• 제목/요약/키워드: US health system

검색결과 243건 처리시간 0.027초

발암물질 분류 및 관리 체계 고찰 (A Study on Classification and Management System for arcinogens)

  • 최상준;임경채
    • 대한안전경영과학회지
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    • 제12권3호
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    • pp.107-119
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    • 2010
  • The aim of this study was to compare the carcinogen classification systems of developed countries or global organizations with domestic system under Industrial Safety and Health Act (ISHA). We selected the representative institutions which had carcinogen classification system such as International Agency for Research on Cancer (IARC), National Toxicological Program (NTP), Environmental Protection Agency (US-EPA), American Conference of Governmental Industrial Hygienists (ACGIH), and European Union (EU). We collected the carcinogen lists issued by 5 institutions, and merged by CAS number of each chemical with Microsoft Access 7.0. We found that confirmed human carcinogens, probable human carcinogens and possible human carcinogens were 34, 179, and 252, respectively. All of the institutions classified chemicals as 2 (NTP), 3 (EU) or 5 (IARC, ACGIH, US-EPA) categories based on the weight of scientific evidences for carcinogenicity and periodically updated the carcinogen list by regular procedure. However, a total of 90 chemicals could be classified as carcinogen under ISHA in Korea. There was no procedure or system which periodically update the carcinogen lists. In addition, the status of carcinogen classification according to regulation was confused. In conclusion, these findings suggest that the carcinogen classification and management system should be amended by consideration of systems of advanced institutions and the domestic regulation system.

미국과 캐나다의 의약품 허가-특허 연계제도 (Drug Approval-Patent Linkage Systems in the US and Canada)

  • 박실비아
    • Journal of Pharmaceutical Investigation
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    • 제38권3호
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    • pp.207-215
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    • 2008
  • Drug approval-patent linkage is the practice of linking drug marketing approval to the patent status of the originator's product and not allowing the grant of marketing approval to any third party prior to the expiration of the patent term unless by consent of the patent owner. Article 18.9.5 of Korea-US Free Trade Agreement requires that Korea introduce the linkage system in drug marketing approval. However, Korea is unfamiliar with the linkage system. In addition, there have been lots of arguments over the impacts of this system on Korean pharmaceutical industry and pharmaceutical market in the future. This report investigated the linkage systems of the US and Canada. The US and Canada have implemented drug approval-patent linkage system since 1984 and 1993, respectively. Both countries have patent lists for drug approvalpatent linkage on which originators are required to list patents on substance, product, and use of their drugs. Generic or follow-on drug applicants must contain a certification regarding each patent listed that relates to the referenced drug. If the patent holder files suit for patent infringement within 45 days of notice of application, drug approval is not allowed for several months - 30 months in the US and 24 months in Canada. Both countries have amended their systems after having experienced unexpected results such as listing improper and additional patents, multiple patent litigations and delayed generic entries. After reviewing the US and Canada's experiences, we suggested three principles needed in implementing the system: protecting patent holder's right; promoting generic drug development and marketing; monitoring the process and the effect of the system.

신종 테러리즘 대응을 위한 보건방재체계의 현황 (Health Disaster Preparedness System for Response to Newly Emerging Terrorism)

  • 왕순주
    • 한국재난정보학회 논문집
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    • 제1권1호
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    • pp.73-89
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    • 2005
  • The disaster preparedness system in Korea has been developed in spite of many obstacles, but there are still many problems for response to newly emerging terrorisms due to the existing problems of disaster response system. The newly emerging terrorism in 21th century like biochemical terrorism has made us focus on terrorism preparedness, but health and medical aspect of terrorism has been overlooked. The health disaster system is more necessary for 21th terrorism response as well as the disaster engineering, economic and administrative aspects. The disaster preparedness system for bioterrorism has been developed by Ministry of Health with syndromic surveillance system and no case has been found in Korea yet and the resources of personnel and equipment as decontamination system in medical facilities are lacking in case of chemical terrorism. So through the multiple access method reflecting the risk factors in real terrorism field and human based health disaster concept, the disaster preparedness and response system to make up for the weak point should be suggested.

