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Home medical care and Home health care system and roles of the public health care in Korea 韩国的家庭医疗保健和家庭医疗保健系统以及公共医疗保健的作用
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.11
Kun-Sei Lee
In the face of rapid aging in Korea, the demand for appropriate medical services for the elderly at home is increasing. This study investigates the current status of home medical care and Home health care in Korea based on the concept of Home-based primary care, and proposes strategies to implement home-care in public health centers and public hospitals that play a major role in the field of public health care.First of all, by presenting a conceptual framework for the current status of Korea’s home medical care and Home health care provision system, and described according to three financial resources: National Health Insurance(NHI), Long-Term Care Insurance(LTCI), and public health care. At the current level, the home health care systems are fragmented and they should be redesigned to improve the home care services.In order to implement home care in public health care institutions, a model centered on public health centers and public hospitals is proposed. Public health centers have various advantages, responsibility positions, and access to information, but they have working conditions and difficulties in providing incentives, and medical and nursing limitations. Public hospitals can provide a variety of services, but community access and insufficient knowledge are pointed out as disadvantages. Therefore, it is important to establish a cooperative system between the two institutions.Finally, we proposes the division and cooperation between public health centers and private medical institutions according to the level of service. Private medical institutions could be in charge of active treatment, medical services and skilled nursing cares. public health centers could perform monitoring and follow-up the patients. it is necessary to establish a coordinating system to cooperate the two parts of institutions.
面对韩国快速的老龄化,老年人对适当的居家医疗服务的需求与日俱增。本研究基于以家庭为基础的初级保健概念,调查了韩国家庭医疗护理和家庭保健的现状,并提出了在公共保健领域发挥重要作用的公共保健中心和公立医院实施家庭护理的策略。首先,通过提出韩国家庭医疗护理和家庭保健提供系统现状的概念框架,并根据三种财政资源进行描述:首先,提出了韩国家庭医疗和家庭保健服务体系现状的概念框架,并根据国民健康保险(NHI)、长期护理保险(LTCI)和公共保健三种财政资源进行了描述。为了在公共医疗机构中实施家庭护理,提出了以公共卫生中心和公立医院为中心的模式。公共卫生中心有各种优势、责任岗位和获取信息的渠道,但其工作条件和提供激励措施存在困难,医疗和护理也有局限性。公立医院可以提供各种服务,但社区就诊和知识不足被指出是其缺点。最后,我们建议公立卫生院与私立医疗机构根据服务水平进行分工与合作。私立医疗机构可以负责积极治疗、医疗服务和专业护理,公共卫生中心可以对病人进行监测和随访。
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引用次数: 0
The Impact of COVID-19 on Medical Institutions in Korea: Focusing on Financial Losses COVID-19 对韩国医疗机构的影响:关注财务损失
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.6
B. Ahn, Jin-Won Noh, Eunji Yun, Hey-Jin Ko, Jun Hyuk Koo, W. Jang, Hyejin Lee, Jinyong Lee
Purposes: It is known that medical institutions suffered substantial financial losses due to the COVID-19 pandemic, but studies that specifically identified the size of losses are lacking. This study aims to analyze in detail how much financial loss medical institutions suffered in 2020, at the beginning of the COVID-19 pandemic.Methodology: This study used national health insurance claim data from 2018 to 2020 provided by the Health Insurance Review and Assessment Service. Financial losses were conceptualized and classified as the increase or decrease in total medical expenses or the proportion of increased or decreased institutions. The trend of total medical expenses was analyzed by medical institution type, health insurance qualification type, and treatment type (inpatient/outpatient).Findings: The results showed that the decrease in medical expenses due to COVID-19 was the largest at clinic-level medical institutions, and the distribution of each clinic’s increases and decreases was wide. In addition, almost all of the pediatrics and otolaryngology clinics had a reduction in medical expenses due to COVID-19.Practical Implications: Medical institutions have been pleading about the pain caused by the COVID-19 pandemic. However, it was known that the decrease in total medical expenses in 2020 compared to 2019 was insignificant. This study overcame the trap of average through more detailed analyses, confirming the need for differentiated policy support in the event of a similar situation.
