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수록정보
30권2호(2020) |수록논문 수 : 13
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30권2호(2020년) 수록논문
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KCI등재

1코로나19 이후 시대

저자 : 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 139-141 (3 pages)

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Coronavirus disease 2019 (COVID-19) is currently in progress. Although it is difficult to predict the end of currently increasing COVID-19, it is expected to last for a long time. The COVID-19 is making a lot of changes. Due to physical distancing and living distancing, non-contacts such as wearing facial masks, online lectures, online medical services, telecommuting, and telemarketing are becoming common. In the era of post-COVID-19, online and offline will coexist. Many countries following China's lockdown strategy, which is agreed with the World Health Organization, should be changed to Taiwan's facial mask strategy for reducing the economic problems. The prolonging COVID-19 will add to the economic difficulties, and the US-China confrontation will be difficult to rebound the global economy. COVID-19, such as plaque, smallpox, and Spanish influenza, will be a historical momentum. How to respond to the crisis of COVID-19 and post-COVID-19 will determine the future of the world and Korea.

KCI등재

2중앙정부와 지방정부의 효과적인 건강증진 정책 추진을 위한 과제: 국민건강증진종합계획을 중심으로

저자 : 오유미 ( Yumi Oh ) , 조인성 ( Insung Cho )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 142-150 (9 pages)

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The purpose of this study is to analyze the long-term plans of the central and local governments in order to plan policy and implementing programs. Through this, the governments is find out to reduce administrative burden. Based on the national health plan, evidence and related laws were collected and analyzed. As a quantitative methodology analyzed the contents of related laws in the overall plan. The qualitative methodologies analyzed and categorized the planning status of cities and provinces in the plan and were collated. There are a total of 39 plans for long-term plans by laws. The role of the central and local governments in the public health sector, there are a total of four plans (10.3%) that need to establish long-term and annual plans for the central and local (cities, provinces) government. A total of seven plans (17.9%) were required to establish a plan by the only local government. In terms of the public health sector on the local governments, 20 plans (51.3%) by cities and 12 plans (30.8%) by provinces were established by law. And in the health sector should be established 9 plans (40.9%) by cities and 7 plans (31.8%) by provinces. The plan needs to be reformed and merged between plans so that governments can focus on the program through planning central government policies, reducing local government administration.

KCI등재

3단일보험자는 강력한 구매자인가: 인도네시아 사례를 중심으로

저자 : 김양희 ( Yanghee Kim ) , 변진옥 ( Jinok Byeon )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 151-163 (13 pages)

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This study reviewed primary care purchasing issues of the Indonesian single-insurer, BPJS-K, in the context of triangular power relations between the government, the insurer, and the providers, and considered its challenges of purchasing as the national single-insurer. Some literature reviews and interviews with Indonesian stakeholders and residents were used to describe the historical and social contexts of Indonesian healthcare and social health insurance systems especially focusing legal and institutional status of BPJS-K and primary care provision and delivery conditions in remote areas. Though BPJS-K directly belongs to the presidential office of Indonesia, it has limited power in terms of purchasing as a single insurer. Mainly it was due to the lack of primary care resources, Ministry of Health's strong power as the regulator and provider, and BPJS-K's powerlessness against monitoring and quality of care assessment. Ambiguous accountability was another issue among the insurer and the Ministry of Health. This created confusions in primary care provision. It is suggested that each agencies' accountability should be obvious in terms of legal, political, and social contexts.

KCI등재

4신의료기술에 대한 진료비 지불: 외국사례와 시사점

저자 : 정설희 ( Seol-hee Chung ) , 권오탁 ( Ohtak Kwon ) , 최연미 ( Yeonmi Choi ) , 문경준 ( Kyeongjun Moon ) , 채정미 ( Jungmi Chae ) , 이루리 ( Ruri Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 164-177 (14 pages)

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This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

KCI등재

5신포괄수가 시범사업 모형개선이 건강보험 보장률에 미친 영향

저자 : 최정규 ( Jung-kyu Choi ) , 김선희 ( Seon-hee Kim ) , 장정하 ( Cheong-ha Chang ) , 윤종민 ( Jong-min Yoon ) , 강중구 ( Jung-gu Kang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 178-184 (7 pages)

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Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance.
Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695.
Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356).
Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

KCI등재

6의원급 노인 외래 정률차등정책 효과분석

저자 : 나영균 ( Young-kyoon Na )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 185-191 (7 pages)

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Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years.
Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method.
Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased.
Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

KCI등재

7건강보험 재정 현황과 전망

저자 : 주재홍 ( Jae Hong Joo ) , 장성인 ( Sung-in Jang ) , 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 192-198 (7 pages)