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Caudal and epidural blocks in infants and small children: historical perspective and ultrasound-guided approaches

  • Kil, Hae Keum
    • Korean Journal of Anesthesiology
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    • 제71권6호
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    • pp.430-439
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    • 2018
  • In infants and small children, ultrasound (US) guidance provides ample anatomical information to perform neuraxial blocks. We can measure the distance from the skin to the epidural space in the US image and can refer to it during needle insertion. We may also visualize the needle or a catheter during real-time US-guided epidural catheterization. In cases where direct needle or catheter visualization is difficult, US allows predicting successful puncture and catheterization using surrogate markers, such as dura mater displacement, epidural space widening due to drug injection, or mass movement of the drug within the caudal space. Although many experienced anesthesiologists still prefer to use conventional techniques, prospective randomized controlled trials using US guidance are providing increasing evidence of its advantages. The use of US-guided regional block will gradually become widespread in infants and children.

건강영향을 고려한 산업단지 개발의 계획 적정성 평가방법론 연구 (A Study on a Plan Adequacy Evaluation forIndustrial Complex Development Considering Health Impact)

  • 신문식;이영수;하종식
    • 환경영향평가
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    • 제29권2호
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    • pp.93-111
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    • 2020
  • 현행 국내 건강영향평가는 환경영향평가제도 내 특정 개발사업에 한해서 수행된다. 하지만 건강영향평가가 개발사업의 시행 단계에서 수행됨에 따라 심각한 건강 악영향이 예상됨에도 불구하고 적절한 조치를 취하지 못하는 경우가 있다. 특히 산업단지 개발사업의 경우에 운영으로 인한 건강 악영향 예상 및 개발단계에서의 건강영향평가로 인해 환경갈등이 자주 발생하고 있다. 이 연구는 산업단지 개발에 있어 건강영향을 고려한 계획 적정성 평가 방법을 제안하고 이를 실제 개발사업들에 적용하고자 하였다. 이 연구는 US EPA의 CalEnviroScreen 3.0 및 US ATSDR의 Public Health Assessment를 참조해서 건강영향을 고려한 계획 적정성 평가 방법을 제안하였다. 평가 방법으로는 지역사회 특성, 배경노출, 그리고 개발부담으로 구분한 지표 사용을 제안하였다. 문헌조사 등을 통해 지역사회 특성 지표 5개, 배경노출 지표 3개, 개발부담 지표 7개를 선정하였으며, 건강영향평가 관련 전문가들에게 계층적 의사결정법 설문조사를 통해 각 지표의 가중치를 산출하였다. 과거 국가 주도의 3개 국가산업단지 개발사업에 대해 시범 적용하였으며, 이를 통해 각 지표들에 대한 활용자료 및 평가값을 세분화하여 평가 방법을 구체화하였다. 건강영향을 고려한 계획 적정성 기준은 산업단지 개발에 대한 정부의 정책방향과 연계하여 첫째 총점기준, 둘째 총점 및 지역사회 특성기준, 그리고 개발부담 지표에 예외를 둔 총점 및 지역사회 특성기준으로 제안하였다.

한국형 통합의료체계 모형 탐색 (In Search of Integrated Health Care System Tailored to Korea)

  • 신영석;윤장호
    • 보건행정학회지
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    • 제24권4호
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    • pp.304-311
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    • 2014
  • This manuscript treats a new paradigm for the Korean health care system. We give an account of innovative health care delivery and payment models widely discussed in the contemporary US accountable care organization and coordinated care organization. In doing so, we explore a new health care model amenable to foreseeable changes to the health care system. We propose creating an integrated health care system in which the network of health care providers delivers coordinated and comprehensive care for enrolled patients residing within the geographic boundaries served by the provider network; providers may participate voluntarily in one or more networks and assume shared responsibility for patient care and cost; provider networks compete with each other based on cost and quality; and consumers are allowed to choose a network. We expect that the new paradigm will create a financially-sustainable system that assures quality of care and improves patient experience, minimizing the existing system-wide inefficiency through cross-network competition and within-network care coordination.

