• Title/Summary/Keyword: Public Expenditure

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Obesity Regulation through Gut Microbiota Modulation and Adipose Tissue Browning (장내 미생물의 조절과 지방세포의 갈색지방화를 통한 비만 조절 연구)

  • Cho, Yejin;Shamim, Rahman Md.;Kim, Yong-Sik
    • Journal of Life Science
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    • v.29 no.8
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    • pp.922-940
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    • 2019
  • Obesity, represented by abnormal fat accumulation due to an imbalance between energy intake and expenditure, is a major public health issue worldwide, leading to multiple noncommunicable diseases, including atherosclerosis, hypertension, type 2 diabetes, and cancer. Diverse solutions have been proposed to combat obesity. Attention has focused on two types of adipose tissues as a promising therapeutic target in obesity: traditional brown and beige or brite. Unlike energy-storing white adipose (endocrine) tissue, traditional brown adipose tissue and beige adipose tissue have energy-dissipating thermogenic properties. Both types of tissue are present in adult humans and inducible through external stimuli, such as cold exposure, ${\beta}3$-adrenergic receptor agonists, and phytochemicals. Among these stimuli, microbiota present in the human intestinal tract participate in multiple metabolic activities. Modulation of gut microbiota may offer a potent and possibly curative strategy against various metabolic diseases. Numerous studies have focused on the effects of established antiobesity treatments on the gut microenvironment or brown-adipose-tissue activation. In this review, we focus mainly on stimuli known to alleviate obesity, weight gain, and metabolic diseases, in addition to known and possible inter-relations between gut microbiota modulation and similar interventions and adipose tissue browning. The findings may pave the way toward new strategies against obesity.

The Impacts of Education and Non-Labor Income on Employment Among the Elderly: An Estimation with a Panel Logit Model to Address the Problem of Endogenous Predictors (교육수준과 비근로소득이 고령자 취업에 미치는 영향: 내생성을 고려한 패널로짓 모형 추정)

  • Kim, Cheoljoo
    • 한국사회정책
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    • v.23 no.1
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    • pp.95-123
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    • 2016
  • As Korean society grows rapidly older, a systematic analysis of the determinants of labor supply behavior among the elderly becomes a prerequisite for designing more effective senior employment policies and income security regime for the elderly. Literatures review shows that a majority of previous researches have been ignoring the problem of "endogenous predictor" especially when it comes to the estimation of the effects of the two key variables, education and non-labor income, on labor supply decisions among older people. They have failed to take into consideration the unobserved heterogeneities which might affect both labor supply decisions of the elderly and their levels of education and non-labor income, which means, according to some econometric literatures, that the estimated coefficients of the two predictors can be inconsistent. The paper tries to redress the endogeneity problem by employing a panel logit model with data from the 1st. to 4th. wave of the KLoSA(Korean Longitudinal Survey of Ageing) to estimate the effects of key predictors on the probability of getting jobs among older people(ages of 60 or older). Both a random effects and a fixed effects model reaffirms that non-labor income has a negative effect on the chances of being employed. And a random effects model shows that the effect of education is also negative, as has frequently been reported by previous studies. That means the effects of education and non-labor income on elderly employment remain negative after the effect of unobserved heterogeneities is controled for and the problem of endogenous predictors is redressed through an appropriate panel data analysis. These findings mean, in turn, that when Korean baby-boomers, who had acquired an unprecedentedly higher level of education and were expected to enjoy ever-larger amount of non-labor income than their preceding generations, retires in near future, their incentives to work will become much weaker and the lack of labor-force and the burden of financing increased public pension expenditure will become more troublesome. The paper concludes with recommending some policy initiatives helpful to solve these expected problems.

