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Health Policy and Mangemnet

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수록정보
수록범위 : 1권1호(1991)~30권3호(2020) |수록논문 수 : 911
보건행정학회지
30권3호(2020년 09월) 수록논문
최근 권호 논문
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KCI등재

1보건부 설립

저자 : 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 265-269 (5 pages)

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Korea has failed to respond to the Middle East respiratory syndrome of 2015 and the early phase of coronavirus disease 2019 (COVID-19) of 2020. This is due to the structural problems of the Ministry of Health and Welfare that has been more increased manpower and budgets of the welfare part relative to those of the health part, and the ministers were appointed welfare experts, not health experts. In 21 (56.8%) of the Organization for Economic Cooperation and Development countries, the Ministry of Health operates independently, and these countries have been relatively well coping with COVID-19. The importance of the Korean health sector is increasing even further. Korea faces on the emerging infectious diseases, chronic infectious diseases such as tuberculosis that has been being a huge burden, and rapidly increasing non-communicable diseases, suicide and mental disorders, and some diseases due to fine dust and climate change. In addition, the rapid advancement of the aging society, the entry of an era of ultra-low fertility and low-economic growth, and the unification of the Korean peninsula are calling for a health policy reform. Therefore, the Ministry of Health should be established and systematically responsible for health policy, disease policy, medical policy, and medical security policy. Ministry of Health will be the control tower for K-Disease Control, K-Bio, and K-Health.

KCI등재

24차 산업혁명 시대의 대한민국 의료기술 전주기 관리현황 및 단계별 개혁과제

저자 : 김아림 ( Arim Kim ) , 김은정 ( Eun-jung Kim ) , 윤석준 ( Seok-jun Yoon )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 270-276 (7 pages)

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Entering the fourth industrial revolution era, health technology is rapidly developing and the people's needs for medical services are gradually increasing. Establishing a life cycle management of health technology has emerged as a new policy agenda to cope with these changes. However, the management of health technology have been conducted without continuity and with several problems pointed out. Therefore, we suggest the reform agendas by stages to establish system for a life cycle management of health technology in the fourth industrial revolution era as follows. In the stage of development, it is important not only to provide research funding, but also consulting by professional about whole cycle of health technologies. In the phase of market entry, there are needs for enhance the system that would expand the early adoption for innovative technology and increase its effectiveness. After the spread of health technology to clinical settings, a reassessment and post management system should be established that have an institutional framework with strong price adjustment and exit mechanism. Furthermore, we hope that discussions will be brisk in macro perspective on the balancing of development in healthcare industry, health of people and national health insurance finance.

KCI등재

3공유진찰제: 만성질환 관리를 위한 혁신적 의료서비스 전달방식

저자 : 이현주 ( Hyunju Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 277-285 (9 pages)

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Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

KCI등재

4다중흐름모형을 적용한 서울형 유급병가 정책 도입과정에 관한 연구

저자 : 정현우 ( Hyun Woo Jung ) , 박소현 ( So Hyeon Park ) , 손민성 ( Minsung Sohn ) , 정혜주 ( Haejoo Chung )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 286-300 (15 pages)

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In 2019, the Seoul metropolitan government established its own 'Seoul-type paid sick leave project'. Although the central government had to introduce such a system, which is also called sickness benefits, it was not implemented. In order to understand the process by which the Seoul government has implemented such a policy, this study used Kingdon's multiple streams framework. As a result, in the problem stream, it was found that the economic burden of sickness has been considered only in terms of medical expenses in the past of Korea. Then Songpa's three women and Middle East respiratory syndrome incidents raised awareness of the necessity of the sickness benefit system in 2014 and 2015. In the political stream, several social affairs such as national health insurance huge surpluses and the 2017 presidential election opened policy window. At that time, Seoul Mayor actively promoted sickness benefits as a policy entrepreneur. In the policy stream, the sickness benefit system has gained new attention through political events. To summary, these three streams flowed separately and then they assembled around huge political affairs. As a result, it was confirmed that Kingdon's model is the most effective theory than any other models in analyzing the health care policy decision process in Korea.

KCI등재

5체제통합국 건강지표 비교를 통한 통일 후 보건의료에 대한 시사점

저자 : 주영준 ( Yeong Jun Ju ) , 허성은 ( Sung-eun Huh ) , 이주은 ( Joo Eun Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 301-310 (10 pages)

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Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary.
Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics.
Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened.
Conclusion: The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

KCI등재

6국내 2018년 의약품 소비량 및 판매액 통계 산출 및 국제 비교

저자 : 김지혜 ( Jihye Kim ) , 이다희 ( Dahee Lee ) , 김수연 ( Sooyon Kim ) , 김동숙 ( Dong-sook Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 311-325 (15 pages)

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Background: Health statistics of pharmaceutical use and expenditure are essential to make and implement evidence-based pharmaceutical policy. This study aims to demonstrate the methods and results of pharmaceutical consumption and sales in 2018 according to the sources and methods given by the Organization for Economic Cooperation and Development (OECD).
Methods: The medication list contains 39,346 medicines both reimbursed and non-reimbursed by the National Health Insurance in 2018. We used the therapeutic categories based on Anatomic Therapeutic Chemical Classification of World Health Organization. This study analyzed National Health Insurance claims data and supply data generated from wholesalers to health care facilities. The indicators are defined daily dose (DDD), per 1,000 inhabitants per day and US$ per capita.
Results: In South Korea, the number of medications to which DDD were assigned was 18,055 and it was 45.9% of the total number of medications on the list. The consumption in anti-infective for systemic use (J) and musculo-skeletal system (M) was higher than the mean consumption among the OECD countries. The pharmaceutical sales per person in Korea was also higher than the mean sales per person across the OECD countries. Conclusion: We sought to explain the methods to produce pharmaceutical consumption and sales statistics which we had submitted annually to OECD. Considering the characteristics of pharmaceutical statistics, a direct comparison should be approached with caution. Since the growth in pharmaceutical spending has greatly increased over the past decade, we need to monitor pharmaceutical consumption and expenditure consistently.

