• Health Policy and Management
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• v.27 no.4
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• pp.273-275
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• 2017

It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

• Korean Journal of Health Education and Promotion
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• v.9 no.1
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• pp.1-13
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• 1992

The purpose of this thesis is to provide the framework of the health education curriculum on a school level which should be accomplishe in futrue and farthermore to establish the health education as a independent and regular course. The relation among the status in quo and the satisfaction degree of health education, the degree of the knowledge about health, the degree of the understanding of the health education and the degree of requirement for the health education curriculum has been analyzed in this paper. The research has been carried out through the questionnaire forms distributed to the girl students and the instructors at a few general senior high school and vocational senior high schools in Seoul, and the consequences are as follows : 1. As to the degree of understanding of the health education, it has been indicated that the health education should be performed one or two hours a week from the elementary school for all the boy and girl students by the experts trained in the departments concerned with health. 2. Concerning the degree of requirement for health education curriculum, the high school girl students have shown the need for first aid, sex education, environmental health, drinking, smoking, drug abuse, maternal and child health, industrial health, safety health, mental health, growth & development, epidemiology, the old health in the order named. On the other hand, the instructors have shown the need for drinking, smoking, drug abuse, sex education, maternal and child health, public health and industrial health also in the order named. The items having low degree of requirement are biostatistics, community health and health administration in case of the gril students and biostatistics, health administration and health economics in case of the instructors. 3. The status in quo and the satisfaction degree of the health education has proved higher in senior high school curriculums than in junior high school curriculums, and the most instructive course about health has turned out to be gymnastics in junior high school and the training course in senior high school respectively. 4. As to the degree of understanding of the health education in case of the girl students, the significance has been found between the health condition and the time for performing the health education, the monthly income and the objects for the health education, and the school records and the school hours per week. The significance has been shown only in regard to the school records in case of the degree of requriement for the health education curriculum. 5. The degree of requirement for the health education in case of the instructors has shown the significance between the teching career and the need for the health education. In addition, the degree of requirement for the health education curriculum has indicated significance with regard to sex and age. 6. The degress of the understanding of the health education according to the degree of knowledge about health and the degree of requirement for the health educatio curriculum have been all turned out to be statistically significant. 8. Among the factors which have an influence on the degree of the understanding of the health education, the recognition of the relation between the health course and the training course has significatly influenced the selection of the health education instructors. In additon, the understanding of the need for the health eduation has significantly influenced the objects for the instructors and the school hours, and the understanding of the need for establishing the health education course has significatly influenced the time for performing the health education.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.13-23
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• 1979

A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.

• Korean Journal of Soil Science and Fertilizer
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• v.45 no.5
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• pp.848-852
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• 2012

Vegetation can make not only to lower the urban ambient air temperature (UAAT) by crop evapotranspiration (ET) and increasing solar radiation albedo, but also to reduce the urban air pollution by $CO_2$ uptake and $O_2$ emission in addition to the reducing ozone concentrations by aid of lower the UAAT. To evaluate the effect of vegetation on urban heat island mitigation (UHIM), the climate change of 6 cities during 30 years are analysed, and the amount of ET, $CO_2$ uptake, $O_2$ emission and ozone concentrations are estimated in Korea. The most hot season is the last part of July and the first part of August, and the highest average UAAT of a period of ten days was $35.03^{\circ}C$ during 30 years (1979 - 2008). The mean values of maximum ET of rice and soybean in urban area during urban heat island phenomena were 6.86 and $6.00mm\;day^{-1}$, respectively. The effect of rice and soybean cultivation on lowering the UAAT was assessed to be 10.5 and $3.0^{\circ}C$ in Suwon, respectively, whereas the differences between the UAAT and canopy temperature at urban paddy and upland in Ansung were 2.6 and $2.2^{\circ}C$. On the other hand, the urban-garden in Suwon city had resulted in lowering the UAAT and the surface temperature of buildings to 2.0 and $14.5^{\circ}C$, respectively. Furthermore, the amounts of $CO_2$ uptake by rice and soybean were estimated to be 20.27 and $15.54kg\;CO_2\;10a^{-1}day^{-1}$, respectively. The amounts of $O_2$ emission by rice and soybean were also assessed to be 14.74 and $11.30kg\;O_2\;10a^{-1}day^{-1}$, respectively. As other cleaning effect of air pollution, the ozone concentrations could be also estimated to reduce 21.0, 8.8, and 4.0 ppb through rice-, soybean cultivation, and urban gardening during most highest temperature period in summer, respectively.

