1.A Comparative Study on Job Satisfaction between Regular and Non-regular workers in Hospitals.
Health Policy and Management 2015;25(4):334-343
BACKGROUND: The purposes of this study is to analysis the differences of the job satisfaction between regular and non-regular workers in hospitals. METHODS: The samples used for data analysis are 632 workers of 6 hospitals using a standardized questionnaires in B, C, D, and G provinces. In research methodology, all the data were analyzed with descriptive statistics, t-test, Pearson's correlation, and multiple linear regression analysis. RESULTS: In case of regular workers, communication, working conditions and employee benefit, and education were found to have a significant positive (+) effect on job satisfaction. In case of non-regular workers, empowerment, reward systems, communication, working conditions, and employee benefit had a significant positive (+) effect on job satisfaction. CONCLUSION: These results showed that hospitals needed to reinforce communication, working conditions and employee benefit to regular and non-regular workers in order to improve job satisfaction. Especially, more empowerment, working conditions, and employee benefit should be given to non-regular workers.
Education
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Job Satisfaction*
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Linear Models
;
Power (Psychology)
;
Research Design
;
Reward
;
Statistics as Topic
2.Outpatient Antibiotic Prescription Patterns for Respiratory Tract Infections of Infants.
Yejee KIM ; Suehyung LEE ; Sylvia PARK ; Hyen Oh NA ; Byongho TCHOE
Health Policy and Management 2015;25(4):323-333
BACKGROUND: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. METHODS: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. RESULTS: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. CONCLUSION: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.
Anti-Bacterial Agents
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Child
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Child, Preschool
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Drug Resistance, Microbial
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Humans
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Infant*
;
Insurance, Health
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Korea
;
Logistic Models
;
Outpatients*
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Pediatrics
;
Prescriptions*
;
Respiratory System*
;
Respiratory Tract Infections*
3.A Study on Ex-Health Professional National Assembly Members' Influences on Health Care Policy Making in the National Assembly.
Health Policy and Management 2015;25(4):307-322
In most democratic countries, influential professional interest groups often become a part of the iron triangle in the policy making process. One of the typical methods by which professional interest groups participate in policy making process is by having interest group members in the national assembly, who is also sympathetic to the group, implement policies through legislation. In this study we found that from the Constitutional National Assembly to the 18th National Assembly, 147 members of the National Assembly of the Republic of Korea have been former health care professionals. The research analyzed the roles of these members in health care law amendments as requested by the professional organizations. This study analyzed 11 major cases that involved nullification or amendment of legislations in favor of the healthcare profession, against the basic policies of the government. The study showed that in the 11 major cases, policies were amended in the direction intended by the National Assembly members and other organizations with similar interests, which was against the policy stance of the government. However, these cases did not unilaterally imply that the National Assembly has been captured by the interest groups through the legislators with health care professional background; rather, they should be perceived to be influenced by the exhibited loss of governability by the government in respect to healthcare policy decisions, loss of initiative due to lack of controllability, and reversals and inconsistencies of the policies.
Delivery of Health Care*
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Iron
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Jurisprudence
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Policy Making*
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Public Opinion
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Republic of Korea
;
Societies
4.The Performance Evaluation of Public Municipal Hospitals: Data Envelopment Analysis and Panel Analysis.
Eun Young CHUNG ; Young Jun SEO ; Hae Jong LEE
Health Policy and Management 2015;25(4):295-306
This study aims to examine the performance of public municipal hospitals through the analysis of data envelopment analysis, efficiency, profitability, and publicness by using panel data during period from 2006 to 2010. The main findings of the study are as follows. First, as a result of efficiency analysis during the period from 2006 to 2010, it was revealed that the number of staff by each job category, labor cost ratio, the number of operating beds need to be decreased. Second, the performance data represented by the indicators of efficiency, profitability and publicness were complementary and showed a tendency of being increased or decreased in same direction. Third, from the result of panel analysis, the efficiency was mainly influenced by the structural factors, while the profitability was influenced by managerial factors, and the publicness by medical environment. In conclusion, in order to enhance the performance of public municipal hospitals in Korea, it is important to harmonize the effort for efficiency, financial and policy support by central and local government, and the continuous participation of community residents.
Hospitals, Municipal*
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Korea
;
Local Government
5.Regional Disparities of Suicide Mortality by Gender.
