• Health Policy and Management
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• v.28 no.2
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• pp.138-144
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• 2018

Background: Diagnostic imaging fee had been reduced in May 2011, but it was recovered after 6 months because of strong opposition of medical providers. This study aimed to analyze the behavior of medical providers according to fee changes. Methods: The National Health Insurance claims data between November 2010 and December 2012 were used. The number of exams per computed tomography was analyzed to verify that the fee changes increased or decreased the number of exams. Multivariate regression model were applied. Results: The monthly number of exams increased by 92.5% after fee reduction, so the diagnostic imaging spending were remained before it. But medical provider decreased the number of exams after fee return. After adjusting characteristic of hospitals, fee reduction increased the monthly number of exams by 48.0% in a regression model. Regardless type of hospitals and severity of disease, the monthly number of exams increased during period of fee reduction. The number of exams in large-scaled hospitals (tertiary and general hospital) were increased more than those of small-scaled hospitals. Conclusion: Fee-reduction increased unnecessary diagnostic exams under the fee-for-service system. It is needed to define appropriate exam and change reimbursement system on the basis of guideline.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.25 no.2
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• pp.229-235
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• 2015

Objectives: We checked hepatitis A virus antibody(anti-HAV IgG) and hepatitis B virus antibody(HBsAb) in three large companies. The result could be a guideline to establish proper health policy for Hepatitis A and B virus preventive plan in company. Methods: We investigated the seroprevalence of anti-HAV IgG and HBsAb, and demographic characteristics of employee volunteer in three companies in southern area of Korea. Company was divided three according to health policy for hepatitis A and B. Results: The seroprevalence rate of anti-HAV IgG in company A, B, and C was 53.6%, 25.8%, and 17.7%(P<0.001), respectively. The seroprevalence rate of HBsAb in workplace A, B, and C was 79.7%, 82.4%, and 70.9%(P<0.001), respectively. Anti-HAV IgG showed more considerable difference among the companies. Conclusions: The results confirmed that low rate of IgG anti-HAV and HBsAb, particularly in the company that had low level of hepatitis education and vaccination program. This study was important for establishing hepatitis education policies, to prevent and control outbreaks in companies.

• Korean Journal of Community Nutrition
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• v.17 no.3
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• pp.341-352
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• 2012

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

• Journal of Environmental Impact Assessment
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• v.2 no.2
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• pp.95-103
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• 1993

EIA has been introduced as a tool for environment protection into promulgation of the Environment Preservation Act in 1977, which replaced the Pollution Control Act in Korea. EIA system has been improved with the enlargement of project type, public participation, guideline improvement, and regulatory development. Recently, Environmental Impact Assessment(EIA) Act will have an important role for sustainable development. This article deals with regulatory development, implementation order, EIA project type, and EIS preparation guidelines by Act promulgated and amended, also it explains comparison analysis of Environmental Policy Act and Environment Impact Assessment Act Major results are summarized in the table.

• Quality Improvement in Health Care
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• v.3 no.1
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• pp.126-143
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• 1996

Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

• Korean Journal of Community Nutrition
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• v.3 no.5
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• pp.748-758
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• 1998

The Recommended Dietary Allowances(RDAs, Nutrient standards), dietary guidelines, and food guides, each define aspects for a healthy diet in different ways. The RDA and food guide for Koreans were first established in 1962 by the Food and Nutrition Committee of the Korea FAO Association. The committee released the RDA and suggested ways to intake the recommended nutrients. Every five years, the committee has added more data and released revisions. The latest edition of the RDA is the 6th revision. In the beginning, the concept of basic food groups was emphasized as basic data for planning means based on RDA. In the 5th revision, the basic food groups and dietary guideline for public health from the Ministry of Health and Welfairs(December, 1990) suggests that, 1) Eat a variety of foods with a recommended fat intake equaling or less than 20% of total calories ; 2) Maintain ideal body weight and prevent obesity ; 3) Eat foods low in salt. Salt intake should not exceed 10g ; 4) Do not drink too much ; 5) Eat regularly and enjoy meals. After these guidelines were established, the first nutritonal education efforts guidelines were developed in 1984. Despite broad possibilities for application, they had limited use, mainly as a nutritional assessment and food balance sheet preparation. They were not well utilized in public nutritional education and nutritonal policy through the media because of the weakness of the government's food and nutriton policy. Also a lack of administrative support and dietitians in the health department and administrative organizations was partly to blame. In regard to public health and nutrition status, life expectancy has increased 10 years since the 70's and the elderly population increased threefold in 1995 compared to 1960. The common causes of death in 1996 by 19 Chapters classification, were first disease of the circulatory system ; the second, neoplasms ; the third, external causes fo mortality ; the forth, diseases of the digestive system ; and the fifth, respiratory system diseases, In food intake, grain and complex starch intake has decreased while fruit and animal foods have considerably increased. Therefore, energy from carbohydrates has decreased while energy from protein and fat has increased. Energy intakes from protein, fat and carbohydrates were respectively 12.5, 7.2 and 80.3% in 1969 but 16.1, 19.1 and 64.8% in 1995. 62.9% of the householes had the fat energy less than 20%, while 37.1% had the fat energy above 20%. The only intakes of vitamin A and calcium were below RDA levles. Therefore, nationwide attention should be focused on public nutriton education and public activities with supplementation of the RDAs, according to the food guide and the dietary guideline.