• Journal of Internet Computing and Services
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• v.21 no.2
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• pp.139-148
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• 2020

Due to change in circumstances in the 2000s such as severe birthrate decline and shortened military service period, the armed forces of the Republic of Korea is currently turning to technologies and equipments from manpower, developing it to become high-tech, high-speed, and complex, resulting in an environment in which a single mistake could cause a mass mortality crisis.It is also evident that, considering aspects such as safety training curriculums and achievements of advanced countries and private education, hands-on training is a must in preventing suicides and accidents in the military, and establishing safety training centers is crucial for systematic and effective hands-on training.Soldiers who are joining the army as of now have experienced the Internet ever since they were born and easily use both virtual and augmented reality, and the current level of science and technology has developed to the point where most of the public safety experience centers are able to be replaced by virtual and augmented reality (VR/AR). Therefore, considering the aspects such as installation space, construction costs, maintenance costs, user characteristics, and education effects, other than for those trainings where real models and objects are more effective such as first aid training, it is with a strong recommendation that establishing military safety training facilities with VR/AR (Virtual and augmented reality) is a must in the coming future. We have derived the need for hands-on training by considering the development of virtual and augmented reality (VR/AR), analysis of operation status of the public safety experience centers, characteristics of military units, installation and maintenance costs, and proposed plan to establish safety training centers where effective training performance can be achieved at a lower cost than the public safety experience center. In addition, we suggested the scale of the required safety training center and the composition of the experience rooms considering the number of trainees and the environment of each military units. Given this analysis it will contribute to the prevention of military safety and suicide by building a safety training center in the future.

• The Korean Journal of Food And Nutrition
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• v.30 no.3
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• pp.405-412
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• 2017

To aid in the development of a food nutrient database that provides the dietary fiber composition of eat-out Korean foods, we determined the total dietary fiber (TDF) content in the eat-out Korean foods Muchim, Bokkeum, and Guk (Tang) using a dietary fiber autoanalysis instrument. A total of 59 samples were collected from Gangwon-do, Gyeonggi-do, Gyeongsangdo, Seoul, Jeonla-do, and Chungcheong-do. First, among 14 samples of Muchim, the TDF content of Kkaennip namul, Goguma-julgi-namul, and Dallae-namul (4.33~6.24, 3.16~5.07 and 3.70~4.99 g/100 g, respectively) was higher than the other types of Muchim. There was no significant difference in TDF content of Muchim (p>0.05) among locations. Among 13 samples of Bokkeum, the TDF content of Pyogo-beoseot-bokkeum (4.77~6.66 g/100 g) and Miyeok-julgi-bokkeum (4.16~7.47 g/100 g) was higher than the other types of Bokkeum. The TDF content of Pyogo-beoseot-bokkeum in Gyeongsang-do was the lowest and the TDF content of Miyeok-julgi-bokkeum in Gangwon-do was the highest (p<0.05). The TDF content of spinach soybean paste soup (1.34~2.21 g/100 g), Dakgogi-yukgaejang (1.61~2.45 g/100 g), duck stew (1.25~2.80 g/100 g) and spicy yellow croacker stew (1.70~2.27 g/100 g) were higher than the other types of Guk (Tang). There was no significant difference in TDF content of Guk (Tang) among locations (p>0.05).

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4517-4525
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• 2016

Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

• The Journal of Korean Society for School & Community Health Education
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• v.1 no.2
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• pp.49-71
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• 2000

