• 보건행정학회지
• /
• 제32권1호
• /
• pp.3-13
• /
• 2022

Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

• 한국대기환경학회지
• /
• 제27권6호
• /
• pp.692-702
• /
• 2011

For more effective indoor radon reduction policy and technique, we researched radon data analysis for some buildings in Seoul. Those buildings were categorized as dwelling, underground and office space and the variations of radon concentration and its sources were evaluated. The variations of radon concentrations of indoor space of buildings for a day were patterned specifically by dwelling habits and different environment. As for the new built apartments which were not yet moved in, their indoor radon concentrations were showed more than 3 times after applying interior assembly, and were 5 times higher than ones of rather old residences. As for the subway stations, the radon concentrations during off-run times were about 15% higher than run-times. 10% of radon seemed to be reduced by installation of platform screen doors. As for office space, radon concentrations during working hours were about 2.5 times higher than non-working hours. Plaster board are expected as a main source of radon for them. By radon measurement method for long-term, its data can be over estimated because it covers non-active time in office or public space. Therefore combination of short and long-term measurement method is required for effective and economic reduction. Furthermore importance of ventilation is requested as public information service for all dwelling space. And also standardization for radium content or radiation of radon is necessary.

• 한국산업보건학회지
• /
• 제30권3호
• /
• pp.299-305
• /
• 2020

Objectives: The most important occupational health activity is work environment measurement(WEM) along with the health examination. The preventive function of the WEM system could be achieved on the assumption that all subjected workplaces are performing correctly the WEM. To achieve properly the original purpose of WEM, we suggested a policy for subjected workplaces that they should register whether subjected or not. Methods: We made registration draft through reviewing laws, reports and thesis for WEM. And we conducted Focus Group Interview for industrial health experts using structured questionnaire about the registration. Results: There were 412 occupational deaths from 2013 to 2017. And it was found that only 130(31.6%) workplaces which involved in these occupational deaths had conducted the WEM. In order to operate the WEM system with effect, the subjected workplaces should register the subject status. Such registration must be completed at the stage of industrial accident insurance enrollment. Conclusions: Conducting WEM is the first step to prevent intoxication accident in workpalces. To operate properly WEM we should correctly understand subjected workplaces. So it is needed for all subjected workplaces to register whether they are subjected or not.

• 한국물환경학회지
• /
• 제23권6호
• /
• pp.985-992
• /
• 2007

There are about 40,000 chemicals used in Korea and 300 new types of chemicals are added to the list every year, influencing quality of air, soil and water. Water quality standards that serve as the basis for water quality management have been proved inefficient and insufficient compared to those of advanced countries. This study aims to improve the existing water quality standards. Most importantly, the water quality standards need to take into account not only protection of human health but also aquatic resources. To that end, water quality criteria need to be set by monitoring each watershed every year and conducting risk assessment. Criteria for human health are set at $10^{-6}$ cancer risk level, and for aquatic life at conservative level, adopting the methodology of the U.S. and Australia, respectively. After carrying out technical and economic feasibility studies, more conservative criteria will be used to decide final water quality standards. The development of this system to establish integrated water quality standards for both human health and aquatic resources protection is urgently needed.

• Journal of Preventive Medicine and Public Health
• /
• 제47권5호
• /
• pp.258-265
• /
• 2014

Objectives: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.

• 보건교육건강증진학회지
• /
• 제35권5호
• /
• pp.1-16
• /
• 2018

Objectives: This study aimed to examine systems behavior of urban walking by analyzing a dynamic structure in Seoul, South Korea. Methods: As a systems thinking approach to urban walking and health promotion, we developed a Casual Loop Diagram based on literature review and expert consultation. The reviewed literature included: 1) qualitative studies that explores the experiences of urban walkers in Seoul; 2) a systematic review study on the built environmental factors related to walking; 3) policy research reports related to urban walking in Seoul. Results: The feedback structure for urban walking was related to the three urban environments (safety & walking environment, socioeconomic environment, and public transportation environment), and was characterized by a trade-off consisting of eight reinforcing loops and four balancing loops. Conclusions: The policies for a walkable city require multi-sectoral cooperation in order to change the causal loop structure related to the decline of walking. Therefore, it is necessary to establish legal and institutional conditions so that multi-sectoral and multidisciplinary approaches are possible.

