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This study identifies the success factors of the Cuban health care system centered on the relationship between the clinic and the community, in terms of the primary health care system which is community-based health care. It has been recognized that the primary health care system could be a practical approach to develop a better structure and a more functional health care system through building the community capacity. In community-based health care, the responsibility and the direct participation of people is crucial because the community empowerment leads to better health care for the people of the community, since they can take more control of local issues like health care. In this paper, we describe and define the characteristics of the relationship between the family doctors-nurses and the community members, using the method of participant observation, which is an anthropological approach. Given that Cuban health care has so far been analyzed mainly from the macro-policy perspective, the understanding of Cuba’s health care system at the community level, where the family doctor and nurse are closely connected to the local people, is a meaningful task. [ABSTRACT FROM AUTHOR]

The Korean government operates a fee-for-service system, as well as a diagnosis-related group (DRG) payment system that only applies to 7 different specific disease groups. To control rapidly increasing health expenditures, the Korean government adopted a compulsory DRG payment system for 7 disease groups in 2013. However, the current Korean DRG (K-DRG) system does not address the cost of new medical technologies and accompanying services, whereas the United States and European countries have implemented incentive systems within the DRG payment system to promote technological innovations. The Korean government is expanding the accessibility of new medical technologies to strengthen the coverage of 4 major conditions with a selective reimbursement system, but the K-DRG system is inconsistent with the selective reimbursement system in terms of adopting new medical technology. Such inconsistency is clearly shown in the case of advanced energy devices that are essential for surgical procedures. Despite their clinical usefulness and the high demand for such instruments, there is little space for compensation for advanced energy devices in DRG groups. Neither healthcare providers nor patients can choose selectively reimbursed medical devices under the current DRG system, leading to unequal healthcare benefits among patient groups. This paper proposes additional payments for new medical technology that is costly but clinically effective to ensure patient access to new medical technology under the K-DRG system, and suggests that a fair and consistent policy would be to apply the selective reimbursement of medical services in K-DRG. [ABSTRACT FROM AUTHOR]

Primary care is a key component of a health care system and many countries have been making efforts to strengthen their primary care. We aimed to outline the status of health service research on primary care in Korea. In Medline and nine Korean databases, we searched the original articles published in peer-reviewed journals through December 2015, and summarized and classified the articles. Their publication year, journal name, research methods and research topics were presented. The main categories of research topics were health care delivery, utilization, quality, workforce, resources, financing, and others. The total number of research papers was 297, and these were mainly published in domestic Korean journals (92.6%). The most frequently adopted research methods were quantitative ones, and various types of data were used. The most two common topics were health care delivery and quality of care. Diversity of data sources, lack of public research funding and low participation of primary care physicians were also found. A clarification of the scope of health services research and refinement of topic classification will be beneficial. In short, this study provides a basis for building a primary care health services research database and can be used as a data source for subsequent research. It is also necessary to set research priorities for the development and evaluation of primary care policy. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the number of practicing nurses required to resolve staffing differences between capital and non-capital regions and analyze the relationship between regional differences in staffing and salary. Methods: Using public data on population, patients, newly licensed nurses, practicing nurses, and annual salaries, regional differences were analyzed in newly licensed nurses per population, practicing nurses per population, practicing nurses per patient (i.e., staffing level), and salary. The number of additionally required practicing nurses was estimated by multiplying staffing differences by the number of patients in the lower-staffed region. Results: During 2002~2022, 71,107 and 243,611 newly licensed nurses were supplied, while the number of practicing nurses increased by 91,886 and 88,070 in the capital and non-capital regions, respectively. The non-capital region had more practicing nurses per population, whereas the capital region had more practicing nurses per patient. In 2020, 31,330 practicing nurses were additionally required in the non-capital region. Salaries were higher in the capital region, and regional salary differences increased during 2011~2020. Regional salary differences were associated with regional staffing differences and the number of additionally required practicing nurses. Conclusion: Government and health insurance policies are required to encourage hospitals in the non-capital region to improve staffing and salaries. [ABSTRACT FROM AUTHOR]

