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Health Policy and Mangemnet

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수록정보
수록범위 : 1권1호(1991)~31권3호(2021) |수록논문 수 : 963
보건행정학회지
31권3호(2021년 09월) 수록논문
최근 권호 논문
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KCI등재

1위드코로나 시대, 어떻게 준비할 것인가?

저자 : 이선희 ( Sun-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 241-243 (3 pages)

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With the increase in vaccinations worldwide, the world is facing the era of coexisting with coronavirus disease 2019 (COVID-19). The government announced that it will change its focus of public health emergency response system, gradually toward daily recovery from November. Hence, this article reviews an overview of policy tasks to prepare for the era of coexistence with COVID-19. The three key policies that should be considered are as follow: (1) vaccination should be administered promptly to improve the immunity of the target population; (2) the government should advance the medical capability for critically ill patients and reorganize the patient delivery system; and (3) epidemiological surveillance system should be reformed in a direction to raise the social capacity.

KCI등재

2코로나19 감염병 대응모델의 국제표준화 요건

저자 : 안선주 ( Sun-ju Ahn )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 244-254 (11 pages)

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The management of emerging infectious diseases cannot help but completely depend on non-pharmaceutical interventions in the early stages of the outbreak. Consequently, South Korea has developed and implemented the 3T (test-trace-treat) models, non-pharmaceutical infection prevention and control (IPC) measures, in response to the coronavirus disease 2019 (COVID-19) pandemic. The IPC measures have gained global attention, rendering them to be essential in the development of a shareable, reusable, and applicable protocol for future pandemics. This study was conducted to identify the requirements necessary for standardizing the IPC measures. Three new work items of the 18 3T models were proposed to ISO/TC 304 (International Organization for Standardization/Technical Committee 304; healthcare organization management). Requirements for each IPC measure, identified by participating members (P-members) countries during the ISO ballots, were analyzed in this study. The three new work items were approved by the P-members countries after a 3-month ballot. There was a consensus that the three IPC measure models should be International Standards (IS). Other comments include (1) the models should include not only COVID-19 but also any respiratory pandemic; and (2) keep donning of level D protection at screening sites as an optional protocol, in consideration for the lack of personal protective equipment. Standardization is a systematic process of developing internationally agreed-upon wisdom and knowledge that consider and respect the diversity and universality of each country. It is expected that such standardized applicable IPC measure models contribute to global efforts to rapidly respond to a public health emergency of international concern during its early stages.

KCI등재

3일반건강검진의 이상지질혈증 검진주기 변경에 대한 문제점 고찰

저자 : 이준희 ( June-hee Lee ) , 이경재 ( Kyung-jae Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 255-260 (6 pages)

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Background: Korea National Health Checkup Programs are aimed at the prevention and early detection of cardiovascular disease in adults. To establish a countermeasure for this tendency, The current Korea National Health Checkup Programs have been providing Health Risk Appraisal (HRA) since 2009, thereby focusing on individual lifestyle correction. However, from 2018, the dyslipidemia screening exam cycle has been changed from 2 to 4 years.
Methods: In this study, we try to investigate whether policy decisions are valid based on domestic reports that have influenced policy decisions. First, considering the epidemiology of the domestic cardiovascular disease, dyslipidemia, and metabolic syndrome, the change of the 4-year cycle is appropriate or not. Second, whether the research method that applies came to make policy decisions appropriate or not. Third, our study also investigates whether the direction of policy decision was suitable for the second comprehensive national examination plan.
Results: The data that are used in the previous study were that of 10 years ago and there also was a problem in selecting the data, especially the use of one of the research methods to calculate the signal to noise ratio that was aimed at improving health had some problems. This is a research method that does not match with the aim itself.
Conclusion: Changing the screening cycle for dyslipidemia does not match the recent trend of general screening to effectively prevent cardiovascular disease in improving individual lifestyles in the national health checkup plan. Studying the relationship with metabolic syndrome, which can be an intermediate stage of cardiovascular disease, could be a policy direction that is more suitable for the national health examination comprehensive plan.

KCI등재

4MRI 외부병원 판독 수가 인상의 효과 분석: 뇌 관련 자기공명영상을 중심으로

저자 : 김록영 ( Logyoung Kim ) , 사공진 ( Jin Sakong ) , 조민호 ( Minho Jo ) , 위세아 ( Seah Wee ) , 이진용 ( Jinyong Lee ) , 김용규 ( Yongkyu Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 261-271 (11 pages)

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Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies.
Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses.
Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities.
Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

KCI등재

5국가별 건강보험체계에 따른 국가건강검진제도 비교 연구

저자 : 이예지 ( Yeji Lee ) , 김은영 ( Eunyoung Kim ) , 이동현 ( Donghyun Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 272-279 (8 pages)

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Background: Korea's health screening program has been faced the need for changes as the population and diseases structure are changing. In addition to Korea, many countries operate state-led health check-up programs to improve the health level of the people, and the operating methods of the program appear in various forms according to each country's health insurance system. This study examines other state-led health screening programs and proposes a direction for the development of Korea's health screening program.
Methods: The study was conducted using the literature review method, and the “country” was set as a unit for the case analysis. The operating method of the health screening programs and the financial resources were compared according to the health insurance system. Five countries were selected as Korea, the United States, the United Kingdom, Japan, and Taiwan.
Results: The analyzed countries mainly operate the health screening program as a management method for chronic diseases, but there were differences in the operating method, financing, and targeted subjects and examination items. In most countries, a risk assessment was performed prior to the examination (screening), and the subjects who needed the examination were first selected, and a follow-up management service was provided in accordance with the risk each individual exposed.
Conclusion: Rather than applying the same screening method to populations with different risk levels, a health screening program will be constructed in consideration of the individual's health level and exposure risk, and the healthcare delivery system will be reorganized so that screening and treatment services can be linked.

