the appropriate functional allocation. To achieve it successfully, the Central Government also has to do the financial support, manpower training and technical support, allocation of health care resources, direction and control, research and development and the health care plan on the macro level. Local Governments which divided into the wide local government and basic local government also have to do their best for health improvement of the community societies like plan of health care program, implementation of health care service program, taking charge of the affairs of health insurance, activation of community residents' participation and security of health care resources etc. To achieve this goal, the Government have to be more active and reformative, the related social and health agencies and educational agencies have to cooperate and support for the goals, and especially, the community residents have to participate actively and voluntarily, When all these conditions promote, local health care administration will be developed, and health level of community residents will be secured. And going one step forward, the country and people will be more healthy

• Journal of Society of Preventive Korean Medicine
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• v.6 no.1
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• pp.1-14
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• 2002

The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.

• Health Policy and Management
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• v.6 no.2
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• pp.58-90
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• 1996

This study provides an empirical analysis of location competition for demand maximization by central place theory among physicians in nonmetropolitan areas of Korea. The results show that the primary care physicians distribute themselves evenly from urban communities to rural communities. The subspecialists, however, cluster together in major cities rather than decentralize themselves in rural counties. This study establishes the three statistical models : Primary care physicians, subspecialist physicians, and total physicians. Two models of primary care physicians and total physicians have a strong significance in multiple regression analysis (p=-.0001). The primary care model explains approximately 45% of the variation and the total physicians model explains approximately 70% of the variation in physician/1,000 population ratios across national counties. The subspecialist physicians model analysze the tobit regreassion because of the left consored and truncated values(57 cases = 0). In all three models, analysis of the coefficiencts for physician centralization degrees in the 0- to 5- and 5- to 10-km rings around the core county reveals each a positive and negative association betwee these degrees and the physician/1,000 population ratios in the core county. Also, the results provide moderate evidence that the relationship between clinic physicians and community hospitals is competitive, and the relationship between clinic physicians and pharmaceutists is synergistic. This suggests that public policy makers and local self-governing bodies must take an active role to ensure procider availability and the regional health planning in all nonmetropolitan areas of Korea.

• Health Policy and Management
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• v.25 no.3
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• pp.149-151
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• 2015

United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (${\leq}70years$) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.

• Korea Journal of Hospital Management
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• v.8 no.4
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• pp.121-148
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• 2003

This study is designed to evaluate the contents of the separation of prescribing and dispensing roles(SPD) policy based on the theoretical backgrounds. The results are as follows; Considering the purpose of SPD policy, 'increasing the efficiency in manpower management by separating the role of medical doctor and pharmacist and improving the quality of SPD service through specialization of function' as a policy objective is valid and very important agenda in health care. But the objectives are not working well by no keeping the detail means to actualize it. Also, some policy objectives are unclear or inappropriate and it makes the focus of that policy obscure or misleads inadequate policy alternatives. In terms of means of policy, it is evaluated to have some limits in effectiveness, efficiency, equity, rationality, technical feasibility, economic feasibility, administrative feasibility, social and time feasibility. In conclusion, it's necessary to investigate the some problem mentioned in this paper with empirical evidence. Also, it should be needed to improve the validity of policy by correcting policy objectives and means in execution of policy.

• Health Policy and Management
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• v.10 no.2
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• pp.103-119
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• 2000

This study is conducted to promote the activation of volunteer activities on the basic of the voluntaarry participation of local by investigating the utillzation of volunteers and analyzing this realted factors in the visiting health services of health centers. Subjects in this study were the whole 245 health centers. Data were collected from April, 12, 1999 to May, 31, 1999, and data for analyses were ones of 41 respondents, which answer " they utilize volunteers in visting health services". The summary of resulth was as follows : 1. In case that the type of health centers is one of county, in case that the number of staff in health center is over 80, in case that model business in not performed, in case that the degree of local financial independence is over 50%, and in case that the location of health centers in not good, there had more of volunteers in visiting health services. 2. 51.2% of analysing health centers answered that the utilization of volunteers has been done since 1998. 56.1% answered that they utillzed volunteers "over 4 hours" per person in a week. The average number of volunteers who was engaged at those visiting health services was 43.3. 3. Most of volinteers were housewives(73.2%). As for the action duration of volunteers. 68.8% answered " under 6 months". 4. As to the tasks of volunter activities, 75.6% were "home services" and 63.4% were "movable bath services". As for the tasks they intend to utilize, 90.2% answered " home services", 73.2% answered "movable health services". 5. Asked abount the purpose in utilizing volunteers, 75.6% answered "to induce the participation og local people". 65.9% answered "to provide various kinds of services". 66.7% provided some kind of education and training for volunteers. 6. Concerming evaluation of performance by volunteers, 90.2% answered " satisfactory". With reagards to the reason for that, 52.9% answered " volunteers can provide kinds of services". and 50.0% answered " volunteers can help local people to care their health". As for the obstacles to the utilization, 51.2% answered " the diffculty of recruitment for volunteers" and 43.9% answered "lack of budget and manpower needed for the utilization of volunteers".lty of recruitment for volunteers" and 43.9% answered "lack of budget and manpower needed for the utilization of volunteers".lunteers&".ot;.