• 보건행정학회지
• /
• 제21권1호
• /
• pp.115-131
• /
• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• 보건행정학회지
• /
• 제19권4호
• /
• pp.98-120
• /
• 2009

The purpose of this study is to elicit preference for drug listing decision criteria and to estimate the ICER threshold in South Korea using the discrete choice experiment (DCE) method. To collect the data, a DCE survey was administered to a subject sample either educated in the principle concepts of pharmacoeconomics or were decision makers within that field. Subjects chose between alternative drug profiles differing in four attributes: ICER, uncertainty, budget impact and severity of disease. The orthogonal and balanced designs were determined through computer algorithm to take the optimal set of drug profiles. The survey employed 15 hypothetical choice sets. A random effect probit model was used to analyze the relative importance of attributes and the probabilities of a recommendation response. Parameter estimates from the models indicated that three attributes (ICER, Impact, Severity of disease) influenced respondents' choice significantly(p${\pm}$0.001). In addition, each parameter displayed an expected sign. The Lower the ICER, the higher the probability of choosing that alternative. Respondents also preferred low levels of uncertainty and smaller impact on health service budget. They were also more likely to choose drugs for serious diseases rather than mild or moderate ones. Uncertainty however is not statistically significant. The ICER threshold, at which the probability of a recommendation was 0.5, was 29,000,000 KW/QALY in expert group and 46,500,000 KW/QALY in industry group. We also found that those in our sample were willing to accept high ICER to get medication for severe diseases. This study demonstrates that the cost-effectiveness, budget impact and severity of disease are the main reimbursement decision criteria in South Korea, and that DCE can be a useful tool in analyzing the decision making process where a variety of factors are considered and prioritized.

• 보건행정학회지
• /
• 제32권3호
• /
• pp.304-316
• /
• 2022

Background: As prevention of coronavirus disease 2019 (COVID-19) transmission in healthcare settings has become a critical component in its effective management, COVID-19 specific infection prevention and control (IPC) guidelines were developed and implemented by numerous countries. Although largely based on the current evidence-base, guidelines show much heterogeneity, as they are influenced by respective health system capacities, epidemiological risk, and socioeconomic status. This study aims to analyze the variations and concurrences of these guidelines to draw policy implications for COVID-19 response and future guidelines development. Methods: The contents of the COVID-19 IPC guidelines were analyzed using the categories and codes developed based on "World Health Organization guidelines on core components." Data analysis involved reviewing, appraising and synthesizing data from guidelines, which were then arranged into categories and codes. Selection of countries was based on the country income level, availability of COVID-19 specific IPC guideline developed at a national or district level. Results: The guidelines particularly agreed on IPC measures regarding application of standard precautions and providing information to patients and visitors, monitoring and audit of IPC activities and staff illnesses, and management of built environment/equipments. The guidelines showed considerable differences in certain components, such as workplace safety measures and criteria for discontinuation of precautions. Several guidelines also contained unique features which enabled a more systematic response to COVID-19. Conclusion: The guidelines generally complied with the current evidence-based COVID-19 management but also revealed variances stemming from differences in local health system capacity. Several unique features should be considered for benchmark in future guidelines development.

• 보건교육건강증진학회지
• /
• 제22권3호
• /
• pp.173-186
• /
• 2005

This paper develops the argument that the 'Healthy Cities Approach' extends beyond the boundaries of officially designated Healthy Cities and suggests that signs of it are evident much more widely in efforts to promote health in the United Kingdom and in national policy. It draws on examples from Leeds, a major city in the north of England. In particular, it suggests that efforts to improve population health need to focus on the wider determinants and that this requires a collaborative response involving a range of different sectors and the participation of the community. Inequality is recognised as a major issue and the need to identify areas of deprivation and direct resources towards these is emphasised. Childhood poverty is referred to and the importance of breaking cycles of deprivation. The role of the school is seen as important in contributing to health generally and the compatibility between Healthy Cities and Health Promoting Schools is noted. Not only can Health Promoting Schools improve the health of young people themselves they can also develop the skills, awareness and motivation to improve the health of the community. Using child pedestrian injury as an example, the paper argues that problems and their cause should not be conceived narrowly. The Healthy Cities movement has taught us that the response, if it is to be effective, should focus on the wider determinants and be adapted to local circumstances. Instead of simply attempting to change behaviour through traditional health education we need to ensure that the environment is healthy in itself and supports healthy behaviour. To achieve this we need to develop awareness, skills and motivation among policy makers, professionals and the community The 'New Health' education is proposed as a term to distinguish the type of health education which addresses these issues from more traditional forms.