KCI등재

7상복부초음파검사 급여확대에 따른 의료이용의 변화: 이중차이 혼합효과모형 추정방법을 이용하여

저자 : 손예나 ( Yena Son ) , 이용재 ( Yongjae Lee ) , 남정모 ( Chung-mo Nam ) , 김규리 ( Gyu Ri Kim ) , 정우진 ( Woojin Chung )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 326-334 (9 pages)

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Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals.
Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables.
Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces.
Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

KCI등재

8장애인 건강검진 접근성 저해요인과 개선방안 도출에 대한 질적 연구

저자 : 홍혜수 ( Hye-su Hong ) , 임명준 ( Myung Joon Lim ) , 김외숙 ( Oi-sook Kim ) , 최은숙 ( Eun-sook Choi ) , 김정환 ( Jung Hwan Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 343-352 (10 pages)

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Background: The purpose of this study was to identify factors inhibiting access of people with disability to health check-ups as well as identify pertinent solutions for improvement.
Methods: Twenty-three people with disability older than the age of 19 who took respective health check-ups within the last 3 years were selected as participants. For the data collection, the 1:1 intensive interview was used. The data were analyzed by the grounded theory by Corbin and Strauss.
Results: The results comprised nine categories, 23 subcategories, and 179 concepts. The central phenomenon was 'failure to obtain check-ups.' Causal conditions were observed as a 'lack of communication method,' 'physical difficulties,' and 'staff unfamiliar with people with disability,' Interventional conditions comprised 'physical accessibility,' 'staffs' competency,' and 'assistant manpower.' The active strategy was included 'to investigate the professional medical institution,' 'to find the medical institution of convenient traffic accessibility,' 'to overcome communication difficulties through equipment,' and 'to overcome linguistic barriers through sufficient communication.' Whereas, 'utilization of ancillary equipment,' 'the education of staffs on people with disability,' 'universal design manual,' and 'customized check-ups' were included in the passive strategy. Such processes arose in the contextual conditions of 'lack of expectations for daily lives' and 'lack of government support.' As a consequence, the subjects participated experienced the 'disadvantages,' 'discrimination,' and 'reduced reliability of the health check-ups.'
Conclusion: The subjects who participated in this study emphasized 'staffs familiar with people with disability' and 'systems customized for people with disability' are mandatory to secure complete health check-ups for people with disability.

KCI등재

9장애가 비만 단계별 유병률에 미치는 영향: 장애중증도, 장애유형을 고려하여

저자 : 정재연 ( Jeong Jae Yeon ) , 구준혁 ( Koo Jun Hyuk ) , 신의철 ( Shin Eui Chul ) , 이해종 ( Lee Hae Jong )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 345-354 (10 pages)

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Background: This study purposed to examine the difference in the prevalence of obesity at each stage among people with and without disabilities considering the severity and type of disability.
Methods: The study targeted a total of 1,315,967 people, including 68,418 disabled and 1,247,549 non-disabled, who completed the national health screenings. Logistic analysis and average marginal effect analysis were conducted in three stages (pre-obesity, obesity, severe obesity). Those analyses were conducted considering the severity and type of disabilities.
Results: People with disabilities were more likely to be at all stages of obesity than non-disabled people. In severely disabled people, the probability of obesity was higher than non-disabled people at all stages of obesity, but mildly disabled people had a higher only in the severe obesity stage, no difference in obesity stage, and a low in the pre-obesity stage. In physical and mental disabilities, the probability of obesity was higher than non-disabled people at all stages of obesity, but external physical function and internal organs disabled had a lower in the obesity and pre-obesity stage, and no difference in severe obesity stage.
Conclusion: This study found that people with disabilities had a higher relationship with obesity than people without disabilities. In addition, severity and types of disabilities have different effects on the stage of obesity. Therefore, it is necessary to care about the health inequality and health of disabled people considering their severity and types of disabilities.

KCI등재

10다수준분석을 활용한 개인특성 및 지역환경에 따른 우울증 관련 영향요인 분석

저자 : 문석준 ( Seok-jun Moon ) , 이가람 ( Ga Ram Lee ) , 남은우 ( Eun-woo Nam )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 3호 발행 연도 : 2020 페이지 : pp. 355-365 (11 pages)

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Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status.
Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels.
Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms. The comparison of area under the curve showed that individual factors had a greater influence than regional factors.
Conclusion: This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.

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1연안해역에서 석유오염물질의 세균학적 분해에 관한 연구

(2006)홍길동 외 1명심리학41회 피인용

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(2006)홍길동심리학41회 피인용

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2미국의 비트코인 규제

(2006)홍길동41회 피인용

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