After the 19th South Korean presidential election was scheduled to be held on May 9, 2017, a number of presidential candidates have rushed to announce their health policies. Regardless of the presidential candidate, almost all health policies have tended to focus on fragmentary pledges. Thus, the Research Institute for Healthcare Policy (RIHP), which is part of the Korean Medical Association (KMA), has selected 5 key policy issues among the 25 health policies that were developed through the planning group for health policy development: the development and passage of the Special Act on Supporting Primary Care, the establishment of a health care delivery system, the independence of the Ministry of Healthcare from the Ministry of Health and Welfare, the implementation of the right to choose prescription drugs, and progress toward addressing the problems faced by the National Health Insurance program. In addition, the KMA has launched a presidential engagement campaign in order to reinforce its political status, as well as to encourage KMA members to participate in politics. I hope that this paper provides guidance in making correct decisions from a public health perspective, and am confident that this election will help medicine to develop in the right direction. [ABSTRACT FROM AUTHOR]

The identity crisis of preventive medicine appears to have been deepening. As a solution, it is insisted that preventive medicine should focus on clinical preventive medicine. However, in the field of heath policy and management, the better solution should be found in a serious search for visions and perspectives of its study on population and society. In this regard, the specialist who studies the field can be defined as a medical doctor majoring in public health. In this paper, I first forecasted major socioeconomic changes to occur in medical and public health arena and explored the role of those studying health policy and management. Secondly, I summarized their career paths and main activities in order to establish visions. Finally, I proposed curriculums on health policy and management for medical school undergraduates and for specialists majoring in preventive medicine, respectively.

This paper aims to examine the factors that affect the amount of official development assistance (ODA) a developing country receives for healthcare by the Korean government. We empirically tested to what extent the amount of Korea's ODA in health care services, infrastructure, HIV/AIDS, and tuberculosis are affected by the relevant demand factors in the recipient countries. To do so, we carried out country-level multivariate regression analyses by setting the amount of ODA for four health care sectors as dependent variables and the relevant demand factors and economic factors as independent variables. A panel dataset was constructed by combining ODA data from the Organisation for Economic Cooperation and Development and World Development Indicators. The analyses showed that the ODA for health care in Korea is partly meeting the recipient's health care needs. In particular, the recipients with a smaller number of physicians are likely to receive more ODA for medical services. Meanwhile, the amount of international trade with Korea is likely to affect the amount of ODA for medical services. However, disease factors, such as prevalence of HIV/AIDS and tuberculosis, did not positively affect the amount of ODA for those diseases. These results indicate that Korea's ODA system for health care needs to be improved to meet the demand of the recipients in order to achieve the humanitarian objectives set by the international community. We hope that the medical community and the government of Korea can cooperate in setting the global policy agenda for health care ODA based on concrete evidence-based healthcare policy research. [ABSTRACT FROM AUTHOR]

This paper examines current status of high-tech medical devices in Korea, especially bringing focus to the computed tomography and magnetic resonance imaging, and traces government policies relevant to this situation. The rapid diffusion of high-tech medical devices mainly led by physician's clinics and small hospitals and lack of efficient policy coordination and synchronization have resulted deterioration of quality and decrease of social benefit. The quality problem could be resolved when the pursuit of micro-efficiencies by the providers are synchronized to the macro-efficiency of health system. If the government disclose quality information of high-tech devices and gives incentives to the provider's efforts to increase quality, the current competition between providers to capture patients could be evolved to the competition for better quality. In addition to this vertical synchronization, horizontal policy synchronizations such as with health insurance policy are also discussed. [ABSTRACT FROM AUTHOR]