目的:众所周知,医疗机构因 COVID-19 大流行而遭受了巨大的经济损失,但缺乏具体确定损失规模的研究。本研究旨在详细分析 2020 年,即 COVID-19 大流行之初,医疗机构遭受了多少经济损失:本研究使用了医疗保险审查与评估服务机构提供的 2018 年至 2020 年全国医疗保险理赔数据。经济损失被概念化并划分为医疗总费用的增加或减少,或机构增加或减少的比例。按医疗机构类型、医保定点资格类型、诊疗类型(住院/门诊)对医疗总费用的变化趋势进行分析:结果表明,COVID-19 导致的医疗费用降幅最大的是诊所级医疗机构,且各诊所的增幅和降幅分布较广。此外,几乎所有儿科和耳鼻喉科诊所都因 COVID-19 而减少了医疗费用:医疗机构一直在为 COVID-19 大流行带来的痛苦而苦苦哀求。然而,众所周知,与 2019 年相比,2020 年医疗总费用的下降幅度微乎其微。本研究通过更详细的分析,克服了平均值的陷阱,证实了在发生类似情况时需要有区别的政策支持。
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引用次数: 0
Health Check-up Support for the Beneficiaries of Basic Livelihood Act: Two Years of the Coalition Experience and Outcomes. 为《基本生计法》受益人提供健康检查支持:联盟两年的经验和成果。
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.2
Minhyun Kim, Jong Seung Kim, Bumjo Oh, Eunyoung Shin, Jung-sun Lim
Objective: Self-sufficiency Center is a organization which provide support for individual skill acquisition and work opportunities to beneficiaries of basic livelihood act. The goal of this study is to provide health care, customized counseling, and treatment at the community level to improve their health status.Methods: The subjects of this study were participants in three district self-sufficiency center of Seoul that received welfare funds in 2015 and 2016. All examinations included self-written surveys, body measurement, blood and urine tests, abdominal ultrasound and gastroscopy. Optional biopsy, colonocopy, lung CT and thyroid ultrasound were charged extra.Result: Through this examination, one case of colon cancer, two cases of cervical cancer, two cases of thyroid cancer and one case of lung cancer were found for malignant tumors. One case of internal carotid artery occlusion, one case of ascending aortic dilatation, three cases of hepatitis B antigen carrier and chronic liver disease, and diseases such as high blood pressure and dyslipidemia were newly diagnosed or found to be poorly controlled. Patients with all abnormal results were requested medical treatment with a specialist, and at least one year after the examination, approximately 45% of them found follow-up lost. In a retrospective telephone survey with 62 participants, they responded that they were not receiving medical treatment or health examinations because lack of time or cost. They responded that they will participate private health examinations again if economic support is provided.Conclusion: Through this private health examination whith people of low economic levels, it was confirmed that they were not in good health, but they have desire to do health examination and will voluntarily participate health examination if they have low economic burden. One clue to health inequality could be that people with low economic status are more likely to develop diseases due to cost burdens and neglect of health care.
