Kim, Sun-Ja;Kang, Sung-Hong;Kim, Won-Joong;Kim, Yoo-Mi
Journal of Korean Society for Quality Management
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v.39
no.3
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pp.391-399
/
2011
Our study was carried out to analyze the variation factors of severity-adjusted length of stay(LOS) in coronary artery bypass graft(CABG). The subjects were 932 CABG inpatients of the Korean National Hospital Discharge In-depth Injury Survey from 2004 through 2008. The data were analyzed using $x^2$ test and the severity-adjusted model was developed using data mining technique. The results of the study were as follows: male(71.1%), older than 61 years of age(61.6%), more than 500 beds(92.8%) and admitting via ambulatory care(70.0%) appeared to have higher rate than otherwise. In-hospital mortality of CABG inpatients was 2.8%. In addition, 46.4% of the patients received their care in other residence. The angina pectoris(45.6%) was found to be the highest in principle diagnosis, followed by chronic ischemic heart disease(36.9%) and acute myocardial infarction(12.0%). We developed severity-adjusted LOS model using the variables such as gender, age and comorbidity. Comparison of adjusted values in predicted LOS revealed that there were significant variations in LOS by location of hospital, bed size, and whether patients received the care in their residences. The variations of LOS can be explained as the indirect indicator for quality variation of medical process. It is suggested that the severity-adjusted LOS model developed in this study should be utilized as a useful method for benchmarking in hospital and it is necessary that national standard clinical practice guideline should be developed.
Kim, Kwangjong;Choi, Jaewook;Choi, Hyunwook;Lee, Eunyoung
Journal of Korean Society of Occupational and Environmental Hygiene
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v.9
no.1
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pp.125-155
/
1999
The objectives of this study were (1) an investigation of the current status of the hazardous substances, (2) a comparative analysis of classification system of hazardous substances between Korea and other countries, (3) a development of the new classification system in Korea, finally a review of prerequisites for effective enforcement of the new system. The results are summarized as follows : 1) The backbone of classification system of hazardous substances in Korea is based on Japanese classification system and EC(European Committee) guideline of hazardous substance. There are many problems in managing and handling of hazardous substances due to discordant of Japanese and EC system. It is desirable to revise the classification system to be harmonized with international guideline for example, guideline of IFCS(The Inter-governmental Forum on Chemical Safety) and EC guideline. 2) There are several problems in definitions of corrosive, sensitizing and irritation in MSDS Code of Ministry of Labour. It is desirable to reform those definitions. 3) Among the hazardous substances under the current system, there are several substances such as, beta-propiolactone, methyl bromide, ethyleneimine, etc that are not used and produced in Korea. It is desirable to exclude the substances from the list of controlled substances. 4) The section 39, about 'substance that designated to attach warning label' in Korea Occupational Safety and Health Act(OSHAct) should be eliminated, because above section is unnecessary under the MSDS system. 5) The researchers recommend to establish a new list of hazardous substance which are controlled by OSHAct. It is desirable that the new list is consist of two types. The first type is 'a list of the specially controlled substances' and the other is 'the generally controlled substances'. 6) It is recommended that the specially controlled substances should include hazardous substances that are highly toxic and widely used in Korea. And the generally controlled substances should include hazardous substances that can be analysed by instrument and carry threshold. limit values(TLV's).
Basrowi, Ray Wagiu;Sastroasmoro, Sudigdo;Sulistomo, Astrid W.;Bardosono, Saptawati;Hendarto, Aryono;Soemarko, Dewi S.;Sungkar, Ali;Khoe, Levina Chandra;Vandenplas, Yvan
Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.
Particulate matter is an air pollutant emitted from both natural and anthropogenic sources, and its adverse health effects have been well documented in time-series analyses and cohort studies. The effect size of particulate matter exposure-a roughly 0.5% increase in mortality for each $10{\mu}g/m^3$ increment of short-term exposure to particulate matter with aerodynamic diameter ${\leq}10{\mu}m$ and approximately a 10% increase for each $10{\mu}g/m^3$ increment of long-term exposure to particulate matter with aerodynamic diameter ${\leq}2.5{\mu}m$-is small compared to other risk factors, but the exposure is involuntary and affects the entire population, which makes particulate matter pollution an important public health issue. The World Health Organization and Korean government have both established guidelines for particulate matter concentrations, but the Korean guideline is less stringent than that of the World Health Organization. The annual mean concentration of particulate matter in Korea is decreasing, but the trend seems to be slowing. In addition to policy efforts to reduce particulate matter emission, personal approaches such as the use of face masks and air purifiers have been recommended. Personal approaches may not solve the fundamental problem, but can provide temporary mitigation until efforts to reduce emission make progress.
