Limitation and Improvement Plan of Maternity Healthcare Delivery System in Korea

The Korean healthcare delivery system has been operating for over 30 years since 1989. Despite a positive performance—providing quality medical services to the people by distributing medical resources—there are limitations to the maternity healthcare delivery system. If the maternity healthcare delivery system was operating successfully, there should have been sufficient delivery hospitals so that pregnant women can access the appropriate maternity medical services whenever needed. Unfortunately, according to the National Health Insurance Service, the number of maternity health facilities in Korea reduced from 1,371 in 2003 to 541 in 2019. Regrettably, a larger number of obstetric hospitals and clinics have closed in medically vulnerable areas, such as farming and fishing areas, than urban areas with sufficient medical infrastructure, creating obstetrically underserved areas. In 2020, 65 out of a total of 250 cities, counties, and districts had no obstetric hospitals or clinics. To improve the collapsing maternity healthcare delivery system, a different approach is required; one in which policy support to stop the closure of delivery hospitals is emphasized. New maternity-related medical insurance payments, such as delivery labor management fees, fetal heart monitoring reading fees, and newborn care in delivery rooms fees, and active support policies are needed to prevent the closure of delivery hospitals. In this era of low fertility, because the maternity healthcare system is essential to maintain the nation, a healthcare delivery system different from the existing one must be established.

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Grants to Spur Investment in Healthcare Delivery System IT

PsycEXTRA Dataset ◽

10.1037/e361722004-007 ◽

2003 ◽

Author(s):

Keyword(s):

Delivery System ◽

Healthcare Delivery ◽

Healthcare Delivery System

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The healthcare delivery system: an overview

10.1093/oso/9780198794837.003.0013 ◽

2017 ◽

Author(s):

Jan Abel Olsen

Keyword(s):

Delivery System ◽

Chronic Care ◽

Tertiary Care ◽

Healthcare Delivery ◽

Healthcare Delivery System ◽

Care Level ◽

Primary Care Level ◽

Internal Markets ◽

System A ◽

Policy Challenge

This chapter provides an overview of the healthcare delivery system. A figure illustrates how six different parts of the system relate to each other. The primary care level plays a key role in many countries by representing the gate, in which referrals to secondary care are being made. Tertiary care is principally of two types depending on patients’ prognosis: chronic care or rehabilitation. In addition to the three care levels, there are two parts with quite different roles: pharmacies provide pharmaceuticals, and sickness benefit schemes compensate the sick for their income losses. A recurrent policy challenge is to make each provider level take into account the resource implications of their isolated decisions outside of their own budgets. A brief discussion is included on the scope for ‘internal markets’.

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Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-043584 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043584 ◽

Cited By ~ 1

Author(s):

Joseph E Ebinger ◽

Gregory J Botwin ◽

Christine M Albert ◽

Mona Alotaibi ◽

Moshe Arditi ◽

...

Keyword(s):

African American ◽

Los Angeles ◽

Delivery System ◽

Healthcare Workers ◽

Los Angeles County ◽

Healthcare Delivery ◽

Healthcare Delivery System ◽

Hispanic Ethnicity ◽

Factors Associated ◽

African American Race

ObjectiveWe sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers.DesignObservational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionnaires.SettingsA multisite healthcare delivery system located in Los Angeles County.ParticipantsA diverse and unselected population of adults (n=6062) employed in a multisite healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions.Main outcomesUsing Bayesian and multivariate analyses, we estimated seroprevalence and factors associated with seropositivity and antibody levels, including pre-existing demographic and clinical characteristics; potential COVID-19 illness-related exposures; and symptoms consistent with COVID-19 infection.ResultsWe observed a seroprevalence rate of 4.1%, with anosmia as the most prominently associated self-reported symptom (OR 11.04, p<0.001) in addition to fever (OR 2.02, p=0.002) and myalgias (OR 1.65, p=0.035). After adjusting for potential confounders, seroprevalence was also associated with Hispanic ethnicity (OR 1.98, p=0.001) and African-American race (OR 2.02, p=0.027) as well as contact with a COVID-19-diagnosed individual in the household (OR 5.73, p<0.001) or clinical work setting (OR 1.76, p=0.002). Importantly, African-American race and Hispanic ethnicity were associated with antibody positivity even after adjusting for personal COVID-19 diagnosis status, suggesting the contribution of unmeasured structural or societal factors.Conclusion and relevanceThe demographic factors associated with SARS-CoV-2 seroprevalence among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modelling techniques, provide a vibrant picture of the demographic factors, exposures and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to COVID-19.

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