• Journal of Chest Surgery
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• 제49권sup1호
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• pp.37-43
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• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

• Journal of Preventive Medicine and Public Health
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• 제44권5호
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• pp.201-209
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• 2011

Objectives: This study examined the use of health impact assessment (HIA) as a tool for intersectoral collaboration using the case of an HIA project conducted in Gwang Myeong City, Korea. Methods: A typical procedure for rapid HIA was used. In the screening step, the Aegi-Neung Waterside Park Plan was chosen as the target of the HIA. In the scoping step, the specific methods and tools to assess potential health impacts were chosen. A participatory workshop was held in the assessment step. Various interest groups, including the Department of Parks and Greenspace, the Department of Culture and Sports, the Department of Environment and Cleansing, civil societies, and residents, discussed previously reviewed literature on the potential health impacts of the Aegi-Neung Waterside Park Plan. Results: Potential health impacts and inequality issues were elicited from the workshop, and measures to maximize positive health impacts and minimize negative health impacts were recommended. The priorities among the recommendations were decided by voting. A report on the HIA was submitted to the Department of Parks and Greenspace for their consideration. Conclusions: Although this study examined only one case, it shows the potential usefulness of HIA as a tool for enhancing intersectoral collaboration. Some strategies to formally implement HIA are discussed.

• 보건행정학회지
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• 제32권4호
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• pp.356-367
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• 2022

Background: The emergence of new infectious diseases threatens public health, increasing socioeconomic damage, and national risks. This study aimed to develop an evidence-based risk assessment tool to quickly respond to new infectious diseases. Methods: The risk elements were extracted by reviewing the risk assessment methods of the World Health Organization, United States, Europe, United Kingdom, and Germany, and the validity and priority of elements were determined through expert meetings and Delphi surveys. Then, the scale and level for each risk element were defined and a final score calculation method according to the risk evaluation result was derived. The developed risk assessment tool was verified using data at the time of domestic transmission of an emerging infectious disease. Results: In case of spread of actual infectious diseases, priority is determined based on the criticality of the elements in each area of transmissibility and severity, from which the weighted score of the risk assessment is derived. Then, the risk score for each element was calculated by multiplying the average value of the risk evaluation by its weight and the evaluation risk assessment score for the two areas was calculated. At last, the final score is plotted in a matrix where the x-axis indicates the transmissibility and the y-axis the severity and plotted on the coordinate plane for time series use. Conclusion: With respect to transmissibility and severity, this risk assessment method to respond to new and re-emerging infectious diseases enables rapid and evidence-based evaluation by quantitatively and qualitatively assessing various risk elements.

• 한국산업보건학회지
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• 제33권1호
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• pp.50-59
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• 2023

Objectives: This study was designed to examine the effect of risk assessment on employee safety behavior in manufacturing workplaces. In addition, this study attempted to explore factors related to the occupational safety and health system in the workplace affect the risk assessment of manufacturing sites. Methods: This research is a cross-sectional study using the Korea Occupational Safety and Health Agency's 2018 Occupational Safety and Health data. The sample for study is 1,967 manufacturing workplaces. Data were analyzed using descriptive statistics, t-test, ANOVA, chi-square test, and hierarchical multiple regression analysis using SPSS (ver.25.0). Results: As a result of the multiple hierarchical regression analysis, it was found that risk assessment had an effect on employee safety behavior (t=4.435, p=<.001). Furthermore, the size of the workplace affected employee safety behavior (t=2.494, p=<.001). In addition, the presence of safety and health management organizations affected employee safety behavior (t=4.301, p=<.001). The factors of the safety and health organization (𝑥²=35.245, p=<.001), the occupational safety and health committee (𝑥²=149.440, p=<.001), and the supervisor (𝑥²=16.472, p=<.001) were identified as factors that increased the possibility of risk assessment in the manufacturing workplaces. Conclusions: In this study, it was found that risk assessment is a factor that increases the level of workers' safety behavior in manufacturing workplaces. Therefore, it is necessary to provide institutional support for activating risk assessment at manufacturing workplaces.