Environmental Regulation and Compliance in USA

  • Underhill, Philip
    • 한국환경보건학회:학술대회논문집
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    • 한국환경보건학회 2006년도 Perspectives of Evironmental Health Issues in Asia-Pacific Region
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    • pp.15-30
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    • 2006
  • o US environmental regulations are complex o Compliance assesment should be part of an effective environmental management system o Companies must assess and report a dollar value for environmental liabilities o Comprehensive assessment of environmental liability and risk should be conducted for all property transfers aquisitions o Independent external audits provide the highest level of compliance oversight and can assist in assessment of environmental liabilities

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우리나라 2006년 약제비의 규모 및 구성 (Scale and Structure of Pharmaceutical Expenditure for the year 2006 in Korea)

  • 정형선;이준협
    • 보건행정학회지
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    • 제18권3호
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    • pp.110-127
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    • 2008
  • Expenditures on pharmaceuticals of different concepts were estimated and their functional, financing and providers' breakdowns were examined in line with the OECD's System of Health Accounts (SHA) manual. This study also shows the way such estimates are made. The results are then analyzed particularly from the international perspective. Data from both Household Survey by the National Statistical Office and the National Health and Nutritional Survey by the Ministry of Health and Welfare of Korea were used to estimate pharmaceutical expenditures that. are financed by out-of-pocket payments of the household, while national health insurance data etc. were used for estimation of pharmaceutical expenditures that are financed by public funding sources. The 'per capita expenditure on pharmaceutical/medical non-durables' in Korea stood at 380 US$ PPPs, less than the OECD average of 443 US$ PPPs in 2006, but its share of the per capita health expenditure of 25.9% noticeably outnumbered the OECD average of 17.1%, due partly to low per capita health expenditure as a denominator of the ratio. This indicates that Koreans tend to spend less on health care than an OECD average, while tending to spend more on pharmaceuticals than on other health care services, much like the pattern found in relatively low income countries. An international pharmaceuticals pricing mechanism is most likely responsible for such a tendency. In addition, it is to be noted that the percentage comes down to 21.0%, when expenditures on both medical non-durables and herbal medicine, which is locally quite popular among the elderly, have been excluded.

Prevention in the United States Affordable Care Act

  • Preston, Charles M.;Alexander, Miriam
    • Journal of Preventive Medicine and Public Health
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    • 제43권6호
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    • pp.455-458
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    • 2010
  • The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.

Reliability and validity of a personal computer based muscle viewer for measuring upper trapezius and transverses abdominis muscle thickness

  • Jeong, Ju-Ri;Han, Ju Hee;Cho, Ji-Eun;Lee, Wan-hee
    • Physical Therapy Rehabilitation Science
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    • 제5권3호
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    • pp.155-161
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    • 2016
  • Objective: This study aimed to investigate the reliability and validity of a personal computer-based muscle viewer (PC-BMW) compared with that of a portable ultrasound (P-US) for measuring upper trapezius (UT) and transversus abdominis (TrA) muscle thickness at rest and during contraction. Design: Observational inter-rater reliability study. Methods: Fifty-five healthy participants (25 men, 30 women) participated in this study. PC-BMW and P-US were randomly measured at the UT and TrA muscles. Two examiners randomly obtained the images of all participants in 3 test sessions lasting 2 days. Intra-class correlation coefficients (ICCs), standard error of measurement, contraction ratio, and correlation were used to estimate reliability and validity. Pearson's correlation coefficients were used to analyze the relationship between muscle thickness measures taken from PC-BMW and P-US. Results: The intra-rater reliability ICCs of UT and TrA muscle thickness for the PC-BMW were >0.995, indicating excellent reliability. Inter-rater reliability ICCs for the PC-BMW ranged from 0.963 to 0.987. The P-US also exhibited high reliability. A high correlation was found between the measurements of the two muscles in PC-BMW and P-US (p<0.01). Conclusions: PC-BMW provides clear and excellent images, is pocket-sized and less expensive than a conventional ultrasound imaging system. PC-BMW can be utilized variously and has the advantage of rehabilitative ultrasound imaging. More research is needed to evaluate the utility of PC-BMW for rehabilitation.