• 한국병원경영학회지
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• 제3권1호
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• pp.238-260
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• 1998

This article describes the theoretical foundations of government policy for hospitals in terms of correcting market failure and enhancing equity. It then discusses the characteristics that desirable payment systems should have, and the effects of the DRG-based prospective payment system on hospital behavior, its financial performance, hospital industry, and health care expenditure. The rationales and impacts of other public policies for hospitals such as antitrust and fair trade regulation, dissemination of practice guidelines and hospital mortality information, regulation of hospital capital investment, and tax policy are also discussed.

• 보건의료산업학회지
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• 제10권2호
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• pp.15-23
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• 2016

Objectives : The purpose of this study was to evaluate the productivity changes of 18 public health centers in Gangwon-do from 2006 to 2013 using the Malmquist Productivity Index(MPI). Methods : Data were collected from Statistics Korea from 2006 to 2013. The input variables were the numbers of medical, nursing and administrative personnels. The output variables were the performances of health promotion programs. Along with the traditional input-oriented DEA analysis, the MPI was calculated. Results : First, among the 18 public health centers, the productivity index of 14 public health centers was increased. Second, the annual productivity showed a 6% increase. Third, the productivity improvements were mainly caused by Scale Efficiency Change. Conclusions : Improving the productivity of public health centers requires the support and external policies of the national and local government. Internally, public health centers need to maintain scale optimization of the center. Additionally, efforts should be made to effectively use limited resources.

• Journal of Preventive Medicine and Public Health
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• 제57권4호
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• pp.327-338
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• 2024

Objectives: Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020. Methods: Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020. Results: The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths. Conclusions: Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

• 보건행정학회지
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• 제11권1호
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• pp.131-152
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• 2001

Public health system and public health practice have changed over the past decades as the result of social and epidemiologic changes. New public health concept emphasizes leadership, strategical thinking, systematic planning and effective performance to identify and solve complex health problem In Korea, the role of Health Center has been expanded rapidly. However there is strong suspicion that Health Center can achieve their mission. This paper aims at understanding what is the needed functions of Health Center and which of its aspects needs improvement. The main results of this study are summarizes as follows. District Health Law does not address the core functions of Health Center. The staffs of Health Center have difficulties in prioritizing their services. The recent attempt to restructure Health Center and change delivery pattern of public health services ended with only limited success. To effectively confront threats to the public's health, the three major function of Health Center must be ${\circled}1$ modifying individual behavior and lifestyle, ${\circled}2$ improving social and economic conditions, and ${\circled}3$ reforming health policies. Better results do not come from setting new functions only; they come from understanding and improving the processes that will then leads to better outcome. We recommend that policy-makers focus economic evaluation of public health programs, building and spreading of the scientific evidence of programs, linkage of public health research and public health program. The criteria of delegation of public health service to private sector is urgently needed. Making community health information data available on a routine basis to providers, managers and researchers of public health services helps promote the efficiency of the overall operation of public health system.

• The Korean Journal of Medicine
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• 제99권1호
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• pp.1-3
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• 2024

Recently, several social issues have raised public concerns about a deficiency of doctors. The government says it will solve the problem by increasing the number of doctors, saying essential medical service is collapsing. However, the medical community argues that there is a fundamental problem with Korea's health care delivery system. The government needs to take advice from the medical community to make policies in the right direction. And the press should no longer provide the public with misinformation that doctors and the public are opposed to. In this article, I would like to mention problems among current medical services and suggest healthcare policies for them.