• Korean Journal of Occupational Health Nursing
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• v.14 no.1
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• pp.44-55
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• 2005

Purpose: The purpose of this study was to describe the current status of work-related back pain among nurses in the U.S. Method: Literature review and website searching were conducted. Key words as 'nurse and back pain (or back injury)' were used in searching the Medline, NIOSHTIC-2and reference list of selected studies. Total studies were selected of which subjects were nurses working in the U.S., and published since 1970. Results: Though there was variation in the measurement among studies, the prevalence rate of back pain among nurses in the U.S. could be estimated about 50%. Risk factors were confirmed as the frequency of patient lifting, ward, nursing shortage, overtime, work shift, stress on physical demand, but age and work experiences showed the inconsistent relation. It has been well known that educational approach is not enough to prevent back pain. Intervention studies to apply the ergonomic approach using mechanical devices reported the effects, but the devices were less diverse than European countries or Canada. The study for lifting team was rare. Federal government developed only the guideline for nursing home that had no legal obligation. As a professional nursing organization, ANA has been trying to educate and advocate for "No lift policy" since 2003. Meanwhile, two trade unions of nurses made efforts to establish the law strengthening the responsibility of health care facilities. Conclusion: The research and policy development will be needed to prepare to rapid increase of back pain among Korean nurses.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.152-165
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• 1998

Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.

• Journal of Preventive Medicine and Public Health
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• v.41 no.2
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• pp.80-83
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• 2008

An economic evaluation is required in order to apply to the Health Insurance Review and Assessment Service (HIRA) for a listing in the national drug formulary. To assist companies in preparing the necessary documents, HIRA published guidelines for the economic evaluation of pharmaceuticals in 2006. The guidelines are composed of two parts: guidance and explanatory notes. Each guideline reflects the best practice which meets both the theoretical consensus within the academic community and local situations, like data availability. To enhance the transparency of evaluation, guidelines emphasize the reproducibility of data and analysis result. That is, all evaluation processes are required to be described in enough detail to be replicated by reviewers. With growing experience and theoretical development in this area, HIRA guidelines will be revised periodically.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.10 no.6
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• pp.161-167
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• 2010

Social individualized broadcasting increases rapidly in an environment that combines communication and broadcasting. Real-time individualized broadcasting is a service that is provided by multiple individuals to many and unspecified persons. In contrast, newly introduced individualized broadcasting service is a service that has not been experienced socially and culturally and therefore many problems are expected. The newly emerging real-time individualized broadcasting service may bring about various dysfunctions as well as desirable functions. Establishment of guideline and its implementation based in vulnerability analysis are necessary to prevent the expected dysfunctions and reinforce the desirable functions. Therefore, the purpose of this paper is to examine dysfunctions of the information-oriented society which threaten cyber-norms, cyber-morality, cyber-dangers, cyber-democracy, etc. at the level of social individualized broadcasting service and to propose appropriate guidelines. Through this paper, first, future changes of dysfunctions of the information-oriented society due to individualized broadcasting service can be forecast, and countermeasures and policy directions can be proposed. Second, Dysfunctions of ICT-based service that may emerge in individualized broadcasting service can be forecast and correct guideline can be prepared to reduce potential dangers and increase desirable functions of the service. This paper will analyze in various aspects the characteristics of a new media with the focus on individualized broadcasting service among the new ICT-integrated services, and forecast the appearance and aggravation of the dysfunctions and then draw the guideline.