June, Kyung Ja;Paek, Do Myung;Kim, Eun Hee;Kim, Ji Yong;Ha, Eun Hi;Kim, Sun Mean;Park, Hea Sook;Jung, Hea Sun
Korean Journal of Occupational Health Nursing
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v.6
no.2
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pp.156-167
/
1997
In Korea, based on the Revised Law of Occupational Safety and Health a new entity of institution was set up in 1990 to provide occupational health services to SSE in which three sorts of personnel as a team have to be involved. These institutions, in charge of scores to hundreds of workplace area-wide, have been providing occupational health services without payment from employers or employees, and government reimburses through the Occupational Injury Prevention Insurance since 1993. As a service provider, a team is composed of doctors, nurses and industrial hygienists. Undergraduate and postgraduate educations for the SSE occupational health are not specified and the question on the performance of the personnel has been raised. This study was designed to analyze the facilitating factors of and barriers to the performance and its improvement of these personnel. In 1997, the survey was conducted with all 58 institutions. Structured questionnaires were mailed to 200 personnel who were providing the occupational health service for SSE. The response rate was 51.7% for doctors, 58.6% for nurses, and 60.3% for industrial hygienist, respectively. Results are as follows : 1) There is a guideline for occupational service mandated by the government. Under the guideline, the minimum frequency of visiting workplace is assured with six times of doctors, 17 times for nurse and industrial hygienist in a year. There are one doctor for every 200 factories, one nurse and one hygienist for every 100 factories. 2) All respondents have basic qualification for occupational health service. About 16.7%. of doctors are certified in industrial medicine or preventive medicine, and 64.7% of industrial hygienists had first grade certification. Totally 66.7% of personnel have been involved in occupational health for more than one year. 3) As a support system for the performance improvement, 66.3% respond that they have been provided with educational materials, advice related to industrial environment and guidance of MSDS from Korea Industrial Safety Corporation. Most respondents indicate the lack of concern of employers and employees as a main barrier to the improvement of the service. Also they are in the need of the training opportunity more focused on SSE. The Governments policy for SSE is a principal facilitating factor. Training program focused on SSE situation, manpower, technical support, etc. are areas to be improved to have a better occupational health service for SSE in Korea.
Chia-Jung Li;Louise E. Anthony;Tomohisa Nagata;Yawen Cheng;Ro-Ting Lin
Safety and Health at Work
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v.15
no.2
/
pp.164-171
/
2024
Background: Telework adoption in Taiwan has surged because of government guidelines during the COVID-19 pandemic. This study examined the disclosure practices of Taiwanese-listed companies, assessing their adherence to government telework guidelines and their correlation with corporate governance, focusing on occupational health measures. Methods: We conducted a guideline-adherent cohort analysis of the 2020 and 2021 sustainability reports of 295 Taiwanese-listed companies. We assessed their disclosure of corporate measures for teleworking in alignment with two government guidelines, specifically occupational health measures. Using the McNemar test and general estimating equation analysis, we compared the 2020 and 2021 responses and examined their associations with corporate governance rankings. Results: Telework adoption increased significantly from 2020 to 2021, with 68% of companies reporting new work modes. The mentioning of government guidelines also increased to 67% by 2021. Companies with higher governance rankings were more likely to adopt online occupational health measures, including occupational health services (RR = 2.03; 95% CI = 1.41-2.94; p < 0.001) and mental health promotion activities (RR = 2.01; 95% CI = 1.06-3.82; p = 0.032), than those with low rankings. Although on-site and online occupational health services increased, home workspace assessments did not. Conclusion: Our findings highlight significant upward trends in the disclosure of telework measures following the issuance of government guidelines. Corporate governance is significantly associated with the implementation of occupational health measures. Amid the evolution of teleworking, both government guidelines and corporate governance have become essential for shaping work arrangements and ensuring workforce well-being.