目标:自给自足中心是一个为基本生计行动受益人提供个人技能学习和工作机会支持的组织。本研究的目的是在社区层面提供保健、定制咨询和治疗,以改善他们的健康状况:本研究的对象是 2015 年和 2016 年领取福利金的首尔市三个区自给自足中心的参与者。所有检查包括自我书面调查、身体测量、血液和尿液检查、腹部超声波检查和胃镜检查。可选择的活组织检查、结肠镜检查、肺部 CT 和甲状腺超声波检查需额外收费:结果:通过这次检查,发现恶性肿瘤 1 例结肠癌、2 例宫颈癌、2 例甲状腺癌和 1 例肺癌。1例颈内动脉闭塞,1例升主动脉扩张,3例乙肝抗原携带者和慢性肝病,以及新诊断或发现控制不佳的高血压和血脂异常等疾病。所有结果异常的患者都被要求接受专科医生的治疗,检查至少一年后,约 45% 的患者发现随访失访。在对 62 名参与者进行的一项回顾性电话调查中,他们回答说,由于缺乏时间或费用问题,他们没有接受医疗或健康检查。他们回答说,如果能提供经济支持,他们会再次参加私人健康检查:通过对经济水平较低的人进行私人健康检查,证实他们的健康状况并不好,但他们有进行健康检查的愿望,如果经济负担较轻,他们会自愿参加健康检查。健康不平等的一个线索可能是,经济地位低的人更容易因费用负担和忽视保健而患病。
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引用次数: 0
Learning the Basics of South Korea’s Healthcare System as a Korean-American 作为韩裔美国人学习韩国医疗保健系统的基础知识
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.8
Claire Jun
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引用次数: 0
Construction and Utilization of Panel to Encourage Community Engagement in Public Health and Medical Services 建设和利用小组,鼓励社区参与公共卫生和医疗服务
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.5
Hyeran Jeong, Jiyoon Jeong, Jeehee Pyo, Mina Lee, Soae Lee, M. Ock
Introduction: Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City (TSPMU) needs to establish a system for analyzing and collecting data on the public health status that can serve as the basis for local evidence-based projects and policy formulation. In order to engage citizens in this process, TSPMU has established an online panel (ULFAM) composed of Ulsan citizensMethods: In 2020, TSPMU planned the features to be implemented on the panel site by benchmarking similar sites. After a development period of approximately 5 months, the site was officially launched.Results: Currently, ULFAM has around 2600 Ulsan citizens as panel members. The panel site is organized into sections such as introduction to institution including vision, major projects, and information about affiliated organizations, as well as sections for survey participation and information board. Panel surveys are conducted through online questionnaires on the site. It also utilized as a means for recruiting participants. Various surveys have been conducted, including the Ulsan Medical Center establishment awareness survey, delivery workers’ health status survey, and more. The survey results are compiled into reports and used as foundational data for various projects. Additionally, the site is designed to link citizens to appropriate health and medical services based on the survey results. Furthermore, the panel is utilized for promotional activities related to Improvement of awareness regarding cancer screening and recognition of symptoms of cardiovascular diseases, and more. During these activities, collaboration with collaborating organizations has been undertaken, achieving a synergistic effect in promotion.Conclusion: The voluntary participation of residents in the field of public health is increasingly important. To implement effective policies, it is necessary to consider the opinions of the residents. ULFAM serves as a means of communication with Ulsan citizens, providing a platform for engaging with Ulsan residents on public health and medical issues in the community.
导言:蔚山广域市公共卫生和医疗服务支援特别小组(TSPMU)需要建立一个分析和收集公共卫生状况数据的系统,以作为地方循证项目和政策制定的基础。为了让市民参与这一过程,TSPMU 建立了一个由蔚山市民组成的在线小组(ULFAM):2020 年,TSPMU 通过参考类似网站,规划了小组网站的功能。经过约 5 个月的开发,网站正式上线:目前,ULFAM 有约 2600 名蔚山市民成为小组成员。小组网站分为机构介绍(包括愿景、主要项目和附属机构信息)、参与调查和信息板等部分。小组调查通过网站上的在线问卷进行。该网站还被用作招募参与者的手段。已经开展了各种调查,包括蔚山医疗中心机构认知度调查、送货员健康状况调查等。调查结果被汇编成报告,作为各种项目的基础数据。此外,该网站旨在根据调查结果将市民与适当的健康和医疗服务联系起来。此外,该小组还被用于与提高癌症筛查意识、识别心血管疾病症状等相关的宣传活动。在这些活动中,与合作机构开展了合作,实现了宣传的协同效应:居民在公共卫生领域的自愿参与越来越重要。要实施有效的政策,就必须考虑居民的意见。ULFAM 作为与蔚山市民沟通的一种手段,为蔚山市民提供了一个参与社区公共卫生和医疗问题的平台。