R&D Service Industry Innovation Plan to Improve R&D Productivity and Vitalize Technology Innovation Ecosystem (R&D 생산성 제고와 기술 혁신 생태계 활성화를 위한 연구 서비스산업 혁신 방안)

  • Pyoung Yol Jang
    • Journal of Service Research and Studies
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    • v.13 no.1
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    • pp.144-158
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    • 2023
  • R&D (Research and Development) investment by companies and the government continues to increase, and the total R&D expenditure of public and private sectors in 2021 reached KRW 102 trillion, and the ratio of R&D investment to GDP was 4.96%. It ranks second in the world after Israel. This study analyzes the current status of the domestic R&D service industry and the research and development (R&D) innovation ecosystem based on the business activity survey data of the National Statistical Office in terms of improving R&D productivity of domestic R&D investment that has exceeded 100 trillion won, and analyzes the global R&D service industry and analyzes the global research service industry and R&D service Industry support government policy As a result of the analysis, in the domestic R&D ecosystem, the R&D outsourcing demand of service companies is rapidly increasing, compared to the stagnant R&D outsourcing demand of traditional manufacturing companies. In order to respond to these changing demands for technological innovation, this study suggests balanced support for R&D outsourcing for manufacturing and service companies, expansion of domestic R&D outsourcing, establishment of R&D outsourcing strategies specialized for the service industry, establishment of an open R&D ecosystem, and innovation in connection with materials/parts/equipment strategies.

Effect of sweet pumpkin powder on lipid metabolism in leptin-deficient mice (Leptin 유전자 결핍 동물모델에서 단호박분말 투여가 지방대사변화에 미치는 영향)

  • Inae Jeong;Taesang Son;Sang-myeong Jun;Hyun-Jung Chung;Ok-Kyung Kim
    • Journal of Nutrition and Health
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    • v.56 no.5
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    • pp.469-482
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    • 2023
  • Purpose: Obesity has emerged as a critical global public health concern as it is associated with and increases susceptibility to various diseases. This condition is characterized by the excessive enlargement of adipose tissue, primarily stemming from an inequity between energy intake and expenditure. The purpose of this study was to investigate the potential of sweet pumpkin powder in mitigating obesity and metabolic disorders in leptin-deficient obese (ob/ob) mice and to compare the effects of raw sweet pumpkin powder (HNSP01) and heat-treated sweet pumpkin powder (HNSP02). Methods: Leptin-deficient obese mice were fed a diet containing 10% HNSP01 and another containing 10% HNSP02 for 6 weeks. Results: The supplementation of ob/ob mice with HNSP01 and HNSP02 resulted in decreased body weight gain, reduced adipose tissue weight, and a smaller size of lipid droplets in the adipose tissue and liver. Furthermore, the ob/ob-HNSP01 and ob/ob-HNSP02 supplemented groups exhibited lower levels of triglycerides, total cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, and insulin, as well as a reduced atherogenic index in comparison with the control group. Molecular analysis also demonstrated that the intake of HNSP01 and HNSP02 resulted in a diminished activation of factors associated with fatty acid synthesis, including acetyl-CoA carboxylase and fatty acid synthase, while concurrently enhancing factors associated with lipolysis, including adipose triglyceride lipase and hormone-sensitive lipase, in the adipose tissue. Conclusion: Taken together, these findings collectively demonstrate the potential of sweet pumpkin powder as a functional food ingredient with therapeutic properties against obesity and its associated metabolic disorders, such as insulin resistance and dyslipidemia.

Analysis of the Investment Suitability relative to the Landscape Elements Construction Costs within the Residents' Value Recognition in the Apartment - Focused on a Public Institutional Apartment Complex near the Capital Area - (아파트 단지 조경요소별 입주민의 가치인지도 대비 공사비 측정의 상대적 적정성 분석 - 공공기관 시행 수도권 분양아파트를 중심으로 -)

