• Proceedings of The Korean Society of Health Promotion Conference
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• 1999.07a
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• pp.165-183
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• 1999

This paper will discuss about how we can foster educational support mechanisms to facilitate health promotion programs at the local level. Health promotion in Korea is in the early developmental stage; it has only been since the Health Promotion Act was legislated in 1995, the health promotion programs have been planned and implemented. In the context of the recent decentralization process, local health departments have a major responsibility for developing and implementing health promotion programs at the local level. The short history of health promotion in Korea has meant that local public health departments have limited experience and organizational capacity for health promotion planning ＆ practice. The results of one survey for investigating the progress of health promotion at the local level are instructive. The survey demonstrated that the public health workers recognized that the lack of personnels, insufficient budget, the lack of policy ＆ the organizational support, the lack of skill ＆ knowledge to be effective health promotors, the lack of guidance for health promotion practice were major barriers to implementing health promotion programs at the local level. The object of this paper is to suggest some ways of overcoming barriers to implementing health promotion programs at the local level This paper emphasizes on the importance of educational supports as well as environmental supports - legislative, policy, organizational, economical - in building the organizational capacity and infrastructure of local health department for health promotion. It suggests some ways of providing educational supports to the public health workers at the local level. and supports the positions that educational opportunities for training in health promotion can be better provided to the public health workers at the provincial level rather than at the national level. It argues that the educational ＆ training programs should be developed and based on the educational need assessment; that the application of the main educational principles ＆ theoretical models for health promotion be used to develop educational programs for the public health workers; and that professional health organizations should make plans to provide more educational programs at their annual conferences or at other convenient times. These kinds of educational supports facilitate the ability of public health workers to improve their capacity for health promotion practice at the local level and help to alleviate some of the pressure on state resources.

• Quality Improvement in Health Care
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• v.4 no.2
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• pp.196-209
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• 1997

• Journal of Preventive Medicine and Public Health
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• v.42 no.5
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• pp.275-282
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• 2009

Objectives : This study aimed to verify the association between wealth or income level and health status after adjusting for other socio-economic position (SEP) indicators among Korean adults aged 45 and over. Methods : Data were obtained from the 1st wave of Korean Longitudinal Study of Ageing (households: 6,171, persons: 10,254). We used self-rated health status and activities of daily living (ADLs) as dependent variables. Explanatory variables included both net wealth measured by savings, immovables, the other valuated assets and total income including pay, transfer, property and so on. Binary logistic regression was conducted to examine the relationships. Also, in order to determine the relative health inequality across economic groups, we estimated the relative index of inequality (RII). Results : The inequality of health status was evident among various wealth and income groups. The wealthiest group (5th quintile) was much healthier than the poorest group, and this differential increased with age. Likewise, higher income was associated with better health status among the elderly. However, these effects, as measured by the odds ratio and RII, showed that wealth was more important in determining health status of elderly people. Conclusions : This study suggests that economic capability plays a significant role in determining the health status and other health-related problems among the elderly. Particularly, our results show that health status of the aged is related more closely to the individual s wealth than income.

• Safety and Health at Work
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• v.11 no.3
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• pp.275-283
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• 2020

Background: In the absence of a vaccine or treatment, the most pragmatic strategies against an infectious disease pandemic are extensive early detection testing and social distancing. This study aimed to summarize public and workplace responses to Coronavirus Disease-19 (COVID-19) and show how the Korean system has operated during the COVID-19 pandemic. Method: Daily briefings from the Korean Center for Disease Control and the Central Disaster Management Headquarters were assembled from January 20 to May 15, 2020. Results: By May 15, 2020, 11,018 COVID-19 cases were identified, of which 15.7% occurred in workplaces such as health-care facilities, call centers, sports clubs, coin karaoke, and nightlife destinations. When the first confirmed case was diagnosed, the Korean Center for Disease Control and Central Disaster Management Headquarters responded quickly, emphasizing early detection with numerous tests and a social distancing policy. This slowed the spread of infection without intensive containment, shut down, or mitigation interventions. After entering the public health blue alert level, a business continuity plan was distributed. After entering the orange level, the Ministry of Employment and Labor developed workplace guidelines for COVID-19 consisting of social distancing, flexible working schedules, early identification of workers with suspected infections, and disinfection of workplaces. Owing to the intensive workplace social distancing policy, workplaces remained safe with only small sporadic group infections. Conclusion: The workplace social distancing policy with timely implementation of specific guidelines was a key to preventing a large outbreak of COVID-19 in Korean workplaces. However, sporadic incidents of COVID-19 are still ongoing, and risk assessment in vulnerable workplaces should be continued.

