Although the New National Health Promotion Plan 2010 target to reduce health inequalities, whether the program will be effective for reducing the health inequalities in Korea remains quite unclear. More and more developed countries have been started to concentrate on comprehensive policies for reducing health inequalities. The health policies of the UK, Netherlands, and Sweden are the most wellknown. I propose that a comprehensive blueprint for tackling health inequalities in Korea should be made and that it must contain five domains: a target, structure and process, life-course approach, area-based approach, and reorganization of health care resources. The target should be based on determinants of health and more attention should be paid to socioeconmic factors. The structure and process require changes from the national health care policy based on medical services to the national health policy that involves the establishment of a Social Deputy?Prime Minister and the strengthening multidisciplinary action. A life-course approach especially focused on the early childhood years. Area-based approach such as the establishment of healthy communities, healthy schools, or healthy work-places which are focused on deprived areas or places is also required. Finally, health care resources should be a greater investment on public resources and strengthening primary care to reduce health inequalities. The policy or intervention studies for tackling health inequalities should be implemented much more in Korea. In addition, it is essential to have political will to encoruage policy action.
Background: Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: "burden of medical expenses," "time constraints," and "lack of care." The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%-13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are "lack of care," "time constraints," and "burden of medical expenses." Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to "lack of care" is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%-14.1%) than in Busan (1.3%; 95% CI, 1.3%-1.4%). The probability due to "burden of medical expenses" is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%-4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%-0.4%). Conclusion: Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents-similar to the approaches of the United Kingdom and France.
Science, technology and innovation (STI) is crucially important to eradicating poverty, and making advances in various areas such as agriculture, health, environment, transport, industry, and telecommunications. Therefore, it is vital to the overall socioeconomic development of nations. The indispensable role of STI in the competitive globalized economy led to several attempts to measure national STI capacities. The present study outlines STI capacity around three sets of capabilities: technological capabilities, social capabilities, and common capabilities. The Global Science, Technology and Innovation Capacity (GSTIC) index was developed to provide current evidence on the national STI capacities of the countries, and to improve the composite indicators used for such purposes. The GSTIC ranks a large number of countries (167) on the basis of their STI capacities and categories them into four groups: i.e. leaders, dynamic adopters, slow adopters, and laggards. For more meaningful assessment of the STI capacities of nations, it captures the achievement gaps of individual countries with the highest achiever. The study also provides ranking and achievement gaps of nations in the nine GSTIC pillars: technology creation, R&D capacity, R&D performance, technology absorption, diffusion of old technologies, diffusion of recent innovations, exposure to foreign technology, human capital, and enabling factors. A more detailed analysis of the strengths and weaknesses in different pillars of STI capacity of ten selected countries is also provided. The results show that there are significant disparities among nations in STI capacity and its various aspects, and developing countries have much to catch-up with the developed nations. However, different countries may adopt different strategies according to their strengths and weaknesses. Useful insight into the strengths and weaknesses of the national STI capacities of different countries are provided in the study.
As the United Nations announced Sustainable Development Goals (SDGs) in 2015, the world changed its development goals from focusing on efficiency to equity. As a result, in the health sector, universal health coverage (UHC) has become one of the main issues. This paper reviews and discusses on future direction and issue of official development assistance program for developing countries. Korea International Cooperation Agency under the Ministry of Foreign Affairs published on Korea International Cooperation Agency's mid-term health strategy 2016-2020 developed on participation program with stakeholder including governments, civil society partner organizations, and educational institutions. The SDGs expands non-communicable diseases, UHC, and global health security from the existing Millenium Development Goals health sector. Progress toward UHC underpins the achievement of all other targets under SDG Goal 3. Progress in reducing health inequality across the life course is drawing on overall data and from specific target. In order to achieve SDG 3, a multi-disciplinary approach, convergence between IT and u-health of this development, is desirable.
The effort to measure and improve the quality of healthcare is a common health policy issue worldwide. Korean Value Incentive Programme is one of that effort, but some concerns exist. Compared to pay for performance program in other countries, it measures healthcare quality with relatively narrow performance domain using a small number of clinical indicators. It was designed without involving hospitals and other key stakeholder, and program participation was mandated. Highest and lowest performers get bonus and penalty using relative ranking. As a suggestion for development, the direction for quality management at the national level should be given first. Therefore the philosophy or strategy for quality improvement should be reflected to the program. And various domains and indicators of healthcare quality should be developed with active communication with healthcare providers. The evaluation method is necessary to be changed to provide achievable goal to the healthcare providers and attract quality improvement.