The new presidential administration of the Republic of Korea will be launched in February 2013. We hope that the Government effectively administers national affairs as well as health care affairs under the new paradigm. In this paper, I make three proposals for the new administration. First, the new government must overcome the wave of aging, the low birth rate, and low economic growth rate. The aging society increases health care demands, but the low birth rate and low economic growth rate decrease the capability to financially underwrite these demands. Furthermore, Korea faces the unification issue as the mission of the era. The economic burden of unification would be bigger than that faced by Germany. The government must prepare rapidly with a step-bystep plan for this approaching situation. Second, the new administration must solve the top-priority policy problems that are derived not only from the existing problems of the "garbage can model," but also from priority setting with an overall and systematic view. These top-priority health policy problems are the high suicide rate, over-utilization of doctors' visits and length of hospital stay, and high out-of-pocket health care fees. The extreme phenomenon of high out-of-pocket costs affects a high percentage of households with catastrophic medical costs, which is about 3%, the highest level among the Organization for Economic Cooperation and Development countries. Third, the policy approach of the new administration must be not unilateral, but bilateral: efficiency and equity of policies, support and regulation of policy tool, demand-side and supply-side management of healthcare utilization, and service benefits and monetary benefits of Health Insurance. In the past, the main approach of healthcare policy has depended on regulation, supply-side control, and service benefits. The administration should pursue a balance of left and right approaches, regardless of which political party wins. I hope that the new government will overcome these challenges in a turbulent era, solve top-priority problems first, and approach all of this with a new paradigm as new wine must be poured into new wineskins. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to describe the current status of the payment rate of the Korean Medical Association (KMA) membership fee and to suggest a way to overcome the decreased payment rate of membership fees by analyzing the causal factors of the decrease. Methods: Quantitative analysis of the KMA membership data, qualitative research of in-depth interviews with 2 staff members of the regional subsidiaries, and literature research were conducted. Results: From the results, 6 major factors for reducing the membership fee payment rate were derived, and plans to improve the payment rate of membership fees were suggested to improve the factors. First, the role of the KMA and the promotion of its members should be strengthened. Second, there should be a flexible adjustment of the membership fee. Third, there should be an enhancement of the transparency of budget execution and increased awareness through the promotion of the members. Fourth, differentiated incentives should be offered to the members who pay dues. Fifth, an improvement of a more efficient and easier payment method should be installed. Finally, legal enforcement measures to pay the membership fee should be considered. Conclusion: In order to improve the payment rate of the KMA membership fee, the KMA should try to make the members understand the performance of the business affairs and health policies. Furthermore, incentives that members can feel should be given. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify subjectivity on smoking cessation of Korean adult males, and to provide basic data, for non-smoking policies. Methods: Q-methodology, a method of analyzing subjectivity of each item, was used. Thirty-nine adult males, classified 36 selected Q-statements into normal distribution, using a 9-point scale. Collected data were analyzed, using the pc-QUNAL program. Results: Among the Korean adult males, three types of smoking cessation were identified. The name for Type I was ‘pursuit of faith’, for Type II, ‘factor of relationship disturbance’ and for Type III ‘ambivalence’. Conclusion: Results of this study indicate that different approaches to intervention on smoking cessation are best served for Korean adult males, based on the three types of smoking cessation, and their characteristics. [ABSTRACT FROM AUTHOR]

Sustainable Development Goals (SDGs) aim to end Millenium Development Goals and proposed 17 Goals, 169 Targets, and 241 Indicators to face humanitarian concerns that challenge nations worldwide. Plans regarding SDGs in Korea consist of Health Plan 2020 (HP2020) established by Ministry of Health and Welfare and Sustainable Development Plans set by Ministry of Environment. Current research compared HP2020 and SDGs to discuss applicability of HP 2020 and examined progresses in HP2020 based on its indicators. It was observed that few SDGs have already been achieved in Korea. This study modified above mentioned goals as per the current status of the country and suggested political measures to achieve the unmet goals. SDGs have been implemented since 2016 and because of varying socioeconomic status and healthcare systems across the world, there were some SDGs that could reflect the current status of Korea. Thus, SDGs need to be studied further to elaborate more on its details. This study also proposed methods for systematic monitoring of the indicators and for the association with domestic policies such as HP2020. [ABSTRACT FROM AUTHOR]

Purpose: The plan proposed by the Ministry of Health and Welfare in 2012 did not reflect the position of nurses and focused only on how to increase the number of nurses. There is a need for coming up with a specific and viable alternative plan considering the qualitative aspect of nursing, delegation of nursing tasks, the in-death analysis of the reasons for leaving the nursing profession, and the legal standards based on varying nursing tasks. Methods: Drawing on a review of existing literature, this report was written to examine policy directions and the factors that influence the institutional environment that regulates the supply and demand of the nursing workforce in Korea. Results: Implementing the government's plan for introducing a new type of nurse, the registered practical nurse, which generally requires a two-year associate's degree, must be reconsidered. Also, a concrete plan to make use of unemployed nurses and to close the salary gap between nurses working at hospitals in cities and those working at hospitals in rural areas must be prepared. Furthermore, there is a need for introducing a new rating system aimed at boosting the quality of nursing care in small-and medium-sized hospitals, thereby increasing the number of nursing professionals who provide high quality care. Conclusion: In preparation for expected poor quality of care and looming unemployment crisis due to the increase in the number of nursing professionals, a practical and concrete plan for the supply and demand of the nursing workforce should be made. The Korean Nurses Association should mount a profession-wide campaign to make the government formulate a new and viable policy on the supply and demand of the nursing workforce. [ABSTRACT FROM AUTHOR]