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보건행정학회지 update

Health Policy and Mangemnet

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수록정보
수록범위 : 1권1호(1991)~32권3호(2022) |수록논문 수 : 1,012
보건행정학회지
32권3호(2022년 09월) 수록논문
최근 권호 논문
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KCI등재

저자 : 이선희 ( Sun-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 245-246 (2 pages)

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Concerns about a global economic recession are rising following the coronavirus disease 2019 (COVID-19) pandemic. Accordingly, government entities, which are committed to overcome two barriers to severe inflation and economic recession, are showing high interest in spending management so as not to undermine fiscal soundness. Since the health care sector especially accounts for a large proportion of fiscal expenditure, it should be managed in a manner that the expense is appropriately spent. The National Health Insurance System and Healthcare System have secured international competitiveness and reliability by effectively responding to the COVID-19 pandemic. Likewise, considerable efforts should be made to reorganize the welfare and healthcare systems so that they can be sustainable during the post-COVID-19 era and the recession.

KCI등재

저자 : 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 247-257 (11 pages)

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The presidential election and the inauguration of the new government are a period of the policy window opening. The newly launched government is expected to improve the quality of life of the people. The Yoon Suk-yeol Government is also launched with new expectations with a transitional period in health care. The sustainability of health care in Korea is threatened. The environment of health care and the main policy issues of health care are difficult to secure the necessary finance for health care in spite of the increasing health care burden. Accordingly, the Yoon Suk-yeol Government's health care policy aims to provide intensive support to those in need of health and welfare and to improve the health of the people through investment in health. And for integrating fragmented health care and welfare services and creating people-centered community-based health care, a health care innovation center will be established for the evaluation platform of new delivery and payment systems, a health care development plan will be established for the blueprint of health care, and reorganizing the central & local government should be reviewed. Although we are facing unfavorable situations such as the distribution of the National Assembly, inflation, and the possibility of economic recession, we expect that announced health care policies will be implemented, recognizing that health care innovation is the only way to improve health care sustainability.

KCI등재

저자 : 윤나영 ( Na-young Yoon ) , 이동현 ( Dong Hyun Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 258-271 (14 pages)

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The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the “country” was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

KCI등재

저자 : Jee In Chung

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 272-281 (10 pages)

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With the outbreak of coronavirus disease 2019 (COVID-19) pandemic, health policymakers are adopting new policies regarding the issue of immunization disparities, especially for children in low-income communities of color who lack awareness and thereby access to vaccines. The purpose of this paper is to propose an evaluation framework using program theory-based evaluation approach and logic model to analyze and evaluate the immunization disparities in children aged 19-35 months. Data is collected from New York City department of Health and the U.S. Census Bureau for Northern Manhattan Start Right Coalition program which consists of 19,800 children, and the community-provider partnership includes 26 practices and 20 groups. Program theory is used to evaluate this community-based initiative with the logic model which is a visual depiction that illustrations the program theory to all stakeholders. The logic model highlights the resources, activities, outputs, outcomes, and impacts of the program to guide to planners and evaluators and to call attention to the inadequacies or flaws in the operational, implementation and service delivery process of the program in offering a new perspective on the program. This framework adds to the literature on evaluations of immunization disparities in determining whether evaluators can definitively attribute positive immunization outcomes in the community to the program and conclude whether it has potential in expanding or duplicating it to other similar settings, especially in other rural areas of the United States, and abroad, where routine immunization equity gaps are wide due to income, racial and ethnic diversity, and language barrier.

KCI등재

저자 : 박수진 ( Soojin Park ) , 남진영 ( Jin Young Nam )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 282-292 (11 pages)

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Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older.
Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis.
Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: β=0.8260, p<0.0001; SCD→MCC: β=0.6607, p<0.0001).
Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

KCI등재

저자 : 장위룡 ( Weilong Zhang ) , 김형준 ( Hyungjun Kim ) , 송라윤 ( Rhayun Song ) , 박명화 ( Myonghwa Park ) , 오근엽 ( Keunyeob Oh )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 293-303 (11 pages)