Eun Won SEO ; Jin Mi KWAK ; Da Yang KIM ; Kwang Soo LEE
Health Policy and Management 2015;25(4):285-294
BACKGROUND: Suicide is one of important health problems in Korea. Previous studies showed factors associated with suicide in individual levels. However, suicide was influenced by society that individuals belong to, so it was required to analyze suicide in local levels. The purpose of this study was to analyze the regional disparities of suicide mortality by gender and the association between local characteristics and suicide mortality. METHODS: This study included 229 city.county.district administrative districts in Korea. Age- and sex-standardized suicide mortality and age-standardized suicide mortality (male/female) were used as dependent variables. City.county.district types, socio-demographics (number of divorces per 1,000 population, number of marriages per 1,000 population, and single households), financial variable (financial independence), welfare variable (welfare budget), and health behavior/status (perceived health status scores and EuroQol-5 dimension [EQ-5D]) were used to represent the local characteristics. We used hot-spot analysis to identify the spatial patterns of suicide mortality and negative binomial regression analysis to examine factors affecting suicide mortality. RESULTS: There were differences in distribution of suicide mortality and hot-spot regions of suicide mortality by gender. Negative binomial regression analysis provided that city.county.district types (city), number of divorces per 1,000 population, financial independence, and EQ-5D had significant influences on the age- and sex-standardized suicide mortality per 100,000. Factor influencing suicide mortality was the number of divorces per 1,000 population in both male and female. CONCLUSION: Study results provided evidences that suicide mortality among regions was differed by gender. Health policy makers will need to consider gender and local characteristics when making policies for suicides.
Divorce
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Female
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Health Policy
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Humans
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Korea
;
Male
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Marriage
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Mortality*
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Spatial Analysis
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Suicide*
6.A Delphi Study on National Public Vaccine Research and Development Policy in Korea.
Somin LEE ; Sang Gu YEO ; Shin Jung KANG ; Soon Young HAN ; Sang Won LEE
Health Policy and Management 2015;25(2):140-148
Vaccination is the most powerful and useful preparation against infectious diseases. However, developing vaccines costs a lot and requires extensive long-term efforts. Therefore, the government should research and develop vaccines with a national-level policy. To greatly enhance the success rate of vaccine development, the policy should be set up considering priorities such as the current status of domestic research, the importance for public health, the urgency of research. The Delphi technique was utilized to draft this survey, through a brainstorming stage, then two inquiries, and finally the final panel meeting where unresolved items were discussed, to draw the conclusion. Among the results, firstly, the highest ranked item on centralized fields for vaccine development by the Ministry of Health was 'self-sufficiency of vaccines.' Secondly, 'emerging infectious disease' was most highly ranked in prioritized fields of vaccine development and research. Thirdly, for the vaccine that needs to be improved and developed further by the government to improve its efficacy and safety, BCG (Bacille de Calmette) for tuberculosis was ranked the highest on both types (intradermal and subcutaneous injection) from National Immunization Programme (NIP) and non-NIP. As for the high risk pathogens, 'anthrax' and 'smallpox' were first and second, consecutively. Lastly, 'development and control of vaccine candidates' was ranked the highest for the area in need for technique development in order to improve domestic vaccine's research level. The results of this study will be put to good use as basic data for the national vaccine research and development (R&D) policy of the country. This study was first step and more studies should be carried out for the final decision of the national vaccine R&D priority.
Communicable Diseases
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Delphi Technique*
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Immunization
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Korea*
;
Mycobacterium bovis
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Public Health
;
Tuberculosis
;
Vaccination
;
Vaccines
7.An Analysis on the Nurse Expansion Policies through Policy Network.
Health Policy and Management 2015;25(2):129-139
BACKGROUND: Policy network theory was proved to be an appropriate analytic tool for the current social welfare policy making process. This study aimed to analyze policy making process related to the nurse expansion and policy output while focusing on the interactions and activities among various policy actors. METHODS: In this study, we used reports related to the need for expansion of nursing personnel journals, dissertations, newspaper articles, for hearings and debate policies for securing nurse data, and interviews. We examined three components of policy network, that is, policy actors, interactions, linkage of interest. RESULTS: For that to expand the nurse before the 2000s in expanding the supply of medical supplies have been conducted without much disagreement among policy actors under the government's initiative. However, there was lacked a close relationship between the expanding supply of nurses and inaccurate analysis of supply and demand. As the policy is applied between the various policy actors' needs and claims, conflict was intensified and many policy options had been developed. Government only took a role as a coordinator among policy actors in the 2000's. Also, it was difficult to find sufficient and clear evidence that policy-making process based on fair judgment. CONCLUSION: Therefore, it is urgently required to determine the policy through a social consensus to address the appropriate policy means and the process by correct analysis of the policy issues.
