• 보건행정학회지
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• 제26권1호
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• pp.63-70
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• 2016

Background: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery (ultrasonic shears, electrothermal bipolar vessel sealers) for gastric cancer patients covered since December 2014. Methods: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. Results: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. Conclusion: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.

• 한국환경보건학회지
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• 제47권2호
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• pp.155-165
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• 2021

Objectives: Acute exposure to high concentrations of chemicals can occur when a chemical accident takes place. As such exposure can cause ongoing environmental pollution, such as in the soil and groundwater, there is a need for a tool that can assess health effects in the long term. The purpose of this study was assessing the health risks of residents living near a chemical accident site due to long-term exposure while considering the temporal concentration changes of the toxic chemicals leaked during the accident until their extinction in the environment using a multimedia environmental dynamics model. Methods: A health risk assessment was conducted on three cases of formaldehyde chemical accidents. In this study, health risk assessment was performed using a multimedia environmental dynamics model that considers the behavior of the atmosphere, soil, and water. In addition, the extinction period of formaldehyde in the environment was regarded as extinction in the environment when the concentration in the air and soil fell below the background concentration prior to the accident. The subjects of health risk assessment were classified into four groups according to age: 0-9 years old, 10-18 years old, 19-64 years old, and over 65 years old. Carcinogenic risk assessment by respiratory exposure and non-carcinogenic risk assessment by soil intake were conducted as well. Results: In the assessment of carcinogenic risk due to respiratory exposure, the excess carcinogenic risk did not exceed 1.0×10-6 in all three chemical accidents, so there was no health effect due to the formaldehyde chemical accident. As a result of the evaluation of non-carcinogenic risk due to soil intake, none of the three chemical accidents had a risk index of 1, so there was no health effect. For all three chemical accidents, the excess cancer risk and hazard index were the highest in the age group 0-9. Next, 10-18 years old, 65 years old or older, and 19-64 years old showed the highest risk. Conclusion: This study considers environmental changes after a chemical accident occurs and until the substance disappears from the environment. It also conducts a health risk assessment by reflecting the characteristics of the long-term persistence and concentration change over time. It is thought that it is of significance as a health risk assessment study reflecting the exposure characteristics of the accident substance for an actual chemical accident.

• 대한한의학회지
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• 제40권3호
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• pp.59-75
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• 2019

Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

• Safety and Health at Work
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• 제9권3호
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• pp.249-256
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• 2018

This article aims to provide a systematic review of the exposure assessment methods used to assign wafer fabrication (fab) workers in epidemiologic cohort studies of mortality from all causes and various cancers. Epidemiologic and exposure-assessment studies of silicon wafer fab operations in the semiconductor industry were collected through an extensive literature review of articles reported until 2017. The studies found various outcomes possibly linked to fab operations, but a clear association with the chemicals in the process was not found, possibly because of exposure assessment methodology. No study used a tiered assessment approach to identify similar exposure groups that incorporated manufacturing era, facility, fab environment, operation, job and level of exposure to individual hazardous agents. Further epidemiologic studies of fab workers are warranted with more refined exposure assessment methods incorporating both operation and job title and hazardous agents to examine the associations with cancer risk or mortality.

• 대한예방한의학회지
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• 제21권3호
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• pp.75-85
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• 2017

Objectives : The new health technology assessment (nHTA) involves evaluating the safety and efficacy of the new health technology under the Medical Services Act by the New Health Technology Assessment Project Division from 2007. The purpose of this study is to understand the status of applications and recent trends of the results, and suggest strategies for the development of new health technologies in Korean Medicine. Methods : We investigated and analyzed the results of evaluation of new health technology of whole conventional medical and the list of new health technologies in Korean Medicine provided by the New Health Technology Assessment Project Division from 2007 to 2016. Results : The number of applications for new health technology of Korean medicine was low as 41 items in the whole number of 2,013 items. The evaluation method of new health technologies in both, the whole medical and Korean medicine fields was the same, but the tendency in results was very different. Most of the new health technology items in Korean medicine were classified as existing technology (20 items), early stage technology (7 items), and Only 2 items were evaluated as research stage technology. Conclusions : In order to develop new health technology in the Korean medical field, we have made suggestions about the health technology assessment systems, R&D infrastructures, and corporation with conventional medicines.

• Journal of Nutrition and Health
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• 제55권3호
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• pp.406-417
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• 2022

Purpose: The incidence of chronic diseases is increasing and the age of onset is decreasing in South Korea. Healthy eating habits to prevent chronic diseases are established in adolescence. This study verified the identified factors and dynamics that affect diet self-assessment for sustainable adolescent health and the prevention of chronic diseases. Methods: Data were collected from 492 middle and high school students in South Korea from June to July 2018, and the participants answered a questionnaire on dietary safety management competency for sustainable health. Results: The healthy dietary self-assessment scores of overweight/obese adolescents and adolescents who perceived their health as normal were significantly lower than those of other groups. Factor analysis verified the validity of the items that comprised each study area before a multiple regression analysis was used to investigate the factors affecting healthy dietary self-assessment. Sweet and salty diets, anxiety, food and nutrition knowledge, weight management knowledge, stress management, exercise, basic eating habits, and healthy eating habits significantly affected healthy dietary assessment among adolescents. A higher perception of one's health indicated a higher healthy dietary self-assessment, dietary safety knowledge, and health management practice scores (p < 0.01). Factors like healthy dietary self-assessment, food and nutrition knowledge, and weight management knowledge appear to have a significant correlation with other identified factors, except overeating. The adolescents' awareness, knowledge, and dietary safety practices influenced healthy dietary self-assessment, which can prevent chronic diseases and achieve sustainable health. Conclusion: This study illustrated how the adolescents' awareness, knowledge, and practices of dietary safety influenced their healthy diet self-assessment. The results indicate that diet-based health management competency education relative to the adolescents' self-perception and weight levels should be implemented.