• Journal of health informatics and statistics
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• v.43 no.4
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• pp.300-306
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• 2018

Objectives: The purpose of this study is to demonstrate empirically through a specialist AHP analysis what factors should be more important in the development of the public health care system. In addition, we will use Analytic Hierarchy Process (AHP) method for experts to achieve research purpose. Methods: The data analysis method of this study is as follows. First, we set up three metrics in order to measure the relative importance between the factors to be improved for the development of the public health care system and each of the sub-factors. A total of nine measurements (items) were set by combining the three measurement criteria for each measurement index. Second, the relative importance and priority analysis use the AHP analysis. Third, the subjects of this study were 15 experts in the field of public health care. The statistical processing was performed using the Expert Choice 2000 statistical program. Results: In order to development of the public health care system, experts ranked the most important as improvement in the systematic aspect of public health care (56%) as the first priority. Next, the relative importance analysis of the measurement items considering the multiple-weights of the sub-factors is as follows. The strengthen institutional improvement (revitalization of secondary public function hospital) was the number one, strengthen cooperation between agencies was the second, and Re-establishing the role of local public health care system was the third place. Conclusions: Considering the relative importance, factors that are considered to be important in the first place may not be improved as the best policy alternative due to limitations in spatial, temporal, financial, and institutional aspects. In this case, we suggest that we should choose the best policy alternative by using prioritization considering relative weights.

• Journal of Preventive Medicine and Public Health
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• v.54 no.5
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• pp.360-369
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• 2021

Objectives: The purpose of this study was to investigate public preferences regarding allocation principles for scarce medical resources in the coronavirus disease 2019 (COVID-19) pandemic, particularly in comparison with the recommendations of ethicists. Methods: An online survey was conducted with a nationally representative sample of 1509 adults residing in Korea, from November 2 to 5, 2020. The degree of agreement with resource allocation principles in the context of the medical resource constraints precipitated by the COVID-19 pandemic was examined. The results were then compared with ethicists' recommendations. We also examined whether the perceived severity of COVID-19 explained differences in individual preferences, and by doing so, whether perceived severity helps explain discrepancies between public preferences and ethicists' recommendations. Results: Overall, the public of Korea agreed strongly with the principles of "save the most lives," "Koreans first," and "sickest first," but less with "random selection," in contrast to the recommendations of ethicists. "Save the most lives" was given the highest priority by both the public and ethicists. Higher perceived severity of the pandemic was associated with a greater likelihood of agreeing with allocation principles based on utilitarianism, as well as those promoting and rewarding social usefulness, in line with the opinions of expert ethicists. Conclusions: The general public of Korea preferred rationing scarce medical resources in the COVID-19 pandemic predominantly based on utilitarianism, identity and prioritarianism, rather than egalitarianism. Further research is needed to explore the reasons for discrepancies between public preferences and ethicists' recommendations.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.2-17
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• 2021

Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases. Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.69-78
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• 2011

Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

• Health Policy and Management
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• v.22 no.4
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• pp.538-560
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• 2012

This study tried to find out the level of national health expenditure and associated factors in the OECD countries and then to derive lessons for Korea's health financing based on the cross-national comparison. As a result, Korea's health expenditure in 2010(7.1% of GDP) accounted for 74.7 percent of the OECD average and ranked as countries to spend less on health. At the same time, the socio-economic indicators such as GDP per capita, elderly population ratio and the total tax revenue to GDP also remained between 72 ~ 82 percent of the OECD average. The public share of health financing(58.2%) was relatively lower than those of other countries. However the health expenditure and the public share have grown 1.9 ~ 2.4 times higher than the OECD average over the past decade. According to the quantitative analysis, countries with relatively high income and elderly population turned out to have high health expenditure. Whereas, an inverse relationship was found between the total health expenditure and the public funding. It was estimated that the value of national health expenditure to GDP decreases 0.083 when the rate of public funding increases 1 percent point. Further, the share of public funding was affected positively by the total tax burden. Based on these findings, this study suggests that the sustainable spending on health and alleviating households' direct burden could be ensured by enhancing the share of public funding along with adjusting the tax burden of the people.

• Health Policy and Management
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• v.31 no.2
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• pp.217-224
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• 2021

The objective of this study is to investigate the healthcare status of South Korea and other member countries of the Organization for Economic Cooperation and Development (OECD) using OECD health statistics 2020. We employed the position value for relative comparison index to measure the healthcare status in five following components: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used to analyze for increasing or decreasing trend of the position value for relative comparison values from 2000 to the recent year. Results showed that Korea was positioned above than the OECD median values in most of components, but lower than the median values in certain indices including healthcare employment, primary care, and mental health care. This study sheds some light on healthcare issues to be improved and the policy-makes can take into account for prior setting process.