• Annals of Occupational and Environmental Medicine
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• 제35권
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• pp.35.1-35.11
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• 2023

Background: Cardio-cerebrovascular diseases (CVDs) are the most common cause of death worldwide. Various CVD risk assessment tools have been developed. In South Korea, the Korea Occupational Safety & Health Agency (KOSHA) and the National Health Insurance Service (NHIS) have provided CVD risk assessments with health checkups. Since 2018, the KOSHA guide has stated that NHIS CVD risk assessment tool could be used as an alternative of KOSHA assessment tool for evaluating CVD risk of workers. The objective of this study was to determine the correlation and agreement between the KOSHA and the NHIS CVD risk assessment tools. Methods: Subjects of this study were 17,485 examinees aged 20 to 64 years who had undergone medical examinations from January 2021 to December 2021 at a general hospital. We classified subjects into low-risk, moderate-risk, high-risk, and highest-risk groups according to KOSHA and NHIS's CVD risk assessment tools. We then compared them with cross-analysis, Spearman correlation analysis, and linearly weighted kappa coefficient. Results: The correlation between KOSHA and NHIS tools was statistically significant (p-value < 0.001), with a correlation coefficient of 0.403 and a kappa coefficient of 0.203. When we compared risk group distribution using KOSHA and NHIS tools, CVD risk of 6,498 (37.1%) participants showed a concordance. Compared to the NHIS tool, the KOSHA tool classified 9,908 (56.7%) participants into a lower risk category and 1,079 (6.2%) participants into a higher risk category. Conclusions: In this study, KOSHA and NHIS tools showed a moderate correlation with a fair agreement. The NHIS tool showed a tendency to classify participants to higher CVD risk group than the KOSHA tool. To prevent CVD more effectively, a higher estimation tool among verified CVD risk assessment methods should be selected and managements such as early intervention and treatment of risk factors should be performed targeting the high-risk group.

• 한국환경보건학회지
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• 제44권3호
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• pp.227-237
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• 2018

Objectives: This study was investigated the characteristics of small-scale water works (SWW) in Gyeongnam area and conduct a health risk assessment of water-quality inspection items unfitted for water-quality standards (WQS). Methods: The characteristics of SWW in Gyeongnam province were analyzed using the data of SWW in the last three years (2014~2016) published in National Waterworks Information System. In addition, the health risk assessment for inspection items unfitted for WQS was carried out in four steps: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Results: The total number of SWW in Gyeongnam area was gradually decreased from 2014 to 2016. In addition, drinking water sources of SWW were in the order of ground water, valley water, spring water, surface water, and river-bed water. The number of points unfitted for WQS in SWW by year was 22, 45, and 18 in 2014, 2015, and 2016, respectively, and a total of 112 points were found to unfit for WQS in SWW during 2014~2016. The hazard quotient (HQ) for fluoride, nitrate nitrogen, boron in the unfitted points for WQS was more than 1.0, and the mean values for turbidity and color in points unfitted for WQS were 2.38 nephelometric turbidity unit and 16.25 color unit, respectively. Conclusions: The HQ for fluorine, nitrate nitrogen and boron was more than 1.0 in points unfitted for WQS among SWW in Gyeongnam area, and the turbidity and the color degree exceeded WQS, which mean that there is a possibility of harmful impacts on the human health.

• 보건행정학회지
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• 제30권2호
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• pp.164-177
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• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• 환경영향평가
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• 제31권4호
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• pp.250-264
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• 2022

현행 환경영향평가 체계 내 건강영향평가 대상사업은 「환경보건법」 시행령 제12조(건강영향 항목의 추가·평가 대상)에 따라 일부 대상사업으로 한정되어 있으나, 대상사업이 아닌 다양한 환경영향평가 대상 사업들에 대해서도 협의과정에서 건강영향 관련 사항들이 추가로 평가·검토되고 있다. 특히 주거지 관련 개발계획에 있어 개발부지가 오염원 주변에 계획될 경우 건강영향 측면에서의 입지 타당성 확보 여부를 평가·검토하게 되는데, 개발부지에서 주요 유해대기오염물질들의 현황농도 조사를 통한 위해도 기준 만족 여부를 확인하여 사후관리 방안을 마련하는 수준에 그치고 있다. 본 논문에서는 주거지 개발계획에 있어 개발하고자 하는 주거지역에 대한 입지의 타당성을 확인하는 정량적 방법을 마련하고 환경영향평가 절차 내에서 건강영향평가 대상사업의 확대 방안을 제안하고자 하였다. 환경영향평가 체계의 스크리닝 및 스코핑 절차를 검토하여 세부 방법론을 제안하였으며, 방법론 검증을 위해 과거 협의된 도시개발계획에 대한 사례분석을 진행하였다.

