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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. doi:10.4332/KJHPA.2015.25.2.140

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 ; Delphi Technique* ; Immunization ; Korea* ; Mycobacterium bovis ; Public Health ; Tuberculosis ; Vaccination ; Vaccines

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An Analysis on the Nurse Expansion Policies through Policy Network.

Yu Kyung KO ; Bo Hyun PARK

Health Policy and Management.2015;25(2):129-139. doi:10.4332/KJHPA.2015.25.2.129

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 ; Equipment and Supplies ; Humans ; Judgment ; Nursing ; Nursing Staff ; Periodicals ; Policy Making ; Social Welfare

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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. doi:10.4332/KJHPA.2015.25.2.118

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* ; Hospitals, Private ; Hospitals, Public ; Korea

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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. doi:10.4332/KJHPA.2015.25.2.107

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 ; Costs and Cost Analysis* ; Dental Clinics* ; Dental Technicians ; Denture, Complete ; Denture, Partial ; Dentures* ; Fee Schedules ; Health Care Costs ; Humans ; Korea* ; National Health Programs

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An Analysis on the Determinants of Efficiency of the Pharmaceutical Firms using Stochastic Frontier Analysis.

Jin SAKONG ; Jeongkyu KIM

Health Policy and Management.2015;25(2):97-106. doi:10.4332/KJHPA.2015.25.2.97

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 ; Commerce ; Investments

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The Effects of Adherence and Hypertension Control on Complication among Newly Diagnosed Hypertension Patients.

Jin Ok HAN ; Jun YIM ; Jeong Soo IM ; Hee Young LEE ; Jong Heon PARK ; Dae Kyu OH

Health Policy and Management.2015;25(2):90-96. doi:10.4332/KJHPA.2015.25.2.90

BACKGROUND: This study aimed to research on how adherence and blood control could make a difference when it comes to develop complications. METHODS: The study's subjects were 255,916 patients who were newly diagnosed with hypertension in 2009 using data collected by National Health Insurance Cooperation. Patients are considered as a group under adherence if visit days and prescription days are more than 300 days. Patients are considered to have successfully controled their hypertension based on actual value measured by National Health Insurance Cooperation and the study takes a look at whether they were diagnosed with complications of cerebrocardiovascular disease in 2012. Chi-square test and logistic regression was used to analyze. RESULTS: Patients who were able to control their hypertension show 0.80 times chance of developing cerebrovascular disease, and 0.89 times chance of developing cardiocerebrovascular disease. The group of adherence shows lower chance of developing complication in general than the group of non-adherence. CONCLUSION: The study revealed that hypertension's constant treatment could control the blood pressure and prevent complications. It is important that encourages patients to effort for persistent treatment for reducing complication.
Blood Pressure ; Humans ; Hypertension* ; Logistic Models ; National Health Programs ; Prescriptions

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Position Value for Relative Comparison of Healthcare Status of Korea in 2014.

Sang Ah LEE ; Eun Cheol PARK

Health Policy and Management.2017;27(1):88-94. doi:10.4332/KJHPA.2017.27.1.88

The aim of this study was to investigate the current and trend of healthcare status of South Korea compared to Organization for Economic Cooperation and Development (OECD) countries. We used the position value for relative comparison (PARC) method for measuring the healthcare status of South Korea by five parts of healthcare policy (demand, supply, accessibility, quality, and cost). Additionally, we conducted Mann-Kendall test for analyzing the trend of PARC from 2000 to the present. Demand, supply, accessibility, and quality of healthcare of Korea were located upon the average of OECD countries, and showed an increasing trend from 2000 to the present. However, primary care and screening for cervical cancer were placed at a lower level compared the OECD average. In conclusion, the current state of healthcare in Korea seems to be generally beyond the average among OECD countries. However, some parts, including primary care, need to be improved.
Delivery of Health Care* ; Korea* ; Mass Screening ; Methods ; Organisation for Economic Co-Operation and Development ; Primary Health Care ; Quality of Health Care ; Uterine Cervical Neoplasms

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Catastrophic Health Expenditure Status and Trend of Korea in 2015.