Consensus
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Equipment and Supplies
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Humans
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Judgment
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Nursing
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Nursing Staff
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Periodicals
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Policy Making
;
Social Welfare
8.The Theoretical Comparison of Malmquist and Luenberg Productivity Indices & Empirical Analysis.
Hyun Suk PARK ; Dong Hyun YANG
Health Policy and Management 2015;25(2):118-128
BACKGROUND: We measured productivity changes of regional public hospitals using both global Malmquist productivity index-based on global production possibility set over all the periods-and the traditional Malmquist productivity index and analyzed the factors of productivity change. METHODS: The data used in this study is two annual inputs and two annual outputs of 32 regional public hospitals in Korea from 2005 to 2009 and the results such as distances and Malmquist productivity index and global Malmquist productivity index are obtained by an R program written for this study RESULTS: The results can be summarized as follows. Firstly, technical efficiencies of regional public hospitals are affected largely by scale efficiency than pure technical efficiency. Second, productivity progressed and technological change has more significant influence on productivity advance over the period between 2005 and 2009. Third, the circularity problem of the traditional Malmquist index is confirmed, and so the global Malmquist index without this problem are valid for the analysis. CONCLUSION: Though this study also has some limitations with the data of regional public hospitals with a short time span, it is the first study of hospitals using global Malmquist productivity index and later it can be expanded to private hospitals and longer time periods.
Efficiency*
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Hospitals, Private
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Hospitals, Public
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Korea
9.Cost Analysis for Dentures Performed at Dental Clinics in Korea.
Seol Hee CHUNG ; Hye Jin LEE ; Ju Yeon OH ; Kyung Suk WOO ; Han Sang KIM
Health Policy and Management 2015;25(2):107-117
BACKGROUND: The purpose of this study is to analyze the cost for the denture treatment in accordance with the government's plan to expand the National Health Insurance coverage for dental prothesis from July 1, 2012. METHODS: We developed the draft of classification of the treatment activities based on the existing researches and expert's review and finalized the standard procedures through confirming by Korean Dental Association. We also made the list of input at each stage of treatments. We conducted survey of 100 dental clinics via post from April 4 to May 20 in 2011 and 37 clinics took part in the survey. The unit of cost calculation is the process from the first visit for denture treatment to setting of denture and adjustment. The manufacturing process performed by dental technician was not included in the cost analysis. RESULTS: The process for the complete denture treatment was classified with 10 stages. The partial denture treatment was classified with 8 stages. The treatment time per each denture is about 5.6 hours for complete dentures and about 6.6 hours for partial dentures. The treatment cost were from 591,108 won to 643,913 won for complete denture and from 670,219 won to 738,840 won for partial denture in 2011, depending on the location, type of the clinics and the types of physician's income. CONCLUSION: This study shows the example of cost analysis for the treatment to set the fee schedule. Measures to get representative and accurate information need to be made.
Classification
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Costs and Cost Analysis*
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Dental Clinics*
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Dental Technicians
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Denture, Complete
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Denture, Partial
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Dentures*
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Fee Schedules
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Health Care Costs
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Humans
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Korea*
;
National Health Programs
10.An Analysis on the Determinants of Efficiency of the Pharmaceutical Firms using Stochastic Frontier Analysis.
Health Policy and Management 2015;25(2):97-106
BACKGROUND & METHODS: The purpose of this research is to estimate the efficiency of the pharmaceutical firms and the determinants of their efficiency. Stochastic frontier analysis(SFA) and panel study are applied to the data of 60 domestic pharmaceutical firms from 2006 to 2012. RESULTS & CONCLUSION: First, the result of the stochastic frontier analysis shows that overall efficiency of the pharmaceutical firms is increasing as time goes by. However, if firms are classified by the scale, the larger firms show more efficiency and if classified by the degree of innovativeness, the innovative firms show more efficiency compared to the non-innovative firms. This evidences show that the scale and R&D investment have significant relationships with the efficiency of the pharmaceutical firms. Therefore, it is necessary to increase the national level of investment for the fundamental researches to vitalize R&D of the new drugs. Second, the result of estimation of the determinants of efficiency shows that the firms with larger sales promotion expenses and entertainment expenses have less efficiency compared to the other firms. This can be explained by the structural characteristics of the small generic pharmaceutical firms. Therefore, the government had better make the pharmaceutical firms to reduce sales promotion and entertainment expenses and increase R&D expenses by introducing systems such as global budgeting system on medicine or reference pricing system.
Budgets
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Commerce
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Investments