NUR 4667 Global Health Presentation/Poster

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  • Global Health Care
    Yulett Christie, Jessica Taylor, Jennifer Haselkamp, Joseph Mills
  • Republic of South Korea
  • Healthcare System
  • The Ministry for Health and Welfare (MoHW) has strategic oversight of health service delivery and sets policy for management and supervision of the National Health Insurance Corporation (NHIC). The NHIC provides health insurance for all citizens. The NHIC is a non-profit single insurer that operates enrollment collecting contributions, contracting with medical suppliers, setting reimbursement levels and making payments.  The Health Insurance Review and Medical Assessment Service (HIRA) evaluate medical fees, quality of care, and adequacy of medical services. The service delivery model is mostly private sector led. It is market-oriented and operates in a mostly deregulated environment. The government sets the framework for health service delivery with quality requirements. The funding is through mandatory health insurance and fee-for-service. All Koreans, except those in the lower income groups are required to pay in to the health insurance premiums. The poor are subsidized by the government. 
  • Access to Healthcare
  • Every citizen is automatically enrolled in either the national health insurance or the Medical Aid system for the very poor and veterans. The insurance is funded by a pool of member premiums, employer contributions and government payments. The national health insurance covers 96.7% of the population. There is no health service cost or premiums for the Medical Aid system. About 90% of health services are provided by private practitioners or organizations. The healthcare providers can not reject socially insured patients. Facilities and services are unevenly spread across the country. The government regulates large expensive equipment to promote equitable distribution. Most institutions (83.93%) and service providers (84.13%) are concentrated in urban areas. There is no mechanism to align services with population need, leaving 18% of rural areas underserved. Long term care insurance is provided to support the elderly who have difficulty caring for themselves for longer than 6 months due to old age or geriatric disease. Certain traditional Korean medicinal treatments and therapies are covered under the national health insurance. 
  • Cultural Beliefs
  • The Korean cultural beliefs have been shaped by centuries of Shamanism, Buddhism and Confucianism. Christianity has only had a limited influence in southern Korea in recent times. The influence of the Buddhist and Confucian doctrines creates a view of illness and death as part of life. Symptoms of illness may be viewed as bad luck misfortune or “Karma”. Illness may be a response to stress in the family and other interpersonal relationships. Health is often viewed as finding harmony between complimentary energies or forces known as “yin and yang”. Many Koreans still believe in and practice traditional herbal medicine. Because of this, many Koreans believe that western medicine is too strong and may not take the full dose or complete the course of treatment. The family is always consulted on serious or terminal illness. The husband, father or eldest son or daughter has the final say. Bad news is often shielded from the patient so as not to dissolve hope. Koreans value emotional control very highly and will appear stoic and may not show pain or anxiety. Korean women are expected to be very modest and may refuse care. The female Korean patient may prefer a female doctor or nurse. 
  • References
  • http://www.wpro.who.int/health-services/health-service-delivery-profiles/en/republic-of-korea
  • euro.who.int/__data/assets/pdf_file/0019/101476/E93762.pdf
  • https://washington.edu/pfes/PDFs/KoreanCultureClue.pdf
  • http://www.everyculture.com/Ja-Ma/South-Korea.html
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