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引用次数: 0
The necessity of a ‘Hospital-Led Total Care Center for Developmentally Disabled Individuals’ explored through autism spectrum disorders. 通过自闭症谱系障碍探讨 "医院主导的发育障碍人士全面护理中心 "的必要性。
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.7
Seihee Park
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引用次数: 0
Sustainability Crisis of Korean Healthcare System: Service Delivery System 韩国医疗系统的可持续性危机:服务提供系统
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.9
Juhwan Oh
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引用次数: 0
Health and Working Conditions of Delivery Workers in Ulsan, South Korea Article type 韩国蔚山分娩工人的健康和工作条件 文章类型
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.4
Jiyoon Jeong, Hyeran Jeong, Jeehee Pyo, Mina Lee, Soe Lee, M. Ock
Objective: This study aimed to determine the current work environment and health conditions for delivery workers in Ulsan Metropolitan City.Methods: Data from 64 delivery workers were collected, including their sociodemographic and employment information, and their opinions on labor environment, health status, health check-ups, and national health services. Quantitative data were analyzed through frequency analysis to explore the results. Qualitative data, such as descriptive responses, were examined through a process of categorization and multi-frequency responses.Results: The primary risk exposure of delivery workers in workplace was vibration from machines, high temperatures enough to sweat even when not working, smoke, gas, dust, etc. (each at 50.0%). Physical threats during work included postures that caused fatigue or pain (76.6%) and direct interaction with people (76.6%). Challenges in welfare and support within the work environment included the lack of rest time or difficulty in utilizing it (60.9%), no regular mealtime (65.6%), and no provision of protective equipment by the company (57.8%). A total of 48.8% of delivery workers responded that there were health and safety risks in their work environment, and overall job satisfaction was low (59.4% expressed dissatisfaction). While the general health condition was good, there were numerous complaints of pain (79.7%). Specific health issues included upper limb muscle pain (70.3%), lower limb muscle pain (62.5%), and the most diagnosed disease was hyperlipidemia (23.4%). Over the past two years, 10.9% of the participants had not had health check-ups. 71.9% expressed their willingness to participate in health promotion services, followed by improvement in working conditions and the management of harmful substances, musculoskeletal disorders, and cardiovascular diseases.Conclusion: This study, by examining the health status of delivery workers in Ulsan Metropolitan City, provides valuable foundational data for improving their work environment and preventing occupational diseases among them.
研究目的本研究旨在了解蔚山广域市分娩工人目前的工作环境和健康状况:收集了 64 名送货员的数据,包括他们的社会人口学和就业信息,以及他们对劳动环境、健康状况、健康检查和国民健康服务的看法。通过频数分析对定量数据进行分析,以探讨结果。定性数据,如描述性回答,则通过分类和多频次回答进行研究:结果:送货工人在工作场所面临的主要风险是机器的振动、即使不工作也会出汗的高温、烟雾、气体、灰尘等(各占 50.0%)。工作期间的身体威胁包括导致疲劳或疼痛的姿势(76.6%)以及与人的直接互动(76.6%)。工作环境中的福利和支持方面的挑战包括缺乏休息时间或难以利用休息时间(60.9%)、没有固定的用餐时间(65.6%)以及公司不提供防护设备(57.8%)。共有 48.8%的送货工人回答工作环境存在健康和安全风险,整体工作满意度较低(59.4%表示不满意)。虽然总体健康状况良好,但有很多人抱怨疼痛(79.7%)。具体的健康问题包括上肢肌肉疼痛(70.3%)、下肢肌肉疼痛(62.5%),诊断出最多的疾病是高脂血症(23.4%)。在过去两年中,10.9% 的参与者没有进行过健康检查。71.9%的人表示愿意参加健康促进服务,其次是改善工作条件和管理有害物质、肌肉骨骼疾病和心血管疾病:本研究通过考察蔚山广域市分娩工人的健康状况,为改善他们的工作环境和预防职业病提供了宝贵的基础数据。
