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Vol.2 No.1

11papers in this issue.

Baegju Na(Department of Preventive Medicine, School of Medicine, Eulji University) pp.10-16 https://doi.org/10.23163/KJHE.PUB.2.1.10
초록보기
Abstract

While there have been many discussions on regional inequalities in healthcare resources in Korea, there has been a lack of analysis of the underlying problems and solutions. In particular, there has been a lack of discussion that criticizes the limitations of healthcare resource allocation policies that utilize the market-oriented private healthcare sector and analyzes the failure of the government and local governments to fulfill their responsibilities and duties. This paper analyzes the historical development and limitations of policies that led to the emergence of regional inequality in healthcare resources in Korea, and suggests that the public healthcare sector should be utilized to resolve regional inequality in healthcare resources and that the role of centralization and decentralization should be divided as a policy direction.

Jun Yim(Department of Public Healthcare Program, Incheon Medical Center) pp.17-23 https://doi.org/10.23163/KJHE.PUB.2.1.17
초록보기
Abstract

It is difficult to control supply and demand of medical personnel through the market, so public regulation is required. In Korea, there is a serious problem of shortage of medical personnel and imbalanced distribution between regions. Due to lack of functional differentiation between medical institutions, personnel allocation that matches the characteristics of the medical institution is not being carried out, and quality management is also not being carried out properly. Although there is a large supply of hospital beds, there is a shortage of medical personnel, and the labor intensity is high due to the competitive medical environment led by the private sector combined with the fee-for-service system. As a result, the turnover rate is high, making it difficult to maintain the quality of medical care at an appropriate level. Under the assumption that the number of oversupplied hospital beds will be reduced and the number of medical personnel per bed will be increased to the level of advanced countries, we need to estimate manpower and train insufficient medical personnel. Rather than increasing the number of students in the nursing school, nurses convert inactive personnel into active personnel, and doctors prepare expansion plans by expanding the number of students in medical schools combined with local talent selection. In addition to expanding the medical workforce, regional imbalances should be resolved by establishing new regional public medical schools. We need to improve working environments, including night work, and improve the quality of medical personnel to increase our ability to respond to future demand. Establish a provincial-level resident training system, expand the number of nurses dedicated to education, and strengthen training for new nurses. It is necessary to strengthen the government's regulatory authority in training and management, and reorganize the fee-schedule and payment system to ensure compensation for appropriate input resources.

Jeehee Pyo(Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, ‘Always be with you’ (The PLOCC Affiliated Counseling Training Center)) ; Hyeran Jeong(Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City) ; Minsu Ock(Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Department of Preventive Medicine in Ulsan University Hospital, Department of Preventive Medicine in University of Ulsan College of Medicine) pp.24-37 https://doi.org/10.23163/KJHE.PUB.2.1.24
초록보기
Abstract

Ulju-gun has poor medical care, the majority of people are in their 60s or older, and transportation is not convenient. We would like to propose ways to increase accessibility to medical institutions by exploring in depth the experiences of residents in Ulju-gun, using medical institutions in terms of transportation convenience. In this study, in-depth interviews were conducted with 12 residents of Ulju-gun. Participants complained that there were clinics in the area they could go to if they had a mild illness, but that there was no medical institution they could go to if they had a moderate illness. When using public transportation to visit a medical institution, the time burden was significant, and when using their own car, they complained of financial burden and difficulties due to lack of parking facilities. Participants felt difficulties in using medical institutions and realized the importance of accessibility to medical institutions, and mentioned that in order to improve this, it was necessary to expand the routes and increase the operation of buses, a means of public transportation. This study is significant in that it explored in depth the experiences of residents living in areas with poor transportation infrastructure and used medical institutions, revealing the need for a multi-layered approach to accessibility to medical institutions.

Ji Eun Park(Center for Global Collaboration, Korea Institute of Oriental Medicine) ; Boyoung Jeon(Department of Health and Medical Information, Myongji College) pp.40-54 https://doi.org/10.23163/KJHE.PUB.2.1.40
초록보기
Abstract