  • Park, Sang-Jin;Cho, Se-Hwan
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.6
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    • pp.177-187
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    • 2016
  • This study started with the question, "Is the cost of landscape construction work in residential areas measured by public enterprises, 'in response to the needs of consumers?" The study analyzed whether the landscape construction expenditure is being introduced at an appropriate ratio according to the value the residents have regarding landscape elements. Following this, research was conducted for the purpose of providing basic data for improving the efficiency of formulating apartment landscape construction costs in the future. This research proceeded based on a questionnaire survey of residents of apartments, and the content of the questionnaire used frequency analysis and descriptive statistics research methods. To take a look at a comparative analysis of value recognition, in particular, a comparative analysis was performed based on the actual input cost based on the ratio of landscape elements by layer. Conclusions were found as follows: First, the degree of interest in the apartment landscape of the tenants was high, and the value of the landscape was high but realistic satisfaction appeared comparatively low. Second, the awareness of residents' values regarding landscape elements appeared to give "plantings" more value than "facilities". Thirdly, as a result of a mutual comparison between the values recognized by the resident regarding landscape elements and the construction input fee, depending on the landscape elements, it appeared that there is a difference in the ratio of up to 52 times from 1.25. Fourth, the fact that there is a difference in the relative proportion of value recognition and inputting construction cost indicates that it is not possible to respond to the needs of tenants during the construction cost development process. It also shows that the utility of inputting construction costs is low. Therefore, a macro-level examination such as reflecting the existing inflation rate is necessary to develop the efficient landscape construction cost of apartment such as the awareness of the value of the residents regarding landscape elements, out of the customary construction cost formulation method based on the microscopic dimensions of the consumer side.

A Study on Rationalization of National Forest Management in Korea (국유림경영(國有林經營)의 합리화(合理化)에 관(關)한 연구(硏究))

  • Choi, Kyu-Ryun
    • Journal of Korean Society of Forest Science
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    • v.20 no.1
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    • pp.1-44
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    • 1973
  • Needless to say, the management of national forest in all countries is very important in view of the national mission and management purposes. Korean national forest is also in particular significant in promoting national economy for the continuous increasing of the demand for wood, conservation of the land and social welfare. But there's no denying the fact that the leading aim of the Korean forest policy has been based upon the conservation of forest resources and recovery of land conservation function instead of improvement of the forest productive capacity. Therefore, the management of national forest should be aimed as an industry in the chain of the Korean national economy. And the increment of the forest productive capacity based on rationalized forest management is also urgently needed. Not only the increment of the timber production but also the establishment of the good forest in quality and quantity are to bring naturally many functions of conservation and other public benefits. In 1908 Korean national forest was historically established for the first time as a result of the notification for ownership, and was divided into two kinds in 1911-1924, such as indisposable national forest for land conservation, forest management, scientific research and public welfare, and the other national forest to be disposed. Indisposable forest is mostly under the jurisdiction of national forest stations (Chungbu, Tongbu, Nambu), and the tother national forests are under custody of respective cities and provinces, and under custody of the other government authorities. As of the end of 1971, national forest land is 19.5% (1,297,708 ha) of the total forest land area, but growing stock is 50.1% ($35,406,079m^3$) of the total forest growing stock, and timber production of national forest is 23.6% ($205,959m^3$) of the year production of total timber in Korea. Accordingly, it is the important fact that national forest occupies the major part of Korean forestry. The author positively affirms that success or failure of the management of national forest controls rise or fall of forestry in Korea. All functions of forest are very important, but among others the function of timber production is most important especially in Korea, that unavoidably imports a large quantity of foreign wood every year (in 1971 import of foreign wood-$3,756,000m^3$, 160,995,000 dollars). So, Korea urgently needs the improvement of forest productive capacity in national forest. But it is difficult that wood production meets the rapid increase of demand for wood to the development of economy, because production term of forestry is long, so national forest management should be rationalized by the effective investment and development of forestry techniques in the long view. Although Korean national forest business has many difficulties in the budget, techniques and the lack of labour due to outflow of rural village labour by development of national economy, and the increase of labour wages and administrative expenses etc. the development of national forest depends on adoption of the suitable forest techniques and management adapted for social and economical development. In this view point the writer has investigated and analyzed the status of the management of national forest in Korea to examine the irrational problems and suggest an improvement plan. The national forestry statistics cited in this study is based on the basic statistics and the statistics of the forest business as of the end of 1971 published by Office of Forestry, Republic of Korea, and the other depended on the data presented by the national forest stations. The writer wants to propose as follows (seemed to be helpful in improvement of Korean national forest management). 1) In the organization of national forest management, more national forest stations should be established to manage intensively, and the staff of working plan officials should be strengthened because of the importance of working plan. 2) By increasing the staff of protection officials, forest area assigned for each protection official should be decreased to 1,000-2,000 ha. 3) The frequent personnel changes of supervisor of national forest station(the responsible person on-the-spot) obstructs to accomplish the consistent management plan. 4) In the working plan drafting for national forest, basic investigations should be carefully practiced with sufficient expenditure and staff not to draft unreal working plan. 5) The area of working-unit should be decreased to less than 2,000 ha on the average for intensive management and the principle of a working-unit in a forest station should be realized as soon as possible. 6) Reforestation on open land should be completed in a short time with a debt of the special fund(a long term loan), and the land on which growing hardwood stands should be changed with conifers to increase productivity per unit area, and at the same time techical utilization method of hardwood should be developed. 7) Expenses of reforestation should be saved by mechanization and use of chemicals for reforestation and tree nursery operation providing against the lack of labour in future. 8) In forest protection, forest fire damage is enormous in comparison with foreign countries, accordingly prevention system and equipment should be improved, and also the minimum necessary budget should be counted up for establishment and manintenance of fire-lines. 9) Manufacture production should be enlarged to systematize protection, processing and circulation of forest business, and, by doing this, mich benefit is naturally given for rural people. 10) Establishment and arrangement of forest road networks and erosion control work are indispensable for the future development of national forest itself and local development. Therefore, these works should be promoted by the responsibility of general accounting instead of special accounting. 11) Mechanization of forest works should be realized for exploiting hinterlands to meet the demand for timber increased and for solving lack of labour, consequently it should promote import of forest machines, home production, training for operaters and careful adminitration. 12) Situation of labour in future will grow worse. Therefore, the countermeasure to maintain forest labourers and pay attention to public welfare facilities and works should be considered. 13) Although the condition of income and expenditure grows worse because of economical change, the regular expenditure should be fixed. So part of the surplus fund, as of the end of 1971, should be established for the fund, and used for enlarging reforestation and forest road networks(preceding investment in national forest).

