• Health Policy and Management
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• v.29 no.3
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• Health Policy and Management
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• v.33 no.4
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• pp.479-488
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• 2023

Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion: In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

• Health Policy and Management
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• v.28 no.3
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• pp.197-201
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• 2018

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.450-461
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• 1995

This paper tested by using Micro TSP, an empirical econometric analysis to approve officially a hypothesis of price elasticity of the demand for medical care services in Korean national medical insurance and the economic effect of health care delivery system with time-series datas of Medical Insurance Statistical Yearbook$(1981\sim1993)$. The results suggest that the Korean medical insurance system shows moral hazard due to the change of coinsurance and the economic effect according to intervention of the health care delivery system, but it is different by insurers regardless of the same structure of the medical insurance scheme.

• Journal of Korean Academy of Rural Health Nursing
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• v.1 no.1
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• pp.5-10
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• 2006

Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.

• Korean Journal of Social Welfare Studies
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• v.47 no.3
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• pp.187-221
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• 2016

This study examines determining factors of effectiveness and satisfaction of Veteran Medical Service Delivery System. Especially, the association between the relevant variables of the effectiveness of the Veteran Medical Service Delivery System and the variables of the satisfaction from the perspective of beneficiaries was studied. Multi-level analysis was utilized to separate results of the evaluation of effectiveness in organizational-level and the evaluation of satisfaction in individual-level. This study tests key posited hypothesis by using survey data collected from 5 medical center of country(Seoul, Busan, Daejeon, Daegu, Gwangju). In terms of the result of the hypothesis testing on the effectiveness variable, integrity(${\beta}=.156$), accountability(${\beta}=.376$, financial sufficiency(${\beta}=.109$), and adequacy (${\beta}=.367$) are the determinants among various factors in evaluating veteran medical service delivery system, statistically reflecting the perception of directors of the veteran medical service delivery facilities on effectiveness. In other word, professionalism variable(${\beta}=0.99$) and effectiveness variable(${\beta}=-1.09$) are statistically reflecting the perception of directors of the beneficiaries satisfaction with employee. The findings suggests that the theoretical and practical implications will improve Effectiveness and Satisfaction of Veteran Medical Service Delivery System.

• The Journal of Economics, Marketing and Management
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• v.6 no.1
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• pp.1-8
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• 2018

Purpose - Local social commerce market has grown up remarkably. And, Coupang has shown new delivery strategy of rocket delivery. Making new paradigm at local market, Coupang has expanded market scale. This study investigated state of local social commerce market, weight and promotion strategy of Coupang market to find out competitiveness edge of Coupang. Research design, data, and methodology - The study investigated state and concept of social commerce to find out state, problems and competitiveness of social commerce. New distribution service was short of precedent studies. Statistical analysis and experimental analysis were not used, and interview was done to investigate three of social commerce businesses. Results - CRM construction is insufficient to have poor system, Local delivery system could not be made enough at overnight delivery and customers were dissatisfied with ties with another company. Promotion shall be done by delivery system for increase of profitability, funding for more investment, chatbot to build new customer control system, and new delivery system to produce profit. Conclusions - Coupang and others have grown up rapidly to worsen profit and to jeopardize survival. Excessive initial investment has threatened the businesses, for instance, low sales of Amazon, excessive expenses, bench marking of logistics system, and others.

• Health Policy and Management
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• v.3 no.2
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• pp.130-158
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• 1993

This study was written to discover the changes that may exist in the contents of medical services after introduction of health insurance system, and to identify the net-effect of health insurance system on medical services. Uncomplicated nornmal delivery and appendectomy patients were divided into 4 groups, the non-insured in pre-NHI periods(group A), the insured of health insurance for employees in pre-NHI periods(group B), the insured of regional health insurance for city residents in post-NHI periods(group C) and the insured of health insurance for employees in post-NHI periods(group D). The mehtod of matching was applied to control for major demographic differences among these 4 groups of each disease. In pre-NHI period, the medical services and the variation of medical services of the non-insured were compared with those of the insured. The difference between the change of medical services from group A to those of group C, and the change of medical services from group B to those group D is defined as the net-effect of health insurance. The results are as follows. First, in length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients, frequency of sitz bath in delivery patients, there was net-effect of health insurance in increasing direction. Second, length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients and frequency of sitz bath in delivery patients were significantly more in the insured than in the non-insured group in pre-NHI period. Third, the variation of medical services of post-NHI period was not less then those of pre-NHI period. Fourth, antenatal care on which the third party does not pay and the patient pays for all, was diffrerent by socioeconomic and educational level of patients.

• Health Policy and Management
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• v.14 no.4
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• pp.21-47
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• 2004

There is general agreement that the Korean health care delivery system has two basic structural problems. One is the limited capacity and role of public hospitals, and the other is the absence of functional differentiation and referral arrangement between the clinics and hospitals of various technological sophistication levels. This study is intended to make an empirical observation of the system's growth process from the viewpoint of the population ecology model of organizations so as to understand the background of these problems and to find out ways of approaching them. As predicted from the population ecology model of organizations, all the types of medical care facilities have expanded in response to the environmental changes for the past three decades or so, and the differences in the extent and pattern of expansion among the types are related to what have taken place in the environment. These findings suggest that the efforts for reforming the health care delivery system should be directed not only to medical care institutions but also to the environmental context under which they function. It is believed that the usefulness of the population ecology perspective on organizations for studying the health care delivery system has been demonstrated. Thus further studies along this line based upon more strict design would improve systematic understanding of the system that is needed for developing policy approaches needed to increase its effectiveness.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.235-262
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• 2019

While traditionally threatening human infectious diseases are decreasing, chronic diseases such as cancer and diabetes, including cardiovascular diseases, are spreading rapidly. Reflecting the characteristics of chronic diseases that are difficult to treat, the management of risk factors and the preparation of health promotion policies corresponding to them have emerged as important concerns around the world. Providing so-called multi-sector approach such as health promotion and disease prevention policy and solution for community response, The value of primary care is once again highlighted in the changed medical environment. As the existing medical delivery system has become difficult to cope with the people's desire for rapid aging, disease paradigm change, and quality of life improvement, European Union countries have made various efforts to improve the quality of their primary medical system, which provides continuous, com- prehensive and coordinated management. This paper examines the current status and problems of the healthcare delivery system in Korea, draws implications from the European Union examples related to the strengthening of primary care, and discusses the plans for establishing a patient-centered future medical delivery system.