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Sang-Yi Lee 2 Articles
Analyzing the Historical Development and Transition of the Korean Health Care System
Sang-Yi Lee, Chul-Woung Kim, Nam-Kyu Seo, Seung Eun Lee
Osong Public Health Res Perspect. 2017;8(4):247-254.   Published online August 31, 2017
  • 4,418 View
  • 39 Download
  • 6 Crossref
AbstractAbstract PDF

Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system.


We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power. This study focuses on how the relationships among social forces can change as a nation’s economic development or governing strategy changes in response to changes in international circumstances such as globalization.


The corporatist Social Health Insurance (SHI) system (multiple insurers) introduced in 1977 was transformed into the single-insurer NHI in July 2000. These changes were influenced externally by globalization and internally by political democratization, keeping Korea’s private-dominant health care provision system unchanged over several decades.


Major changes such as integration reform occurred, when high levels of state autonomy were ensured. The state’s power (its policy capability), based on health care infrastructures, acts to limit the direction of any change in the health care system because it is very difficult to build the infrastructure for a health care system in a short timeframe.


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Nurse-Perceived Patient Adverse Events depend on Nursing Workload
Jeong-Hee Kang, Chul-Woung Kim, Sang-Yi Lee
Osong Public Health Res Perspect. 2016;7(1):56-62.   Published online February 28, 2016
  • 3,044 View
  • 20 Download
  • 38 Crossref
AbstractAbstract PDF
The purpose of this study was to investigate the correlation between nursing workload and nurse-perceived patient adverse events.
A total of 1,816 nurses working in general inpatient units of 23 tertiary general hospitals in South Korea were surveyed, and collected data were analyzed through multilevel logistic regression analysis.
Among variables related to nursing workload, the non-nursing task experience had an influence on all four types of patient adverse events. Nurses with non-nursing tasks experienced patient adverse events—falls [odds ratio (OR) = 1.31], nosocomial infections (OR = 1.23), pressure sores (OR = 1.16), and medication errors (OR = 1.23)—more often than occasionally. In addition, when the bed to nurse ratio was higher, nurses experienced cases of pressure sores more often (OR = 1.35). By contrast, nurses who said the nursing workforce is sufficient were less likely than others to experience cases of pressure sores (OR = 0.78). Hospitals with a relatively high proportion of nurses who perceived the nursing workforce to be sufficient showed a low rate of medication error (OR = 0.28).
The study suggested that the high level of nursing workload in South Korea increases the possibility of patient adverse events.


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PHRP : Osong Public Health and Research Perspectives