• 보건행정학회지
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• 제22권4호
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• pp.467-496
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• 2012

Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

• 대한예방한의학회지
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• 제9권1호
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• pp.77-89
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• 2005

Since 1990's, the Korean society, experiencing the low fertility and aging society, has been confronting with the threats in health care sector. The threats are the increases in the demand for health care, health care financial burden, and so on. In particular, the change of disease pattern and aging population result in the increases patients' demand for not only western medical services but also oriental medical services and complimentary medicine. Recently, the increases in availability of oriental medical services and the health care resources related to oriental medicine are raising some issues and conflicts in the Korean health sector. Theses circumstance required policy makers, central and local government, and public health sector to develop health policies related to oriental medicine and interface or integrate of traditional Korean medicine and Western medicine. For the near future, these issues will probably remain the focus of integration of traditional Korean medicine and Western medicine in public health sector. To cope with the threats in health care sector, one of the opportunities is to scale-up e public role of traditional Korean medical services. The main purpose of this study was to develop strategies to scale-up the Public role of traditional Korean medical services for the future society. The research questions are: what are the trends and problems in traditional Koran medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the cause?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? The results of this study are as follows. In order ta scale-up the public role of traditional medicine, this research offered health policy directions for traditional Korean medicine in response to a change environment of health care sector. There are four directions to be addressed: 1) the development of and investment in public oriental medicine infra-structure; 2) the development of public policy on oriental medicine; 3) modernization and globalisation of traditional Korean medicine; 4) the expansion of academic exchange between Western medicine and traditional Korean medicine. Finally, we discussed stakenholders' on traditional Korean medicine in the health care market. Then, public policy options for future society was suggested.

• 한국환경과학회지
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• 제4권3호
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• pp.153-167
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• 1995

Recycling is receiving increasing social attention today as our nation begins to grapple with the significant problems caused by huge amount of municipal solid waste. The topic of recycling is not simple but extremely complicated. This study attempts to provide basic data and policy options for expanding and improving separated collection and recycling in public residential areas, through three case study of apartment housing areas in Taegu Metropolitan City. The main results of this study are summarized as follows. For the significant period of time, all three case areas had in common the extreme difficulty in establishing and operating the system of connecting public participation, collection and storage, transportation, and actual recycling of materials because of a variety of problems involved in this process. Both amounts of and prices for collected materials fluctuated considerably over time mainly due to monthly changes in recyclable home materials and the dynamic nature of recycling markets. Public questionnaire survey revealed the very high level of participation in separated collection, not only because almost all respondents well understood the necessity and importance of recycling, but because they also knew how to do separated collection. But overall activities were rated low and most respondents suggested the enlargement of public participation, the improvement of collection and storage facilities, and collection transportation networks. In particular, most respondents had little experience of using recycled Products and used mainly reproduced soap and bathroom tissue. Furthermore, they were considerably unsatisfied with low variety and quality of recycled products, their high prices and low availability in the market. Finally potential policy options and activities for improving separated collection and recycling are suggested.

• 한국시스템다이내믹스연구
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• 제8권2호
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• pp.5-23
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• 2007

According to the system dynamics model of this study, if there is a significant network effect on vehicle operating costs, it is difficult to achieve the shift to AFV even in the long term without a policy intervention because the car market is locked in to the current structure. Network effect can be caused by an increasing return to scale in fuel supply sector as well as in maintenance service sector. It is also related to the fact that the reliability and awareness of consumers on new products increases with the growth of the market share of the new products. There are several possible policy options to break the 'locked in' structure of car market, such as subsidy on vehicle price (capital cost), subsidy on fuel (operating cost) and niche management policy. Combined policy options would be more effective than relying on a single policy option to increase the market share of AFV.

• 한국사회복지학
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• 제69권2호
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• pp.9-30
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• 2017

체제의 전환은 정책의 변화나 정부의 교체보다는 덜 자주 발생한다. 사회경제 연합, 정치경제 제도, 공공정책의 양상이라는 체제를 구성하는 세 가지 요소 모두의 변화가 이루어질 때 체제의 전환은 가능하다. 이 연구는 한국 생활보장체제의 전환 가능성이 상당히 높은 지금의 시점에서 필요한 과제를 모색하는 것을 목적으로 한다. 이를 위해 2절에서는 한국 생활보장체제의 전개과정과 특성을 필자의 선행연구들에서 주장한 '개발국가형 생활보장체제'의 관점에서 살펴보았다. 3절에서는 한국 생활보장체제의 전환을 위해 필요하다고 생각하는 3가지의 과제를 제시하였는데, 그것은 정치제도의 개혁, 재정지출 구조의 개혁, 그리고 비공식 취업의 축소 등이다. 이러한 과제들은 사회경제 연합의 변화와 새로운 정치경제 제도의 등장을 요구한다는 점에서 체제전환과 관련한 정책적 과제이다. 한편, 4절에서는 한국 사회복지의 새판 짜기와 관련하여 우리 학문 공동체에 붙여보고 싶은 두 가지의 토론거리를 결론을 대신하여 제기하였다.