• 보건행정학회지
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• 제8권1호
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• pp.203-230
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• 1998

This purposes of this study is to develope policies on the facilities for the elderly care in Korea. Methodology of this study adopts comparative analysis on the facilities for the elderly care in 6 countries which have experienced various problems on the elderly. These 6 countries are Japan, Sweden, America, Australian, England and Germany. Major issues for comparative analysis are the standard of care facilities, residence condition, finance of facilities establishment and expense, operating system, management, and the law and administrative structure about the facilities for the elderly care. The elderly people need various kinds of welfare services such as medical care facilities, nursing home facilities, home care facilities etc.. Thus the public policies for the aging population nations are compose of income maintenance program, health and medical care services and social welfare services. The policies of facilities for elderly care are very important since these policies include the characteristics of income maintenance, me\ulcorner미 care program and welfare program. This study willsupply basic data for the development of facilities for the elderly care in Korea, especially conceming the system and institutional device of the facilities.

• 보건행정학회지
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• 제20권3호
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• pp.36-57
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• 2010

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea's health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high, compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage, income inequality after deduction of health care expenditure should be continuously monitored.

• 보건행정학회지
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• 제31권4호
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• pp.409-422
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• 2021

The growing use of prescription analgesic opioids has rapidly escalated the treatment of chronic pain since the 1990s; however, it is also highly needed to control opioid-related issues, including opioids misuse, abuse, and addiction. In 2018, Organization for Economic Cooperation and Development (OECD) secretariat administered the survey on opioids use and policies to OECD countries and presented it at the Health Committee meeting of December 2018. This study aimed to review the opioids use in OECD countries and their policies to prevent and reduce associated harms, also seek the available policy lessons from OECD countries. More recently, opioids prescribing rate have been increased 14.7% between 2011-2013 and 2014-2016 and steadily focused on the main substance misused and abused in Korea. In addition, policy efforts have contributed to developing a guideline for prescribing opioids to steer the appropriate use of prescription analgesic opioids since 2000 in Korea, so it is not enough to control opioids compared with other OECD countries. Therefore, taking a people-centered and public health perspective, it will consider the health system policies and interventions at a national level to improve their preparation and approach to control opioid-related issues.

• 보건행정학회지
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• 제22권4호
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• pp.467-496
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• 2012

Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

• 치위생과학회지
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• 제9권1호
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• pp.69-74
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• 2009

본 연구는 보건의료정책에 관한 주요 언론의 선거보도를 분석하기 위하여 17대 대선과 18대 총선 기간 중 지상파 방송인 KBS, MBC, SBS의 메인 뉴스와 조선일보, 중앙일보, 동아일보, 한겨레에서 보도된 선거 기사 2,624 건을 SPSS Program을 이용하여 분석하여 다음과 같은 결론을 얻었다. 1. 17대 대선과 18대 총선 기간에 주요 언론에서 보도한 기사 중 판세중심의 보도가 35.6%로 가장 많았고, 정책중심의 보도기사는 10.8%로 가장 낮게 보도되었다. 2. 주요 언론사별 정책 중심기사를 살펴보면, 다른 언론사에 비하여 KBS와 한겨레에서 보다 많은 정책중심기사가 보도되었다. 3. 보도된 284건의 정책중심기사 중에서도 사회분야가 75건(26.4%), 경제분야가 73건(25.7%)으로 전체 정책기사 중 50%이상이었고, 그 중 9.9%(28건)만이 보건의료 정책에 관한 기사였다. 4. 보도된 보건의료정책 관련기사를 크게 의료비 관련, 건강보험제도 관련, 노인보건 관련, 보건복지 관련항목으로 나누어 분석한 결과 그 중 의료비와 관련된 기사가 39.3%로 가장 많이 보도되었다. 이상의 결론으로 종합하면, 17대 대선과 18대 총선 기간에 주요 언론에서 보도된 보건의료정책에 관한 기사는 매우 적었고, 그 내용도 의료비와 노인보건과 관련된 특정부분에 치우쳐 있었다. 따라서 보건의료에 관한 주요한 정책문제를 해결하기 위해서는 보건의료정책의 개발과 더불어 개발된 정책이 정책 의제화 되어 구현될 수 있도록 언론의 효율적 활용을 위한 노력이 필요할 것으로 사료된다.