Korean Journal of Health Policy and Administration最新文献

{"title":"Variation in hospital length of stay according to the DRG-based prospective payment system in the voluntarily participating providers","authors":"S. Choi, Soonman Kwon, Gil-Won Kang, S. Moon, Jin-seok Lee","doi":"10.4332/KJHPA.2010.20.2.0167","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.2.0167","url":null,"abstract":"This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers` behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions` the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127811110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus on definition and quality standard of clinical practice guideline using RAND method","authors":"Seon-Mi Ji, S. Kim, S. Sheen, D. Heo, N. Kim","doi":"10.4332/KJHPA.2010.20.2.001","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.2.001","url":null,"abstract":"Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as \"scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances.\" Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123942075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Priority-setting procedures for NHI benefit package","authors":"Heesuk Yun, Soonman Kwon, Y. Kwon","doi":"10.4332/kjhpa.2010.20.2.053","DOIUrl":"https://doi.org/10.4332/kjhpa.2010.20.2.053","url":null,"abstract":"In health care, the process of resource allocation becomes a controversial process of rationing, as scarce resources are allocated between the numerous health care interventions. Especially for the last few years, decisions to define and expand the benefit package of National Health Insurance have always become the object of fierce criticism. It is partly because we have not reached a collective agreement as to what the most important criteria for spending priorities are. This paper considers the procedures and the principles which could be used to determine rationing in health care, and emphasizes the need to have explicit principles which determine patient access to care and to have an evidence base to inform rationing decisions. Also, the need to set up a public committee is suggested to take rationing decisions on behalf of government and NHS and to present them as evidence-based decisions.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131218983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difference in Resource Utilization according to Beneficiary Characteristics of the Long-term Care Facilities","authors":"Sue-Hyung Lee, Hosung Shin","doi":"10.4332/KJHPA.2010.20.1.019","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.1.019","url":null,"abstract":"Fee for long-term care insurance in Korea are determined in proportion to resources utilized according to severity rather than based on categorization of beneficiaries in consideration of the characteristics of resource utilization. This adoption is based on the assumption that as beneficiaries of long-term care insurance, characteristically, demands social services rather than needs medical treatments, the characteristics of beneficiaries and the quality of utilized resources are comparatively homogenous. Therefore, the proposition is that the size of resource consumed by beneficiaries in the same grade is identical. However, even in the same grade, the level of utilized resources is different depending on the characteristic of beneficiaries. In this regard, this study is to examine whether there are differences in the volumes of utilized resources depending on the characteristics of beneficiaries even","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134645385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and magnitude of out-of-pocket payment and factors influencing them in Industrial Accident Compensation Insurance","authors":"Bo-Hyun Park, T. Lee, W. Lim","doi":"10.4332/KJHPA.2010.20.1.103","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.1.103","url":null,"abstract":"The out-of-pocket payment (OOP) of the Industrial Accident Compensation Insurance (IACI) in Korea was investigated empirically in terms of its incidence, magnitude and factors influencing them. The subjects were sampled with stratified, randomized methods among medical institutions of which the number of monthly IACI claims exceeded its median as of May 2008. Out of 204 institutions selected, 118 institutions (57.8%) responded to this survey. A total of 24,826 episodes(2,457 inpatient and 22,369 outpatient episodes) were included in this analysis. The incidence and magnitude of OOP of IACI were calculated by characteristics of institution as well as patient.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127944146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top Management Team Heterogeneity, Interaction and Organizational Performance in Korean Hospitals","authors":"Moung-Suk Jung, Se-Hoon Lee, Kwangjum Kim","doi":"10.4332/KJHPA.2010.20.1.137","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.1.137","url":null,"abstract":"This study empirically analyzed the effects of the Top Management Team (TMT) on organizational performance. We verified whether the age heterogeneity, job heterogeneity (core career, core function and major), and process (communication and integration) of the TMT affect organizational performance (management performance and healthcare service quality evaluation level). We collected data about 473 members of the 2006 TMT in 81 medical institutions. We also utilized statistics of organizational performance from the Ministry for Health, Welfare and Family Affairs and the Korean Institute of Hospital Management. Results of the study showed that the age heterogeneity of TMT exerted a","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125394182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Related to Fundus Examination in Diabetes Mellitus Patients","authors":"Joo-Hyuck Choi, B. Na, Sung-A Chun","doi":"10.4332/KJHPA.2010.20.1.125","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.1.125","url":null,"abstract":"Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"173 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122289175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Determinants of Population Health in OECD countries","authors":"Byongho Tchoe, S. Nam","doi":"10.4332/KJHPA.2010.20.1.001","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.1.001","url":null,"abstract":"This article examines social determinants of population health in OECD countries, where life years, infant mortality, and PYLL are used as proxy variables of health. The unit of analysis is a country which is the OECD affiliate. A panel regression estimation is chosen as a method, using OECD Health Data. The results are: the increasing national health expenditure affected positively to improve population health. Education was rather a significant determinant of health than income level. The government direct investment for public health did not contribute positively to enhance population health. The expansion of health care coverage was working positively for improving health, but with a time lag. The supply of doctors was a most influential determinant of health. In case of Korea, the coverage expansion of health care was the most important determinant of health. The supply of doctors was, however, not a positive factor for better health, which is different result with the case of OECD countries.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"315 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122735227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projecting Public Expenditures for Long-Term Care in Korea","authors":"Heesuk Yun, Hyung-Joon Kwon","doi":"10.4332/KJHPA.2010.20.1.037","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.1.037","url":null,"abstract":"part estimated the numbers of elderly people with different levels of health status by age group, gender, household type. The second part estimated the levels of long-term care services required, by attaching a probability of receiving long-term care services to each cell using from the sample from current year. The third part of the model estimated long-term care expenditure, along the demographic and non-demographic factors' change in various scenarios. Public spending on long-term care could rise from the current level of 0.2~0.3% of GDP to around 0.44~2.30% by 2040.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123441211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis on the Effect of the Government R&D Subsidies on the Private R&D Investments : in the Case of the Pharmaceutical Industry","authors":"Jin Sakong, You-Ho Shin","doi":"10.4332/KJHPA.2010.20.1.183","DOIUrl":"https://doi.org/10.4332/KJHPA.2010.20.1.183","url":null,"abstract":"The purpose of this study is to analyze the effect of the R&D subsidies by the government on the private firms` R&D investments in the Korean pharmaceutical industry, which are supposed to have positive effects on their economic performance. We also estimate the relationship between the private firms` R&D investments and firms` economic outcome. Empirical analysis is done by Error Component 2 Stage Least Squares(EC2SLS) estimation using 43 pharmaceutical firms` 8 years` panel data. The elasticity of the government R&D subsidies on the private R&D investments is 0.021%, which we cannot say `efficient`. Also R&D investments have positive effects on the economic outcome of the pharmaceutical firms, as we expected. We propose several suggestions in the conclusion for the efficient way of government R&D subsidies to induce more private R&D investments.","PeriodicalId":253456,"journal":{"name":"Korean Journal of Health Policy and Administration","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132594293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}