• 보건행정학회지
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• 제14권3호
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• pp.97-121
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• 2004

Recently, human embryonic stem cell research raises exciting public expectation on medical possibilities as well as ethical debate. Embryo management has become an integral part of the management of infertility treatment, researches on embryo and human embryonic stem cells and so on. Britain has permitted the research on stem cells derived from human embryo which made the first nation to allow the cloning of human embryo for the stem cell research. However, new technologies such as the assisted reproductive technologies and human embryonic stem cell research continue to pose an increasing source of ethical dilemmas for physician, scientists, legislators, religious authorities and the general publics to deal with. None the less, the United Kingdom has adopted the most liberal policies regarding human embryo and human embryonic stem cell research. The implication of the British embryo management system are as follows: 1) the development of reproductive technologies and new stem cell research technologies continue to pose legal and ethical debates, since those involve several parties; 2) the UK has taken the legal and institutional approaches to cope with those serious issues; 3) the UK adopted most liberal policies regarding embryonic and human embryonic stem cell researches; 4) the British HFE Act is consistent with the existing Acts related to human embryo management and researches; 5) through amending the HFE Act to accomodate the changes of technologies, the UK try to minimize the legal and ethical burden on undertaking research regarding embryo. The debates about the researches on human embryo and human embryonic stem cells is likely to continue in the Korean society. Because of the controversy and competing ethical values, as well as the evolving technologies, so far no consensus exists in our society. It suggest that it is premature to bring closure by ruling out any particular approaches. Thus our society needs to make an efforts to find a basis which could resolve the societal controversies through enriching the societal conversation about the profound ethical issues regarding embryo management.

• 보건행정학회지
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• 제5권2호
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• pp.70-103
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• 1995

The aim of this study sets out to discover a desirable form of public centers among the alternative ones and make a health center model. Especially, this study attempts; (i) to investigate factors that affect the performance of health centers; (ii) carry out cost-effectiveness analysis (CEA) for the various type of health centers; (iii) identify innovative strategies to increase the use of health center. Cost-effectiveness analysis is used to compare the performance of all the centers. The following is taken to create the index. Wi = Ti x Mi x Eij (Wi: weight for service item I, Ti : time spent for service I, Mi ; number of health personnel involved in service I, Eij : years of schooling for personnel j in providing service I). As a result of these analyses, policy options as follows are recommended; (i) proper manpower, especially public health physician (oriental medical doctor), should be enough to provide health care adequately; (ii) facilities ad equipments in the health center should be provided sufficiently. (iii) the utilization of health centers should be raised by active operation of mobil service, community participation and health education program. Ultimately health centers in public sector are to be fostered for the promotion of health care by enhancing the financial and quality, continuity and efficiency of health services.

• Asian Journal of Innovation and Policy
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• 제5권2호
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• pp.197-207
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• 2016

This paper seeks to measure the monetary value of technical development in the deep seabed manganese nodule mining by applying the compound option model (COM). The COM is appropriate for the project in terms of its decision-making structure and embedded uncertainty. The estimation results show that the deep seabed mining project has more economic potential than shown by the previously obtained results from the discounted cash flow (DCF) analysis. In addition, it is reasonable to invest in the project taking the various uncertainty factors into consideration, because the ratio of the value to the cost of the project is far higher than one. This information can be utilized in national ocean policy decision-making.

• 한국의료질향상학회지
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• 제24권2호
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• pp.62-75
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• 2018

Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3363-3368
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• 2013

Background: The burden due to cancers is an emerging public health concern especially in resource-limited countries like Nigeria. The WHO estimates that cancer kills more people than tuberculosis, HIV/AIDS and malaria combined. As people in Nigeria and other developing countries are beginning to survive infectious diseases, there is an observed epidemiologic transition to chronic diseases, such as cancers. In 2008, 75 out of 1,000 Nigerians died of cancer. Despite the rising incidence and public health importance, Nigeria lacks an organized and comprehensive strategy to deal with cancers. Materials and Methods: This article reviewed 30 peer-reviewed manuscripts on cancer care in four countries. It highlights the limitations to cancer care in Nigeria; due to lack of awareness, low health literacy, absence of organized screening programs, inadequate manpower (in terms of quality and quantity) as well as limited treatment options. Results: This review led to the formulation of a proposal for Nigerian National Cancer Policy, mainly drawn from effective strategies used in Canada, Brazil and Kenya. This is a vertical cancer program that is patient-centered with an emphasis on tobacco control and cancer disease screening (similar to Canada and Brazil). Additionally, it emphasizes primary cancer prevention (similar to Kenya). Its horizontal integration with other disease programs like HIV/AIDS will improve affordability in a poor resourced country like Nigeria. Capacity building for health professionals, hub-and-spoke implementation of screening services, as well as investment in effective treatment options and increased research in cancer care are essential. International 'twinning collaborations' between institutions in richer countries and Nigeria will enhance effective knowledge translation and improve the quality of patient care. Conclusions: A national cancer policy must be developed and implemented in Nigeria in order to overcome the present limitations which help contribute to the observed increases in cancer morbidity and mortality rates. Cancer control is feasible in Nigeria if the nation was to consider and employ some of the cost-effective strategies proposed here.