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.
High price equipment is one of the major factors that increases national health expenditure in developed countries. Computerized Tomography(CT), one of the important high price equipment, has been concerns of health service researchers and policy makers in many countries. In Korea, CT, first introduced in 1984, have spreaded nationwide with rapid speed. Though the Committee for Approving Import of High Price Medical Equipment, founded in 1981, tried to regulate the introduction of high price medical equipment including CT, the effort resulted in failure. The exact situation of diffusion of the high price equipment, however, was not yet investigated. We aimed at the description of the diffusion of CT in Korea and analysis of influencing factors on hospitals for the adoption of CT. We mainly used the database of CT, made in 1996 by the National Federation of Medical Insurance for the purpose of insurance payment for CT. Also characteristics of hospitals were gathered from yearbooks published by the central and local governments and by the Korean Hospital Association. We calculated the cumulative number of the CT per one million population year by year. In turn, multiple linear logistic regression was done to find out the contributing factors for the adoption of CT by each hospital. In the logistic regression model, it is regarded as dependent factor whether a hospital retained CT or not in 1988 and 1993. The major categories of the independent factors were hospital characteristics, environmental factors and competitive conditions of hospitals at the period of the adoption. The results are as follows: Number of CT scanners per one million persons in Korea marked more higher level compared with those of most OECD countries. Major influencing factors on the adoption of CT scanners were hospital characteristics, such as hospital referral level, and competitive condition of hospitals, such as number of CT scanners per 10,000 persons in each district where the hospital was located. In Korea, CT diffused with rather rapid speed, comparable with those of the United States and Japan. The major factors contributing on the adoption of CT for hospitals were competitive condition and hospital characteristics rather than regional health care need for CT. In conclusion, a kind of regulating mechanism would be necessary for the prevention of the indiscreet adoption and inefficient use of high price equipment including CT.
Hepatitis C infection is responsible for high morbidity and mortality rates globally as well as for significant indirect costs. The disease burden caused by the hepatitis C virus (HCV) is comparable to the one caused by human immunodeficiency virus or tuberculosis. Today, simple detection methods, highly effective and easy to administer therapies and efficient preventative measures are available to combat hepatitis C. Nevertheless, in most countries around the world, the World Health Organization target of eliminating this infectious disease and its consequences by 2030 are not being met. Significant gaps in care for hepatitis C sufferers still exist, the shortcomings ranging from education and treatment to aftercare. Hepatitis C infection was and still is not on the radar of most politicians and health authorities. National programmes and strategies to combat the disease exist or are being developed in many countries. However, for these to be implemented efficiently and successfully, clear political commitment, strong civil society actors, well-functioning public health structures and the relevant support from global donors are needed.
Internationally, many countries are facing the demand for reshaping health care systems to cope with rapid changing circumstances in health care sector. The recent growth of oriental medicine and complementary and alternative medicine (CAM) in the many countries is, to a large extent, due to the growth of the number of oriental medical doctors and physicians who have taken up alternative therapies alongside conventional medicine. To cope with the changing environments, many countries consider to develop integrative health care which is now used widely in health care sector. In both biomedical and CAM sectors(including oriental medicine), attention appears to have shifted away from separating therapeutic modalities into categories such as biomedical or CAM, towards a focus on merging diverse modalities into a 'new' integrative health system. In Korea, one of peculiar characteristics of health care system is that as health care provider, Hanbang medicine (traditional Korean medicine) and (western) medicine coexist since 19 century. Recently, the government of Korea has given many efforts to enhance the role and function of traditional Korean medicine in health care sector. However, the strategies and measures for integrative health care settings combining traditional Korean medicine and western medicine on health sector have not been developed yet. The research question of this study is In Korea, what are the trends and problems in interface of traditional Korean medical sector and Western medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the causes?; 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? In order to do this, this study explores the current situations and issues on the interface between traditional Korean medicine and (western) medicine in various ways using contents analysis of existing data and documents related to traditional Korean medicine and health policy. Finally, we discussed stakeholders' views on the interface in the health care sector. Then, health policy options to have shifted away from separating therapeutic modalities into categories such as 'traditional Korean medicine' or 'western medicine', towards a focus on merging diverse modalities into a 'new' integrative health system.
Objectives : The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). Methods : In closely fellowing the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. Results : The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. Conclusions : Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.
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