• 대한안전경영과학회지
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• 제26권2호
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• pp.79-86
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• 2024

Scientific exploration of how occupational health risks relate with occupational illnesses are essential for mitigating health-related issues in industries. This study analyzed the risk scores obtained by occupational health risk assessments at 3,172 manufacturing companies and examined their effects on occupational illness. Statistical analyses revealed that companies with an occupational health manager (scored 89.1 out of 100) had significantly higher activity scores of health management compared to those without (78.2). However, companies with a history of occupational illness (79.1) or those classified as high-risk industries (85.2) had significantly lower activity scores than their counterparts (81.7, 87.3). In addition, regression analyses using factor analysis showed that latent risk factors such as cardiovascular disease/job stress, health management, and musculoskeletal problem significantly influenced the risk of occupational illness. The activity factors such as health management, work environment management, and regulatory complaisance significant impacted the reduction of occupational illness. The findings of this study can be used to improve the occupational health risk assessment method and utilized in effectively managing occupational risks in industries.

• 한국학교보건학회지
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• 제7권1호
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• pp.9-28
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• 1994

This study is to investigate the status and problems in the anual physical examination in elementary & secondary schools. The study helps the introduction of health assessment. Two hundreds and forty nurse teachers of elementary & seconcary school in Seoul received in-service traomong fpr 20 daus frp, September 7 to September 27, 1992. Questionnaires were given to the 240 teachers and the number of collected questionnaire is 112. The result of the questionnaire analysis is like the following. First, the answered teachers aged 35~39, 36.6%; experience 6~10 years 37.5%; the number of class 31~40, 28.6%. Among the answered of the school doctors is practicioners. The doctors major subjects are 26.8% of internal medicine and 35.7% of surgery. Second, in elementary & secondary school nurse teachers received in-service training for the primary health assessment. And then 37.5% of schools practiced the health assessment. The term of the health assessment is largely a-year-length, occurately its rate of schools have practiced the assessment reaches 81.0%. The number of health assessment are consist of eyes, nose, ear, throat, skin, spine, heart and other abnormal regions and diseases all over the body. And 83.3% of the rate of the health assessment includes all these contents. The period of the health assessment is 7 to 28 days. Third, the physical examination conducted by school doctors is 91.0%. The method is various; one is 56.6% of the students who checked first by he nurse teacher. The number of 15.1% of the schools is directly checked by the school doctor. The invited medical doctors are divided into two categories. The number of general physician is 61.9%. Contrary to that school doctors are 38.1%. The contents of the medical examination is all the items printed on the medical examination sheet. To follow the medical examination sheet the number of school is 59.6%. Eyes, throat, skin and heart etc. partly medical examination is 40.4%. The rate of schools that used only stethoscope, tongue pressor as the medical instruments reaches 53.4% and 87.1% of elementary & secondary school give the invited doctors the allowance a nurse teachers conference decided. The number of 8.9% schools pay the doctors independent allowance. The medical examomatopm allowance is 200 to 250 won per capita. The rate is 56.1%. Forth, after the medical examination 72.1% of school sends letter to the parents to notice the result of the examination. The number of response from parent is 12.5%. The observation record in secondary school is 70.6% for junior, and 80.0% for senior respectively, and 65.5% is for the elementary school children. To conclude the regular physical examination in elementary & secondary school is very important. Because the students are in the stage of rapid growth and development. Early finding of the students diseases can help to cure with ease. In the light of public health the management of health program in the elementary & secondary school is of consequence.