The purpose of this study was to serve as a basis for school health care of better quality, by making a comparative analysis of the health care satisfaction and attitude of elementary school students in consideration of their general characteristics and the presence or absence of nurse teacher. The subjects in this study were 919 selected six graders in 16 elementary schools in the city of Tongduchun, Koyang and Euijungbu, Yangju-kun and Yeunchun-kun. A survey was conducted with questionnaire designed for measurement of health care satisfaction and attitude. As a result of analyzing the data collected from June 1 through 15, 2000, the conclusions were as follows. 1) As for the general characteristics of the students investigated, the subjects included 513 boys(55.8%) and 406 girls(44.2%). The schools where 390(42.4%) students attended were located in municipal area, and the schools where 529(57.6%) students attended were located in kun area. 608(66.2%) students had a nurse teacher at their schools, while 311(33.8%) students had no nurse teacher. 498(54.2%) had an experience to use the health room this year, but 421(45.8%) had no such an experience. Their mean school life satisfaction was scored $3.42{\pm}.71$, above the average. And their health condition was rated $3.81{\pm}.87$, which implied they tended to be in good health. 2) The mean satisfaction at the health room operation was scored $3.33{\pm}.71$, above the medium level. What they were most satisfied with($4.02{\pm}1.08$) was, among the health room facilities, that there were beds. But they expressed the least satisfaction($2.83{\pm}1.17$) at the location of health room. The presence or absence of nurse teacher made a significant difference to their satisfactionat health room operation, because the students in schools with nurse teacher showed greater satisfaction($3.42{\pm}.72$) than the others in schools with no nurse teacher did($3.15{\pm}.66$). 3) Concerning their attitude to use the health room in case of disease or accident occurrence, a lot of students in schools with a nurse teacher, who had ever suffered from indigestion, headache or traumatic injury, used the health room. In schools with no nurse teacher, there was a tendency to talk to their class teachers(p<.001). The recognition of the necessity for health counseling was generally on a medium level. The counselor whom they wanted to discuss health problem with was family or friend in the largest cases. Few students discussed with class teachers in case there was a nurse teacher in school. Instead, some of them discussed with friend, family or nurse teacher, and there was a significant difference between them(p<.001). 4) The mean satisfaction at health, sanitation and environmental management was rated $3.20{\pm}.90$, above the average. The classroom lighting gave them the best satisfaction with $3.67{\pm}1.07$, but the satisfaction at toilet cleanness and disinfection was not good with $2.83{\pm}1.19$. By the presence or absence of nurse teacher, those who had a nurse teacher expressed better satisfaction at water supply facilities including hot water than the others who had no nurse teacher did(p<.001). But no significant difference was observed in the other items. 5) The health education satisfaction was rated $3.19{\pm}.99$, which was on a medium level. By item, the mean satisfaction level was $3.36{\pm}1.19$ at nurse teacher's explanation about treatment, $3.13{\pm}1.15$ at the frequency of health education, and $3.08{\pm}1.16$ at the explanation on the cause of disease. By the presence or absence of nurse teacher, the students with nurse teacher showed significantly better satisfaction at every factor0(p<.001). 6) Regarding health education attitude, their recognition of the need for school health education was scored $3.89{\pm}.96$. Those who had a nurse teacher felt it more necessary($3.96{\pm}.92$), yet the others who had no nurse teacher felt its necessity a little less($3.74{\pm}1.01$). The most preferred thing for them to learn in health education was first aid, followed by sex education, obesity prevention, safety accident prevention in school and outdoors, smoking-related health, good use of leisure time, and environmental pollution cause in the order named. According to the presence or absence of nurse teacher, there was a significant difference in sex education(p<.01), but no significant disparities were found in the other factors. The most preferred person who would offer health education was a lecturer from the outside(45.8%) and nurse teacher(45.4%). Their preference for class teacher as a person in charge of health education was just 8.8%. But the presence or absence of nurse teacher didn't produce any differences to their preference for a person in charge of health education.

• Journal of agricultural medicine and community health
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• v.31 no.1
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• pp.21-34
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• 2006

Objectives: The purpose of this study was to investigate the knowledge, attitude and practice toward sanitary administration of the new restaurateurs, to carry out the sanitary management of business for improvement of sanitary level, and to provide basic data which were necessary for sanitary education of the restaurateurs. Methods: The self-recording survey on the attitude and the knowledge toward the sanitation, the sanitary administration, and its education was conducted against new 393 restaurateurs by the administrative division of Gwangju city in charge of the food industry which put in the regular sanitary education annually for the new restaurateurs. Results: In regard to food sanitation, some 87.9% to 94.4% got the right knowledge about the reason and precaution of food poisoning, storage methods of frozen or cold food, and the disposal of product after expiration of validity term. But it was about 56.0% to 63.0% who knew right about the cause and the major precaution of food poisoning, storage temperature in the refrigerator. 30.6% of the subject placed an emphasis on personal sanitation of the workers as the most important thing in the sanitary management. 83.6% replied that it was necessary to improve the sanitary level. Concerning the health examination, 78.3% replied it was needed. 76.4% pointed the need for education, but respondents with higher educational level less emphasized its needs. It was most frequently pointed out by 71.6% restaurateur's poor awareness about it. 36.7% indicated the environmental sanitation like facilities in the restaurants as the first thing to be improved. The rate of personal sanitation was 43.7%. Conclusions: To improve the poor sanitary conditions of the food service business, it was recommended to offer institutional backing and financial aid from administrative office, to encourage restaurateurs to take pride in their job, and to conduct the sanitary education effectively by the technical education institution.

• Journal of agricultural medicine and community health
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• v.35 no.2
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• pp.151-164
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• 2010

Objective:Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. Methods: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. Results: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. Conclusion:In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.