This research investigated changes in the caregiving burden and health status of primary family caregivers (PFC) providing care to the elderly in the community before and after the onset of the COVID-19 pandemic. The study delineated alterations in caregiving burdens, subjective health, pain and discomfort as physical health, and stress as mental health experienced by PFC beore and after COVID-19 pandemic period. Utilizingsing the 2019 and 2020 of the 2nd Korean Health Panel, the study focuses on 78 PFC to elderly individuals in need of care over the two-year span. The logit regression was conducted, to show the factors associated with deterioration of the outcomes before and after the COVID-19 pandemic. This study found that spousal relationships were most prevalent between PFC and the elderly, followed by daughter, son, and daughter-in-law. Despite a non-significant decrease in the caregiving burden from 76.9% before to 69.2% after the pandemic, there was a noteworthy surge in the prevalence of poor subjective health, escalating from 25.6% to 35.9%. Furthermore, a significant increase in pain and discomfort levels was observed, rising from 44.9% to 59%. While change of stress levels was not statistically significant. The caregiving burden of PFC before and after COVID-19 was lower than that of other groups in the first income quartile. Subjective health was found to be associated with providing care for elderly individuals with cancer and when taking home-based long-term care services. The exacerbation of pain and discomfort was linked to female caregivers, while increased stress levels were associated with the elderly with cancer and stroke. This study holds significance as it sheds light on the caregiving dynamics during the COVID-19 pandemic, elucidates changes in caregiving burden and health status among PFC, and underscores the societal imperative attention for family caregivers.

Hyun-Hee Heo(Institute for Future Public Health) ; Jung Suk Sung(Institute for Social Work, the Wave) pp.55-75 https://doi.org/10.23163/KJHE.PUB.2.1.55
초록보기
Abstract

This study analyzed the intersectionality of the social determinants that shape health among single parents from a gender perspective. Single parent women and men (n=8) were purposively sampled and individually interviewed online from September to October 2022, using inductive thematic analysis. Findings revealed that multidimensional systems of oppression intersect in the context of gendered discrimination and stigma to influence health inequities among single parents. Normal family ideology, sexuality, and masculinity norms constituted the sociostructural context of gender inequalities. The key social determinants of health among single parents were identified: “paid work”, “unpaid care work”, “poverty”, and “bias in health care system”. Paid work and unpaid care work interacted to constrain each other's conditions, perpetuating poverty and intersecting with biased health care system. The results highlight the limitations of pre-existing conceptual frameworks of social determinants of health, which emphasize paid work while invisibilizing the impact of unpaid care work, which is considered to be private, and provide a basis for refining the abstractions of the “Framework for the role of gender as a social determinant of health.” The theoretical implications of a gender perspective on the social determinants of health are discussed, along with policy and practice recommendations for reducing health inequities among single parents.

Hongjo Choi(Korea University Division of Health Policy and Management, People’s Health Institute) ; Korean COVID-19 Human Rights Network pp.78-90 https://doi.org/10.23163/KJHE.PUB.2.1.78
초록보기
Abstract

The tension between infectious disease policy and human rights has long been a topic in academia. During the COVID-19 pandemic in South Korea, this debate resurfaced. The COVID-19 Human Rights Network was formed as advocates for human rights during public health crises. In this article, the network defines itself as a social power seeking changes in the dominant discourse of infection control. It attempts to analyze the network’s activities using Eric Olin Wright’s three transformative models. Summarizing the network’s actions as a social power during the public health crisis, the article examines similarities and differences with disruptive, interstitial, and symbiotic transformative strategies. The analysis indicates that the COVID-19 Human Rights Network has implemented both disruptive and symbiotic transformative strategies. While employing various practical strategies on the ground, it did not significantly impact the dominant discourse. However, the network self-validated the presence of social power during the public health crisis in South Korea.

초록보기
Abstract

People with disabilities are subordinate to medical care throughout their daily lives. The disability movement has fought to guarantee the rights of the disabled against the pathogenesis of disability. Until now, the disabled community has not sufficiently dealt with the body and motor thoughts about disease to resist medical power. Meanwhile, patients' demands for recognition of disability gradually increased. This is a result of the lack of a support system for patients in constant medical situations, and at the same time, it is to counter discrimination by stigma against disease. The absence of a support system for patients is due to a treatment-oriented medical system, and medical institutions do not deal with causal areas of treating diseases in the patient's body. The treatment-oriented medical system did not guarantee other areas of care, and unlike the disabled who have been left to die in rehabilitation and healing spaces for national growth, patients have been left to die in the absence of a support system outside the hospital. The process of hospitals becoming facilities and facilities becoming medicalized served as a strong factor in maintaining the category of disabled people in facilities. The health rights movement centered on medical providers did not deviate from treatment-oriented medical care. Now, disabled bodies and various bodies should fight the pathology of the disease together and start a movement to shift to care-oriented medical care rather than treatment-oriented medical care.

Korean Journal of Health Equity