• Safety and Health at Work
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• 제4권2호
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• pp.95-99
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• 2013

Background: Work-related stress is one of the major causes of occupational ill health. In line with the regulatory framework on occupational health and safety (OSH), adequate models for assessing and managing risk need to be identified so as to minimize the impact of this stress not only on workers' health, but also on productivity. Methods: After close analysis of the Italian and European reference regulatory framework and workrelated stress assessment and management models used in some European countries, we adopted the UK Health and Safety Executive's (HSE) Management Standards (MS) approach, adapting it to the Italian context in order to provide a suitable methodological proposal for Italy. Results: We have developed a work-related stress risk assessment strategy, meeting regulatory requirements, now available on a specific web platform that includes software, tutorials, and other tools to assist companies in their assessments. Conclusion: This methodological proposal is new on the Italian work-related stress risk assessment scene. Besides providing an evaluation approach using scientifically validated instruments, it ensures the active participation of occupational health professionals in each company. The assessment tools provided enable companies not only to comply with the law, but also to contribute to a database for monitoring and assessment and give access to a reserved area for data analysis and comparisons.

• 환경영향평가
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• 제21권5호
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• pp.813-821
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• 2012

Environmental and public health concern for the emission of air pollutants from burn-up process in waste incineration plants located in the vicinity of living environment was increased during the past decade. The purpose of this study was to suggest of the simple and rapid method of priority setting model for the decision of full-scale public health assessment. This method was consists of total 5-step. Step 1 was "secure the satellite map" and we can use the satellite map which serves from the website such as NAVER Co. Step 2 was "drawing mesh on the map" for catch the point of occupation of environmental sensitivity facilities, and step 3 was "identification and sorting of the facilities", Step 4 was "setting of weight" using the "weighted linear combination (WLC) method". Finally, all facility was sorted by score. As a result, we can set a priority of 145 facilities based on 177 facilities which managed in local government. Facilities in Seoul metropolitan area was high rank in priority list. On the other side, Facilities located at the country or rural area was low rank because of low occupation of the house and the environmental sensitivity facilities such as kindergarten, elementary school, and hospital. In this study, we suggested simple and rapid method that using for screening procedure of public health assessment.

• 한국환경보건학회지
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• 제37권1호
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• pp.12-21
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• 2011

The objective of this study is to review retrospective exposure assessment methods used in wafer fabrication operations to determine whether adverse health effects including mortality or cancer incidence are related to employment in particular work activities and to recommend an appropriate approach for retrospective exposure assessment methods for epidemiological study. The goal of retrospective exposure assessment for such studies is to assign each study subject to a workgroup in such a way that differences in exposure within the workgroups are minimized, as well as to maximize the contrasts in exposure between workgroups. To reduce the misclassification of exposure and to determine if adverse health effects including mortality or cancer incidence are related to particular work activities of wafer fabrication workers, a minimum requirement of work history information on the wafer manufacturing eras, job and department at which they were exposed should be assessed. Retrospective assessment of the task that semiconductor workers performed should be conducted to determine not only the effect of a particular job on the development of adverse health effects including mortality or cancer incidence, but also to adjust for the healthy worker effect. In order to identify specific hazardous agents that may cause adverse health effects, past exposure to a specific agent or agent matrices should also be assessed.

• Safety and Health at Work
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• 제1권1호
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• pp.1-10
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• 2010

The Finnish risk assessment practice is based on the Occupational Safety and Health (OSH) Act aiming to improve working conditions in order maintain the employees' work ability, and to prevent occupational accidents and diseases. In practice there are hundreds of risk assessment methods in use. A simple method is used in small and medium sized enterprises and more complex risk evaluation methods in larger work places. Does the risk management function in the work places in Finland? According to our experience something more is needed. That is, understanding of common and company related benefits of risk management. The wider conclusion is that commitment for risk assessment in Finland is high enough. However, in those enterprises where OSH management was at an acceptable level or above it, there were also more varied and more successfully accomplished actions to remove or reduce the risks than in enterprises, where OSH management was in lower level. In risk assessment it is important to process active technical prevention and exact communication, increase work place attraction and increase job satisfaction and motivation. Investments in OSH are also good business. Low absenteeism due to illness or accidents increases directly the production results by improved quality and quantity of the product. In general Finnish studies have consistently shown that the return of an invested euro is three to seven-old. In national level, according to our calculations the savings could be even 20% of our gross national product.