KCI등재

6공공기관의 공공성 이행 검토: 의료분쟁조정중재원 사례를 중심으로

저자 : 양화인 ( Fain Yang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 280-291 (12 pages)

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Background: Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications.
Methods: Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present.
Results: As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders' perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens' use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized.
Conclusion: While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.

KCI등재

7우리나라 고혈압 환자의 투약 순응도 연구

저자 : 홍재석 ( Jae-seok Hong )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 292-300 (9 pages)

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Background: Medication adherence in hypertension is the most important to control blood pressure and prevent major complications. The purpose of this study was to identify factors affecting medication adherence and to examine the relationship between medication adherence and blood pressure control in Korea.
Methods: This study used data from the 7th Korea national health and nutrition examination survey (2016-2018) of the Korea Disease Control and Prevention Agency. We selected 4,063 hypertensive patients from the data. And we choose socio-demographic, health behavior, healthcare utilization, and severity characteristics as hypertensive patient characteristics.
Results: Of the patients with hypertension, 92.3% had shown adherence to medication as of 2016-2018 and shows variation according to the characteristic of patients. The cases with male, under 50 years old, urban area, single household, unmet medical services, less than 5 years of hypertension duration, no comorbidities (diabetes mellitus, myocardial infarction) showed significantly low medication adherence. After adjusting for confounders, adherent patients tended to have lower current systolic blood pressure (β=-10.846, p<0.001) and diastolic blood pressure (β=-5.018, p<0.001) than nonadherent patients. And, adherent patients increased the control odds of blood pressure compared with nonadherent patients (odds ratio, 3.02; 95% confidence interval, 2.21-4.12).
Conclusion: This study confirmed that adherence to antihypertensive drugs was effective in controlling blood pressure. In order to more actively manage hypertensive patients at the national level, it is necessary to make an effort to improve the medication compliance of nonadherent groups, such as early-diagnosis patients, young patients under 50 years of age, and patients living alone.

KCI등재

8지역 소멸위험지수와 지역의 만성질환 의료이용의 관계

저자 : 이현지 ( Hyun-ji Lee ) , 오재환 ( Jae-hwan Oh ) , 김재현 ( Jae-hyun Kim ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 301-311 (11 pages)

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Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region.
Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases.
Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately.
Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.

KCI등재

9A Comparative Analysis of Healthcare-Associated Infection Policy in South Korea and Its Implications in Coronavirus Disease 2019

저자 : Yoolwon Jeong , Kinam Kim

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 312-327 (16 pages)

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Background: Infection prevention and control (IPC) to manage healthcare-associated infection (HCAI) has emerged as one of the most significant public health issues in Korea. The purpose of this study is to draw implications in IPC policies by analyzing the context, process, and major actors in policy development and comparatively analyzing IPC policy contents of Korea with three other countries. Additionally, IPC policies were analyzed in the context of coronavirus disease 2019 (COVID-19) to provide implications for future pandemics and HCAI events.
Methods: This study incorporates a qualitative approach based on document and content analysis, applying codes and thematic categorization. IPC policy contents are comparatively analyzed by adopting the concept model, developed by the World Health Organization, which consists of core components of IPC structure at the national and facility level.
Results: National IPC policies were developed within a complex social and political context, through the involvement of various stakeholders. IPC policies in Korea place a high emphasis on establishing IPC programs and built environments in healthcare facilities, whereas there were potentials for improvement in policies involving patients and promoting a safety culture. IPC policies, which currently focus on general hospitals and certain functions of hospitals, should further be expanded to target all healthcare facilities and functions, to ensure more efficient and sustainable IPC responses in the current and future disease outbreaks.
Conclusion: IPC is a complex policy arena and lessons learned from the analysis of existing policies in the context of COVID-19 should provide valuable strategic implications for future policies.

KCI등재

10우리나라 성인 당뇨병 환자의 미충족의료 관련 요인

저자 : 장혜영 ( Hye Young Jang ) , 한미아 ( Mi Ah Han ) , 박종 ( Jong Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 31권 3호 발행 연도 : 2021 페이지 : pp. 328-334 (7 pages)

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Background: This study was conducted to investigate factors related to unmet medical needs of medical care in adult diabetes patients and to suggest factors related to unmet medical in Korea.
Methods: This study used data from the Korea National Health and Nutrition Examination Survey (KNHNES) 2014-2017. The subjects of the study were conducted on patients with unmet medical needs experience among the patients and analyzed using the IBM SPSS ver. 25.0 program (IBM Corp., Armonk, NY, USA).
Results: Overall, 10.9% of patients had unmet medical needs. Being female, less educated, and lower medical aid were related to unmet medical needs. And subjects with poor subjective health and higher stress level were more likely to report unmet medical needs.
Conclusion: Although comprehensive health insurance coverage, 10.9% of people with diabetes experienced unmet healthcare needs. The results of this study suggest that socioeconomic factors such as low education and medical aid were associated with unmet medical needs.

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