Woorim KIM ; Eun Cheol PARK

Health Policy and Management.2017;27(1):84-87. doi:10.4332/KJHPA.2017.27.1.84

Catastrophic healthcare expenditure refers to out-of-pocket spending for healthcare exceeding a certain proportion of a household's income and can lead to subsequent impoverishment. The aim of this study was to investigate the proportion of South Korean households that experienced catastrophic healthcare expenditure between 2006 and 2015 using available data from the Korea Health Panel, National Survey of Tax and Benefit, and Household Income and Expenditure Survey. Frequencies and trend tests were conducted to analyze the proportion of households with catastrophic healthcare expenditure. Subgroup analysis was performed based on income level. The results of the Household Income and Expenditure Survey revealed that around 2.88% of households experienced catastrophic healthcare expenditure in 2015 and that this proportion was highest in the low income group. Results also showed a statistically significant increasing trend in the number of households with catastrophic healthcare expenditure (annual percentage change=0.92%, p-value <0.0001). Therefore, the findings infer a need to strengthen public health care financing and to particularly monitor catastrophic healthcare expenditure in the low income group.
Delivery of Health Care ; Family Characteristics ; Health Expenditures* ; Korea* ; Public Health ; Taxes

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Unmet Healthcare Needs Status and Trend of Korea in 2015.

Hyo Jung YOON ; Sung In JANG

Health Policy and Management.2017;27(1):80-83. doi:10.4332/KJHPA.2017.27.1.80

The proportion of people who reported unmet healthcare needs is an important indicator to measure the access problem in healthcare service. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, ‘2007–2015); the Community Health Survey (CHS ‘2008–2015); the Korea Health Panel Survey (KHP ‘2011–2013); the Korean Welfare Panel Study (KOWEPS ‘2006–2015). The proportion of individual reporting unmet healthcare needs as of 2015 was 12.6% (KNHNES), 11.7% (CHS), and 16.3% (KHP, as of 2013). Annual percent change which characterizes trend for follow-up period was -9.4%, -3.4%, and 7.6%, respectively. The proportion of individual reporting unmet healthcare needs due to cost was 2.8% (KNHNES), 1.7% (CHS), and 4.6% (KHP). The proportion of household reporting unmet healthcare needs due to cost was 1.2% (KOWEPS). Annual percent change was -9.0%, -14.9%, 9.4%, and -18.2%, respectively. Low income population reported about 5 times more unmet needs than high income population. Therefore for decreasing the unmet healthcare needs, strategies focusing on low income population were needed.
Delivery of Health Care* ; Family Characteristics ; Follow-Up Studies ; Health Surveys ; Korea* ; Nutrition Surveys ; Population Growth ; Poverty ; Socioeconomic Factors

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Yeong Jun JU ; Sung In JANG

Health Policy and Management.2017;27(1):75-79. doi:10.4332/KJHPA.2017.27.1.75

Suicide is becoming a public health issue in many countries, and even more so in Korea. Korea has the highest suicide rate in the Organization for Economic Cooperation and Development countries. To address these issues, we investigated the recent trends in suicidal ideation and suicide attempts among the adult population. We used data from four sources: Korean National Health and Nutrition Examination Survey (KNHANES, ‘2007–2012, ‘2013, ‘2015), Korean Community Health Survey (KCHS, ‘2008–2009, ‘2013), Korean Wealth Panel Study (KOWEPS, ‘2012–2015), and Korea Health Panel Survey (KHP, ‘2010–2013). Weighted frequencies and trend tests were used. The rate of suicidal ideation as recent year was 5.10% (KNHANES, ‘2015), 8.95% (KCHS, ‘2013), 2.34% (KOWEPS, ‘2015), or 5.39% (KHP, ‘2013). Regarding the suicide attempts, the rate of suicide attempts as recent year was 0.61% (KNHANES, ‘2015), 0.41% (KCHS, ‘2013), or 0.04% (KOWEPS, ‘2015). Average percent change of suicidal ideation during survey year was -2.80% (KNHANES, ‘2007–2012), 5.78% (KNHANES, ‘2013–2015), 0.62% (KCHS, ‘2008–2013), -5.63% (KOWEPS, ‘2012–2015), and -10.94% (KHP, ‘2010–2013). Average percent change of suicide attempts during survey year was -3.84% (KNHANES, ‘2007–2012), 4.55% (KNHANES, ‘2013–2015), -2.54% (KCHS, ‘2008–2013), and -18.96% (KOWEPS, ‘2012–2015). Those who had lower income level were more likely to have self-reported suicidal ideation and suicide attempts. Our results suggest that further efforts are needed for more effective intervention to identify and manage low income strata with suicide problem.
Adult ; Health Surveys ; Humans ; Korea* ; Nutrition Surveys ; Organisation for Economic Co-Operation and Development ; Public Health ; Suicidal Ideation ; Suicide*

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