• Health Policy and Management
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• v.30 no.1
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• pp.100-111
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• 2020

Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.

• Journal of Environmental Health Sciences
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• v.38 no.3
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• pp.184-194
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• 2012

Objectives: We investigated the effects of air pollution on allergic diseases (allergic rhinitis, asthma, atopic dermatitis) in metropolitan cities in Korea, adjusting for meteorological factors. Methods: Data on daily hospital visits and hospital admissions for 2003-2010 was obtained from the National Health Insurance Cooperation. Meteorological data was obtained from the Korea Meteorological Administration. We then calculated daily mean temperature, daily mean humidity, daily mean air pressure at sea level, and diurnal temperature range. We used data on air pollution provided by the National Institute of Environmental Research. Maximum daily eight-hour average ozone concentrations and the daily mean $PM_{10}$ were used. We estimated excess risk and 95% confidence interval for the increasing interquatile range (IQR) of each air pollutant using Generalized Additive Models (GAM) that appropriate for time series analysis. Results: In this study, we observed an association between ozone and hospital visits for allergic rhinitis, asthma, and atopic dermatitis in all metropolitan cities, adjusting for temperature, humidity, air pressure at sea level, diurnal temperature range, and day of the week. Ozone was associated with hospital visits for allergic rhinitis, asthma, and atopic dermatitis across all metropolitan cities. However $PM_{10}$ was associated with allergic-related diseases in only select cities. Also, ozone and $PM_{10}$ were associated with hospital admission for asthma in all cities except Gwangju. Hospitalization for the other diseases failed to show consistent association with air pollutants. Conclusion: In the findings of this study, there was a significant association between air pollutants and allergic-related diseases. More detailed research subdivided age group or conducting meta-analyses combining data of all cities is required.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.14-22
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• 2019

The aim of this study was to determine the factors contributing to the barrier of dental treatment for special needs patients perceived by the main caregivers of the patients. A questionnaire was developed with three parts: patient-related factors, caregiver-related factors, and factors for treatment barriers. Patient- and caregiver-related factors were analyzed for correlations with the barrier factors. Fisher's exact test and Chi-square test were used at the level of 0.05. A total of 52 caregivers (mean age [SD]=50.2 [11.5] years) for the patients with intellectual and cognitive disabilities (mean age [SD]=38.9 [21.3]) responded to the questionnaires. Oral hygiene status, need for assistance in tooth brushing, and cooperation for tooth brushing were correlated with the level of treatment cooperation of the patients (p<0.05). The above three factors were also correlated with the treatment barrier despite patients presenting oral symptoms (p<0.05). Two thirds of the caregivers felt the treatment cost as severe or a considerable financial burden. For patients, insurance types and need for assistance in tooth brushing, and for caregivers, education levels and financial status were significant factors contributing to financial burden (p<0.05). There were background factors of the patients and their caregivers associated with access to dental treatment for special needs patients. Deficient cooperative skills and financial burdens were the main obstacles to treatment access. Tooth brushing skills and oral hygiene status can be proxy measures to cooperative ability for dental treatment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.161-169
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• 2020

The factors influencing the quality of life of physical and mental health in middle-aged women were examined. Secondary analysis was conducted using the data from the 2016 Korea Health Panel data. Method: The Korea Health Panel data 2016 were collected from February to August 2016 by the Korea Institute for Health and Social Affairs and the National Health Insurance Corporation and included 2,437 people who responded to the questionire. Using the SPSS Win program, the data were analyzed using a t-test, ANOVA, Pearson correlation coefficient, and multiple regression analysis. For physical health, the factors affecting the HRQoL were hearing problems, visual problems, eating problems, and physical activity. For mental health, the factors affecting HRQoL were suicidal impulse, stress subjective health. Conclusion: The results indicated that to improve the HRQoL of middle-aged women, a psychological nursing intervention program will be needed to reduce the stress and suicidal thoughts and improve the positive cognitive attitude and subjective health condition.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.343-350
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• 2016

To prepare a method for improving the oral health-related quality of life for Chinese foreign students by examining the oral health care behavior affecting the oral health-related quality of life, a self-administered survey was conducted with 236 Chinese foreign students at an university located in Jeonbuk during April 2 -May 5, 2013. The results showed that 65.3% had not visited the dentist within one year, 82.6% had not received scaling within one year, and 68.2% had not received oral health education. In regards to the OHIP-14 according to the general characteristics, there was a significant difference in the school year, health insurance enrollment status and overseas study life satisfaction (p<0.05). In regards to the OHIP-14 according to the oral health care behavior, there was a significant difference in the subjective oral health condition, the experience of having visited a dentist within one year and an experience of having received scaling (p<0.05). As for the influencing factors on the oral health-related quality of life, they were found to be the subjective oral health condition and the experience of having received scaling within one year (p<0.05). For the purpose of helping Chinese foreign students to conveniently use medical institutions when oral health-related problems arise, there is a need for a translated version of the guidebook in their native language, the availability of medical professional interpreters, the availability of a university level oral health service center, and practical oral health education to enhance oral health.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.203-210
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• 2018

The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

• Korean System Dynamics Review
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• v.17 no.1
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• pp.5-24
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• 2016

This study structurally analyzes major inefficiency of Korea's healthcare delivery system by utilizing the systems thinking. In particular, the phenomenon of patient's concentrated visits to large hospitals, waste of resource due to competitions between clinics and large hopitals, and the structure of oversupply were visualized using the causal loop diagram. The inefficient structure of healthcare delivery system can be understood more clearly by utilizing the major system archetypes of 'success to the successful', 'tragedy of commons', 'escalation' and 'limits to growth'. This study also finds solution from archetypal structure suggested by Wolstenholme. The inefficient status of healthcare delivery system might be explained by the 'out of control' archetype. In conclusion, the public resources such as the national health insurance need to be acknowledged as the entire achievement. All the participants should cooperate with each other in order to improve the inefficiency of the healthcare delivery system. In addition, the arrangement of incentive system for cooperation, acceleration of health information technology, and development of innovative business models make the sustainable healthcare delivery system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.2
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• pp.85-94
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• 2017

This study examined the factors influencing the health status according to class and socioeconomic class recognition by the employment type. To take advantage of the 18 original sources of the Korea Labor panel materials carried out in the South Korea Labor Institute, 5,158 adults over 20 years old were included in the final analysis. The research results revealed that the incomes of regular workers and non-regular workers between the hierarchy and socioeconomic hierarchy recognition showed a statistically significant difference between the cage; it was consistent between the hierarchy in only the "heavy" category. Regular workers of society, and regardless of non-regular workers, were analyzed to be relatively low compared to the actual income. Regression analysis showed that regular jobs had higher socioeconomic hierarchy recognition. Non-regular workers had a lower income bracket and lower socioeconomic hierarchy recognition. In particular, in the case of non-regular workers, the pension was not subscribed and they had a poorer state of health. Therefore, the pension insurance payment for non-regular workers needs to compensate for the lost income during non-employment periods. In addition, the government should improve public relations through education, management fields, and cooperation with labor.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.28-37
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• 2015

Objectives: Among the Korean elderly (those 65 years of age and older), the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey) that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects. Methods: Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson's correlation test, and path analysis. Results: Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts. Conclusions: Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.237-264
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• 2017

With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.