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引用次数: 0
Home-based Medical Care of Hospital - Transitional care 医院的家庭医疗护理 - 过渡性护理
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.3
Sun Young Lee
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引用次数: 0
Nurse Wage Status and Wage determinants 护士工资状况和工资决定因素
Pub Date : 2023-12-31 DOI: 10.29339/pha.23.10
Young-Kyoon Na
Purpose: The purpose of this study is to identify the causes of the shortage of nurses in local small and medium-sized hospitals by confirming the wage status according to the characteristics of nurses and the characteristics of medical institutions and analyzing the factors affecting the wages of nurses.Methods: The study was conducted by linking the DB of medical institutions owned by the National Health Insurance Corporation, DB of medical personnel, and DB of health insurance qualification. As of the end of 2018, only nurses working at hospital-level medical institutions who were reported to the Health Insurance Review & Assessment Service were registered as registered members of the health insurance at the medical institution. The dependent variables were the monthly average wage of nurses, and the independent variables were age, institution establishment, medical institution type, region, and number of beds. In the analysis, first, wages by individual and institutional characteristics were identified through basic statistical analysis, and factors affecting wages were analyzed through regression analysis.Result: As a result, the wages of nurses increased 71,184 won as the age increased, and the establishment of medical institutions was 291,574 won less and corporations 660,725 won less than the national government. The types of medical institutions were 400,964 won less and 675,829 won less than general hospitals. The size of the city was 325,989 won less in metropolitan cities and 263,672 won less in metropolitan areas than in the metropolitan area. As the number of beds at medical institutions increased by one bed, it was 708 won higher.Conclusion: According to the analysis of the wage status according to the characteristics of nurses’ personal characteristics and medical institutions, and the wage determinants of nurses, the relatively low wages of nurses in local small and medium hospitals were the main cause of job shortage. The market principle is that the wage increases if there is a shortage of supply in the labor market compared to the demand of nurses. On the contrary, the wage is lower in local SMEs. As a result, there seems to be some nurses who give up their activities. In order to resolve the labor shortage in local small and medium-sized hospitals, it is necessary to narrow the wage gap, and to create a working environment such as elastic working so that the daily work can be balanced.
目的:本研究的目的是根据护士的特点和医疗机构的特点确认工资状况,分析影响护士工资的因素,从而找出地方中小型医院护士短缺的原因:将国家医疗保险公司所属医疗机构DB、医务人员DB、医保定点资格DB联系起来进行研究。截至 2018 年底,只有在医院级医疗机构工作并向医疗保险审查评估服务机构报备的护士才被登记为医疗机构的医疗保险注册会员。因变量为护士月平均工资,自变量为年龄、机构编制、医疗机构类型、地区、床位数。在分析中,首先通过基本统计分析确定了个人和机构特征的工资,并通过回归分析对影响工资的因素进行了分析:结果显示,随着年龄的增长,护士的工资增加了 71184 韩元,医疗机构的编制比国家政府少 291574 韩元,法人少 660725 韩元。医疗机构的类型比综合医院少 400 964 韩元和 675 829 韩元。城市规模方面,大都市比首都圈少 325 989 韩元,大都市圈比首都圈少 263 672 韩元。医疗机构的床位数每增加一张,就会增加 708 韩元:根据护士个人特点和医疗机构特点对工资状况进行的分析,以及护士工资决定因素的分析,地方中小型医院护士工资相对较低是造成岗位短缺的主要原因。根据市场原理,如果劳动力市场上护士供不应求,工资就会上涨。相反,本地中小型企业的工资较低。因此,似乎有一些护士放弃了他们的活动。为了解决当地中小型医院的劳动力短缺问题,有必要缩小工资差距,并创造弹性工作等工作环境,以平衡日常工作。
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