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Analysis on Research Projects Trends of the Geoscientific Research Institution in Korea since the Fiscal Year of 1976 (지질자원 전문연구기관의 연구과제 추이 분석 연구: 1976년 이후)

  • Kim, Seong-Yong;Ahn, Eun-Young;Lee, Jae-Wook
    • Economic and Environmental Geology
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    • v.46 no.3
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    • pp.235-246
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    • 2013
  • The importance of R&D has been recognized around the world and Korean research funding has rapidly increased in recent years. As a results, interest in strategic R&D Investment is growing in both the public and private sectors. This study was carried out to find trends in the research projects of the KIGAM since the fiscal year of 1976. The KIGAM expended 1,193.3 billion won during the 36 years from the fiscal years of 1976 to 2011, which is 1,795.8 billion won calculated using the present value in 2011 at discount rate of 5%. R&D expenditure of KIGAM increased approximately 132.9 times from 885 million won in 1976 to 117,600 million won in 2011, and about 24.1 times from 4,882 million won in 1976, as calculated using the present value in 2011. The number of research projects increased about 6.75 times, from 28 projects in 1976 to 189 projects in 2011. Based on research trend analysis over the last 36 years, the percentage of research projects by research fields were as follows: mineral resources research, 39.5%; geologic environmental research, 28.8%; geological research, 15.6%; petroleum and marine research, 12.1%; and policy research, 3.1%. The percentage of the R&D budget dedicated to each type of research were as follows: mineral resources research, 33.1%; geologic environmental research, 25.6%; geological research, 22.8%; petroleum and marine research, 15.9%; and policy research, 2.1%. Allocation of R&D investment was determined by considering the governmental priority of such research, as well as which area were most promising. Based on the research projects trends within KIGAM and analyses of its R&D, we should build our R&D portfolio in the areas of geosciences and mineral resources.