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Background: Coronavirus disease 2019 (COVID-19), which has occurred since the end of 2019, has caused tremendous damage not only in terms of disease and death but also in terms of economy. Accordingly, governments implemented health and quarantine policies to prevent the transmission and spread of COVID-19 and minimize economic effects, and implemented various countermeasures to reduce social and economic damage. However, the damage varies from country to country, and there are differences in the response of each government.
Methods: Using 2020 data from the Organization for Economic Cooperation and Development countries, the effectiveness of governments' quarantine and economic policies in response to COVID-19 was calculated, and what factors determine the effectiveness were analyzed. While most of the previous studies analyzed the relationship between the government's quarantine policy and corona transmission and death, this study is characterized by considering the economic aspect in addition.
Results: As a result of the analysis, the following results were obtained. First, when economic aspects are not considered, Asian and European countries have similar levels of efficiency, but when economic aspects are taken into account, Asian countries have higher efficiency. Second, population density had a negative effect on the efficiency of each country's policy, and long-term orientation was found to have an important impact when considering the economic aspect.
Conclusion: We found that the governance index is an important variable influencing the efficiency, which shows that the effectiveness of government policies in response to the coronavirus depends heavily on the trust relationship between the government and the people.

KCI등재

저자 : Yoolwon Jeong , Sun-hee Lee

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 304-316 (13 pages)

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Background: As prevention of coronavirus disease 2019 (COVID-19) transmission in healthcare settings has become a critical component in its effective management, COVID-19 specific infection prevention and control (IPC) guidelines were developed and implemented by numerous countries. Although largely based on the current evidence-base, guidelines show much heterogeneity, as they are influenced by respective health system capacities, epidemiological risk, and socioeconomic status. This study aims to analyze the variations and concurrences of these guidelines to draw policy implications for COVID-19 response and future guidelines development.
Methods: The contents of the COVID-19 IPC guidelines were analyzed using the categories and codes developed based on “World Health Organization guidelines on core components.” Data analysis involved reviewing, appraising and synthesizing data from guidelines, which were then arranged into categories and codes. Selection of countries was based on the country income level, availability of COVID-19 specific IPC guideline developed at a national or district level.
Results: The guidelines particularly agreed on IPC measures regarding application of standard precautions and providing information to patients and visitors, monitoring and audit of IPC activities and staff illnesses, and management of built environment/equipments. The guidelines showed considerable differences in certain components, such as workplace safety measures and criteria for discontinuation of precautions. Several guidelines also contained unique features which enabled a more systematic response to COVID-19.
Conclusion: The guidelines generally complied with the current evidence-based COVID-19 management but also revealed variances stemming from differences in local health system capacity. Several unique features should be considered for benchmark in future guidelines development.

KCI등재

저자 : 옥현민 ( Hyun Min Ok ) , 김성현 ( Sung Hyun Kim ) , 지석민 ( Seok Min Ji )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 317-322 (6 pages)

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Background: Limited access to medical services causes problems in patients' health and life. Also, hospital closures cause concentration towards general hospitals, which leads to worsening National Health Insurance finance. Therefore, hospital closure is an important topic to be analyzed.
Methods: This paper analyzed the factors that affect hospital closures using survival analysis with the data of 970 hospitals opened between 2010 and 2019 in Korea. The number of medical personnel, hospital rooms, sickbeds, and medical departments were used as explanatory variables.
Results: The number of medical personnel and hospital rooms increased the survival probability while the number of sickbeds and medical departments decrease the survival probability.
Conclusion: The results suggest that hospitals have economies of scale and diseconomies of scope in management.

KCI등재

저자 : 박희선 ( Hee Sun Park ) , 최정규 ( Jung Kyu Choi ) , 태은숙 ( Eun Sook Tae ) , 최상길 ( Sang Gil Choi ) , 김의혁 ( Eui Hyeok Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 323-329 (7 pages)

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Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the “referral and return of patients to clinics” program and reduce the rate of returning patients.
Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as “failure to transport,” among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the “failure to transport” patients.
Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes.
Conclusion: The success rate of the “referral and return of patient to clinics” program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

KCI등재

저자 : 홍사민 ( Samin Hong )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 3호 발행 연도 : 2022 페이지 : pp. 330-333 (4 pages)

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Korea's quarantine response to the novel coronavirus (coronavirus disease 2019 [COVID-19]) pandemic is based on the sacrifice of health professionals, especially public health doctors (PHDs) who were called out first and put in the first place in the country. PHDs performed major quarantine tasks, such as collecting samples from screening clinics and epidemiological investigations, in various parts of the country, including the Daegu area, where the first large-scale COVID-19 confirmed cases in Korea and explosively increased. Because of their position as fixed-term civil servants, however, PHDs' professionalism as doctors was ignored, and they were not properly compensated for their work. They were also exposed to problems such as a high risk of infection, mental suffering, and various human rights violations. We must prepare concrete measures to improve the fundamental treatment of PHDs and protect their human rights in order to prepare for a possible infectious disease pandemic in the future.

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