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Background: Korea National Health Insurance Service (NHIS) is operated as a social insurance system in which people pay a portion of their monthly income as insurance premiums and receive benefits when they experience illness or injury. Since 2005, the national health insurance remained surplus accumulating cumulative reserves each year. However, as of 2018, NHIS revenue recorded 62.11 trillion won and spending of 62.29 trillion won. The deterioration of NHIS finances is expected to accelerate with the aging population, income growth, new medical technology development, and enhanced security policies.
Methods: To examine the financial health and sustainability of NHIS, we estimated the future revenue and spending until 2030 using the data from Korea Health Insurance Review and Assessment Service statistical yearbook. 2004-2018 average percentage change in NHIS revenue and spending was calculated. We estimated the future NHIS financial status using two methods. In the first method, we calculated the revenue and spending of the future NHIS by applying the 2004-2018 average percentage change to the subsequent years consecutively. In the second method, we estimated the future NHIS financial status after adjusting for the predicted demographic changes such as the aging population and declining birth rate in South Korea.
Results: The estimates from this study suggest that the NHIS's cumulative reserves will run out by 2024.
Conclusion: In terms of spending on current health insurance, there should be a search for ways of more efficient spending and funding options.

KCI등재

8지역 간 흡연율 격차 영향요인 분석 및 금연사업 상대적 효율성 평가: Clustering Analysis와 Data Envelopment Analysis를 활용하여

저자 : 김희년 ( Heenyun Kim ) , 이다호 ( Da Ho Lee ) , 정지윤 ( Ji Yun Jeong ) , 구여정 ( Yeo Jeong Gu ) , 정형선 ( Hyoung Sun Jeong )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 199-210 (12 pages)

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Background: Based on the importance of ceasing smoking programs to control the regional disparity of smoking behavior in Korea, this study aims to reveal the variation of smoke rate and determinants of it for 229 provinces. An evaluation of the relative efficiency of the cease smoking program under the consideration of regional characteristics was followed.
Methods: The main sources of data are the Korean Statistical Information Service and a national survey on the expenditure of public health centers. Multivariate regression is performed to figure the determinants of regional variation of smoking rate. Based on the result of the regression model, clustering analysis was conducted to group 229 regions by their characteristics. Three clusters were generated. Using data envelopment analysis (DEA), relative efficiency scores are calculated. Results from the pooled model which put 229 provinces in one model to score relative efficiency were compared with the cluster-separated model of each cluster.
Results: First, the maximum variation of the smoking rate was 16.9%p. Second, sex ration, the proportion of the elder, and high risk drinking alcohol behavior have a significant role in the regional variation of smoking. Third, the population and proportion of the elder are the main variables for clustering. Fourth, dissimilarity on the results of relative efficiency was found between the pooled model and cluster-separated model, especially for cluster 2.
Conclusion: This study figured regional variation of smoking rate and its determinants on the regional level. Unconformity of the DEA results between different models implies the issues on regional features when the regional evaluation performed especially on the programs of public health centers.

KCI등재

9제14기(2018년) 청소년건강행태조사 자료를 이용한 청소년 주관적 체형 인지와 자살 생각 사이의 연관성

저자 : 류한준 ( Hanjun Ryu ) , 김영호 ( Youngho Kim ) , 김재현 ( Jaehyun Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 211-220 (10 pages)

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Background: This study aimed to demonstrate the importance to recognize subjective body image on their mental health on adolescents.
Methods: We used the chi-square test and the multiple logistic regression model to analyze the data of the “Korean Youth Health Behavior Survey in 2018” (n=42,259) conducted by the Korea Centers for Disease Control and Prevention.
Results: As a result of the analysis, suicide ideation increased when the subject body image is thin and fat. Especially, the suicide ideation who recognized the subjective body image as thin is higher (odds ratio [OR], 1.666; 95% confidence interval [CI], 1.050- 1.295), and who recognized the subjective body image as fat is higher (OR, 1.134; 95% CI, 1.032-1.245) than the group who recognized the subjective body image as normal.
Conclusion: When preparing a health policy on adolescent suicide issues, we need to consider the association between subjective body image and suicide ideation.

KCI등재

1020대 성인의 우울감 경험에 영향을 미치는 요인: 2017 지역사회건강조사 자료 활용

저자 : 김경숙 ( Kyung Sook Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 30권 2호 발행 연도 : 2020 페이지 : pp. 221-230 (10 pages)

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Background: The purpose of this study is to identify the factors affecting the depressive mood experience of adults in their 20s.
Methods: This study is a descriptive survey that conducted a secondary analysis using data from the 2017 Community Health Survey, which is conducted annually in Korea. The study targets 21,324 adults in their 20s. Data analysis was conducted after creating a composite sample plan file that reflected layering variables, colony variables, and weights.
Results: Factors affecting the depressive mood experience were suicide thought experience, subjective stress level, gender, monthly household income, smoking status, subjective health level, breakfast status, participation in social activities, and whether the Internet, games, and smartphone interfered with daily life (p<0.05).
Conclusion: It is necessary to establish and realize a system that enables early detection and support of depression and suicide high-risk groups at the individual, home, community, and national levels.

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