The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men (건강한 중년 남성에서 커피 음용 습관이 혈중 총 콜레스테롤 값에 미치는 영향)

  • Shin, Myung-Hee;Kim, Dong-Hyun;Bae, Jong-Myun;Lee, Hyung-Ki;Lee, Moo-Song;Noh, Joon-Yang;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.200-216
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    • 1994
  • In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices (e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.) through the program of biennial health check-up offered by Korean Medical Insurance Corporation (KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were $-0.4{\pm}3.56mg/dl$ for those drinking less than 1 cup a day, $-0.6{\pm}3.60mg/dl$ for those drinking 1 cup a day, and $7.1{\pm}3.41mg/dl$ for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total choleaterol, we re-analyzed those relationship in smokers and non-smokers separately Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index (cigarette-years; r=0.10), Quetelet's index ($Kg/m^2$, r=0.16), daily calory expenditure (kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption (g/week, r=0.08), other caffeinated beverage intake (cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index (in smokers) were remained in the models. After adjustment, the corresponing differences of total cholesterol in smokers were changed to $0.4{\pm}5.24mg/dl,\;-0.5{\pm}4.97mg/dl,\;and\;8.9{\pm}4.78mg/dl$, which were significantly different among themselves (P=0.011). In non-smokers, however, the differences were not statistically significant (P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, p=0.48 for DBP). Asuming instant coffee in the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers, is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.

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The Study on the Effects of Technology Orientation and Market Orientation on Managerial Performance in Innopolis Start-ups: Focusing on the Moderating Effects of Marketing and R&D Expenses (연구소기업의 기술지향성과 시장지향성이 경영성과에 미치는영향: 마케팅 및 연구개발 비용의 조절효과를 중심으로)

  • Kwon, Haram;Yang, Young Seok
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.1
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    • pp.119-133
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    • 2024
  • As a result of significant investments by the government in promoting public technology commercialization and fostering a venture startup ecosystem, there have been quantitative achievements, such as the registration of over 1,600 Innopolis Start-ups since 2006, generating a total revenue of 1.1 trillion won as of 2021. However, these achievements have been overshadowed by critical qualitative challenges, including a continuous decline in average revenue per Innopolis Start-up. This led to a focus on whether managers' technological and market orientations affect business performance. This study aims to provide insights into improving the qualitative growth of Innopolis Start-ups by analyzing the effects of technological and market orientations on business performance, as well as the moderating effects of adjusting marketing and research and development (R&D) costs on this relationship. Through prior research and empirical analysis, this study derives three main findings. First, technological excellence and innovation significantly influence the business performance of Innopolis Start-ups, while technological intensity does not. Second, customer orientation and competitive orientation significantly impact business performance, whereas entry barriers as a single factor do not. Third, adjusting marketing and R&D costs, as controlled variables obtained through general situations, has no direct impact on other variables. However, it interacts with entry barriers, influencing financial business performance, with R&D costs exhibiting a negative buffering effect and marketing costs showing a positive enhancing effect. This study confirms that both technological and market orientations directly influence the business performance of Innopolis Start-ups, thus being crucial factors affecting their growth. Moreover, it establishes that investments in marketing and R&D play significant roles in alleviating initial entry barriers and enhancing financial performance. Consequently, it underscores the importance of reinforcing technological and market orientations tailored to the characteristics of Innopolis Start-ups. Additionally, it proposes five theoretical contributions: strengthening institutional support systems for technology commercialization and innovation, improving qualitative evaluation criteria during the selection process of Innopolis Start-ups, conducting comprehensive analyses of technological and market aspects during startup selection, enhancing support for marketing education and consulting for smooth market entry, and supporting expenditure strategies and milestone setting tailored to the industrial characteristics of individual Innopolis Start-ups.

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Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

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