For the longest time, our government has played an inconsiderable role in the public health services of Korea, especially as it relates to their investment. Voices have cried out against increases in national health expenditure and for more establishment of public medical facilities. In light of this, the necessity and importance of public medical facilities have come into focus amidst the recent medical crisis. When public medical facilities filled in the gap created by the suspension or closure of private hospitals and clinics as a result of this national crisis and acted as a safety net, the demand for more establishment of such facilities increased. Although patient diagnosis and treatment are the first priority of public medical facilities, they must also deal with scopes that private medical facilities do not deal with, dislike, or have difficulty with. In this respect, the closure or privatization of public hospitals to reduce their number just because of their low profits or financial burdens that must be carried by the government is to ignore their innate importance and social role; therefore, we must do all we can to block such efforts and further empower these public health facilities according to demands of the time. The improvement of public health services can be realized by redefining its goals and roles, increasing government funding, strengthening of existing public health facilities and reorganizing the public health services system. Even if public health facilities were to increase their medical services and be reinforced, they cannot take on all the services related to public health services, Therefore, in a country like ours where public health services come second to private health services in the health care system, the health of citizens can be safeguarded only when private and public facilities cooperate and private medical facilities share the social responsibilities. Only the show of interest and effort by government, politicians, health professionals, professional organizations and public can initiate the improvement that is sought.
Public health system and public health practice have changed over the past decades as the result of social and epidemiologic changes. New public health concept emphasizes leadership, strategical thinking, systematic planning and effective performance to identify and solve complex health problem In Korea, the role of Health Center has been expanded rapidly. However there is strong suspicion that Health Center can achieve their mission. This paper aims at understanding what is the needed functions of Health Center and which of its aspects needs improvement. The main results of this study are summarizes as follows. District Health Law does not address the core functions of Health Center. The staffs of Health Center have difficulties in prioritizing their services. The recent attempt to restructure Health Center and change delivery pattern of public health services ended with only limited success. To effectively confront threats to the public's health, the three major function of Health Center must be ${\circled}1$ modifying individual behavior and lifestyle, ${\circled}2$ improving social and economic conditions, and ${\circled}3$ reforming health policies. Better results do not come from setting new functions only; they come from understanding and improving the processes that will then leads to better outcome. We recommend that policy-makers focus economic evaluation of public health programs, building and spreading of the scientific evidence of programs, linkage of public health research and public health program. The criteria of delegation of public health service to private sector is urgently needed. Making community health information data available on a routine basis to providers, managers and researchers of public health services helps promote the efficiency of the overall operation of public health system.
The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system's weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of "control tower" in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.
한국환경보건학회 2004년도 International Conference Global Environmental Problems and their Health Consequences
/
pp.160-164
/
2004
This study was carried out to investigate the removal of TNT (2,4,6-trinitrotoluene) and parathion in the batch and the continuous constructed wetland microcosms consisting of marsh and pond. The batch system study showed that TNT was almost reduced in the marsh and pond system within 20 days and parathion was within 8 days. The major reductive metabolites of TNT includes 2,4-diamino-6-nitrotoluene (24DANT) >2,6-diamino-4-nitrotoluene (26DANT) >4-diamino-2,6-nitrotoluene(4ADNT) > 2-diamino-4,6-nitrotoluene (2ADNT), and the concentrations of these metabolites were decreased during further operation. The generation rates of 4-nitrophenol, the major metabolite of parathion, were 82% and 15% in the bottom of marsh and pond system, respectively. In the continuous system study, although TNT/parathion degradation pattern was similar to the batch's, marsh-pond system showed the most stable TNT/ parathion removal among various continuous reactor combinations.
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.
This paper provides the guidelines from which to develop a visiting health care program at the Public Health Center in Korea and involves an expanded payment compensation system of preventive services based on the new long-term health insurance system in Japan. The function and management methods to achieve the goals practiced in a community contact center for elderly support which have recently been established will guide the specific directions and strategies that the Public Health Center should pursue. That is to say, comprehensive and continuous efforts will be put forth in preventive home visiting care targeting the elderly in certain jurisdictions. At this point in time in which the visiting care nursing program has not yet started, visiting health care provided by the Public Health Center oversees chronic diseases of a vulnerable population. But after it has been developed nationwide, the visiting health care system at the Public Health Center will be distinctive and focused on health promotion and prevention.
Objectives: A people-counting system measures real-time occupancy through motion detection. Accurate people-counting can be used to calculate suitable ventilation demands. This study determined the optimum motion threshold for a people-counting system. Methods: In a closed room with two occupants moving constantly, different thresholds were tested for the accuracy of a people-counting system. The experiments were conducted at 150, 300, 450 and 600 lux. These levels of brightness included the illumination levels of most public indoor areas. The experiments were repeated with three types of clothing coloration. Results: Overall, a threshold of 16 provided the lowest mean error percentage for the people-counting system. Brightness and clothing color did not have a significant impact on the results. Conclusion: A people-counting system could be used with threshold of 16 for most indoor environments.
During the last decade, Health Impact Assessment (HIA) has been discussed worldwide as being an important tool for the development of healthy public policy. HIA has been advanced as a means of bringing potential health impacts to the attention of policy makers, particularly in sectors where health impacts may not otherwise be considered. HIA, a systematic assessment of potential health impacts of proposed public polices, programs, and projects, offers a means to advance population health by bringing public health research to bear on questions of public policy. In Korea, health-related items under current EIA (Environmental Impact Assessment) system can only be found in the categories of hygiene and public health. However, environment and public health are not adequately connected and also health is underestimated even though health is an important objective component for the implementation of Environmental Assessments (EA). As a result, health is not well integrated within criteria for investigating the impacts on environment. This study examines linkages for HIA from the related and relatively well-developed field of Prior Environmental Review System (PERS) which is similar to SEA and EIA in Korea.
The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.
Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.
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