• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.457-467
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• 2003

Purpose: This study examined the development and performance of the school health promotion policy guideline that is applicable to Korean school health. Methods: 1. The WHO's guideline was translated into Korean and modified by school health experts 2. A questionnaire was conducted to assess the performance of school health policy on 207 nurses in elementary schools in Seoul and Cheonbuk. Result: The Korean version of the school health promotion policy guidelines were developed including 9 components and 36 checkpoints. Compared to that of WHO, the component 'school nursing teacher' was added and three components were eliminated: 'equitable access to school resources', 'control of helminth', and 'sun protection policy'. The performance degree of first-aid, closure of school in a calamity, and control of HIV/AIDS was very low. The performance degree of a healthy diet, and regular physical examination was quite high. This study was the first that developed the school health promotion policy guideline and examined the performance. Further research is needed to validate the guidelines developed by this study.

• Health Policy and Management
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• v.12 no.2
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• pp.92-114
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• 2002

While making a vigorous discussion about self-regulation for exponential growth of harmful health information on the Internet, many countries lave made various efforts to select and circulate high quality health information on the Internet. The purpose of this study Is to review the serf-regulation methods of health information on the Internet and to suggest quality control methods of health information on the Internet suitable for Korea. Self-regulation methods of the health information on the Internet include ‘content rating system(or content selection system)’, ‘codes of conduct or guideline’, ‘internet hot-line’, ‘education for information providers and consumers’. Any self-regulation method should be used with other methods. We can regulate health information on the Internet effectively by using both self-regulation methods and compulsive methods such as law. Also information providers, information consumers, specialists, consumer representatives, scholars, governments officers should take part in doing these efforts and make concern.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.4
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• pp.413-427
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• 2006

It is necessary to study and develop guidelines for providing comfort and health indoor air quality for office workers since air-tight envelope system of current office building may cause poor indoor air quality. The purpose of this study is to propose guideline for volatile organic compounds in office base on the field study, human health risk assessment and cost-benefit analysis. The field study was conducted to survey the concentrations of volatile organic compounds in indoor air of 69 offices from June to September, 2005 in Seoul and Gyeonggi-do. The rate of excess to guideline of volatile organic compounds in indoor air of new apartment on the Ministry of Environment in Korea(MOE) was surveyed 37.6% for benzene, 6.8% for toluene, and 1.5% for ethylbenzene. As the result of human health risk assessment, mean cancer risk did not exceed 10-6 which is guideline of US.EPA. Also, total hazard index did not exceed 1 which is guideline of US.EPA. Through the cost-benefit analysis of angle on the social-economics to verify the necessary to establish the standards of volatile organic compounds for improvement and development of indoor air quality in office, the present value of benefit was higher than the present value of cost. With the above considerations in mind, it is suggested that the field study for indoor air quality in offices should be expanded and human health risk assessment and cost-benefit analysis be performed th offer scientific data for decision-making of policy for improvement and management of indoor air quality in office.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• Korea Journal of Hospital Management
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• v.14 no.1
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• pp.62-98
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• 2009

A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

• Journal of Korean society of Dental Hygiene
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• v.11 no.2
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• pp.275-289
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• 2011

Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.

• Health Policy and Management
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• v.31 no.4
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• pp.409-422
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• 2021

The growing use of prescription analgesic opioids has rapidly escalated the treatment of chronic pain since the 1990s; however, it is also highly needed to control opioid-related issues, including opioids misuse, abuse, and addiction. In 2018, Organization for Economic Cooperation and Development (OECD) secretariat administered the survey on opioids use and policies to OECD countries and presented it at the Health Committee meeting of December 2018. This study aimed to review the opioids use in OECD countries and their policies to prevent and reduce associated harms, also seek the available policy lessons from OECD countries. More recently, opioids prescribing rate have been increased 14.7% between 2011-2013 and 2014-2016 and steadily focused on the main substance misused and abused in Korea. In addition, policy efforts have contributed to developing a guideline for prescribing opioids to steer the appropriate use of prescription analgesic opioids since 2000 in Korea, so it is not enough to control opioids compared with other OECD countries. Therefore, taking a people-centered and public health perspective, it will consider the health system policies and interventions at a national level to improve their preparation and approach to control opioid-related issues.

• Health Policy and Management
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• v.32 no.3
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• pp.304-316
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• 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.

• Health Policy and Management
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• v.14 no.2
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• pp.138-162
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• 2004

This study was performed to investigate small area variation in rates of three common surgeries in general surgery department across 156 small areas. Three surgery rates were analyzed; Anal and/or stomal procedures, inguinal and/or femoral hernia procedures, appendectomy. Methods: We used health insurance claims data and the number of patients were 13,845, 2,154 and 7,151 persons respectively. Surgery rates were directly standardized with age and sex and logistic regression was used to analyze surgery rates. Results: Mapping of the surgery rates, there was small area variation in anal and/or stomal procedures. The clinic which was located in more competitive market and chose DRG payment system tends to do more anal and/or stomal procedures. There was no factor except DRG bed rates had effect on rate of inguinal and/or femoral hernia procedures. Conclusions: Findings of this study will contribute to developing investigation method on small area variation and policy to reduce the variation such as developing evidence based medical practice guideline.

• Health Policy and Management
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• v.14 no.2
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• pp.34-57
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• 2004

Universal health insurance normally requires a basic benefit package, whose design intersects with almost all other aspects of the health insurance debate. Despite its central importance, basic benefit package has not received the analysis it deserves in Korea. The issue of how to decide which health services should be delivered and to whom has been a matter for consistent policy debate. Many industrialized countries observed in this study have been dealing explicitly or implicitly with the basic benefit package. The methods vary from having a specific positive list of services (Bismarkian countries) to the use of guidelines (Beveridgian countries). The purpose of this paper is to form the underlying principles and process for determining what is included or left out by getting accurate and representative responses from health-related personnel. Mail survey is used. Economic burden for treatment, seriousness of disease and urgency of treatment are ranked at the first three priorities. Services that had been suspended because of financial crisis in health insurance scheme in 2001 were selected as items which should firstly be expanded into coverage. Diagnostic test against heart disease and vaccination were also selected as items which should additionally belong to the list of covered services.