Background: Among various pollutants, fine particle (PM2.5, defined as particle less than 2.5 nm in aerodynamic diameter) shows the most consistent association with adverse health effects. There is scientific evidence documenting a variety of adverse health outcomes due to exposure to PM2.5. Objectives: This study aims to assess the health benefits of that would be achieved by meeting the World Health Organization's air quality guidelines for PM2.5 using AirQ+ and BenMAP. Methods: We estimated PM2.5 related health benefits in Korea from implementing the World Health Organization's air quality guidelines (annual average 5 ㎍/m3 and 10 ㎍/m3) and Korea's National Ambient Air Quality Standard (annual average 15 ㎍/m3). We used World Health Organization's AirQ+ and U.S. Environmental Protection Agency's Environmental Benefits Mapping and Analysis Program. Results: The annual number of avoided PM2.5 related premature deaths exceeding WHO guideline levels was assessed using both AirQ+ and BenMAP. We estimated that the health benefits of attaining the World Health Organization's air quality guidelines for PM2.5 (annual average 5 ㎍/m3) would suggest an annual reduction of 26,128 (95% confidence interval [CI]: 17,363~34,024) and 26,853 (95% CI: 18,527~34,944) premature deaths. Conclusions: Our study provided useful information to policy makers and confirms that the reduction of PM2.5 concentration would result in significant health benefits in Korea.
Journal of The Korea Institute of Healthcare Architecture
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v.22
no.2
/
pp.25-33
/
2016
Purpose : The information of mental health facilities in Korean law is so unclear that people hardly enable to understand what sort of proper mental health service is prepared for them. Futhermore, there is not enough regulation and standard to classify each type of facilities in the law. Therefore the purpose of this study is to provide data on the basis for classification and facility standards by analysing Korean law and policies. Methods : This study was conducted by a research on law and regulation of mental health facility. Results : The result of this study can be summarized into three points. The first one, current law and policy do not reflect a change in community mental health services paradigm. The second one, the classified facility should be designed to fit the community mental health services. The third one, overall, it requires more detailed guidelines to enhance the quality of mental health services. Besides, the treatment as well as the function of the prevention and rehabilitation are necessary criteria that can also be enhanced. Implications : This study looked at the classification and facility standard of mental health facility by the change in community mental health services paradigm. Forward according to these changes, there is a need for specific guidelines for mental health facility.
Background: Studies have shown that a return to spirituality is a major coping response in cancer patients so that therapists can adopt a holistic approach by addressing spirituality in their patient care. The present study was conducted to develop a guideline in the spiritual field for healthcare providers who serve cancer patients in Iran. Materials and Methods: Relevant statements were extracted from scientific documents that through study questions were reviewed and modified by a consensus panel. Results: The statements were arranged in six areas, including spiritual needs assessment, spiritual care candidates, the main components of spiritual care, spiritual care providers, the settings of spiritual care and the resources and facilities for spiritual care. Conclusions: In addition to the development and preparation of these guidelines, health policy-makers should also seek to motivate and train health service providers to offer these services and facilitate their provision and help with widespread implementation.
This paper was performed for a cost-effectiveness analysis of pharmacologic treatment of hypercholesterolemia. Agents modeled were cholestyramine, gemfibrozil. bezafibrate, lovastatin, pravastatin, simvastatin. Pharmacologic effectiveness was estimated by regression from reported clinical trials. Pharmacologic effects were expressed as the percent change of blood cholesterol level. Cost estimates included patients' travel expenses and time loss as well as resource consumption in the health care sector. Bezafibrate was the most efficient agent for reducing total cholesterol levels, having an cost over 1 year of ₩31.400 per percent reduction in total cholesterol. Simvastatin (10mg/d) was also efficient(₩33,100 per percent reduction). Chole styramine(8g/d) was least efficient at ₩90,200. For low-density lipoprotein cholesterol. simvastatin(10mg/d) was most efficient, at ₩23,200 per percent reduction, followed by lovastatin(20mg/d) at ₩28,000. Gemfibrozil was least efficient at ₩77,800 per percent reduction. For high-density lipoprotein cholesterol. bezafibrate(400mg/d) was most efficient at ₩39,300 per percent increase of high-density lipoprotein cholesterol. Cholestyramine was least efficient at ₩514,700. Analyses combining low-density lipoprotein cholesterol and high-density cholesterol effects suggest that bezafibrate(600mg/d) and simvastatin (10mg/d) were most efficient for reducing cardiovascular risk. The cost-effectiveness analysis results show that both simvastatin and bezafibrate could be efficient treatment. Simvastatin provide more effective treatment at higher cost, whereas bezafibrate is more cost-effective, as it may be less effective, at lower cost. Therefore, clinicians should choose reasonable treatment according to the patient's needs This pharmacoeconimc analysis will provide a guideline for efficient pharmacologic treatment and also be reference data for pricing new drugs.
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