• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.18-28
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• 2017

Objectives: Low birth weight (LBW) is a major public health concern, especially in developing countries, and is frequently related to child morbidity and mortality. This study aimed to identify key determinants that influence the prevalence of LBW in selected developing countries. Methods: Secondary data analysis was conducted using 10 recent Demography and Health Surveys from developing countries based on the availability of the required information for the years 2010 to 2013. Associations of demographic, socioeconomic, community-based, and individual factors of the mother with LBW in infants were evaluated using multivariate logistic regression analysis. Results: The overall prevalence of LBW in the study countries was 15.9% (range, 9.0 to 35.1%). The following factors were shown to have a significant association with the risk of having an LBW infant in developing countries: maternal age of 35 to 49 years (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.2 to 3.1; p<0.01), inadequate antenatal care (ANC) (aOR, 1.7; 95% CI, 1.1 to 2.8; p<0.01), illiteracy (aOR, 1.5; 95% CI, 1.1 to 2.7; p<0.001), delayed conception (aOR, 1.8; 95% CI, 1.4 to 2.5; p<0.001), low body mass index (aOR, 1.6; 95% CI, 1.2 to 2.1; p<0.001) and being in the poorest socioeconomic stratum (aOR, 1.4; 95% CI, 1.1 to 1.8; p<0.001). Conclusions: This study demonstrated that delayed conception, advanced maternal age, and inadequate ANC visits had independent effects on the prevalence of LBW. Strategies should be implemented based on these findings with the goal of developing policy options for improving the overall maternal health status in developing countries.

• Journal of agricultural medicine and community health
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• v.16 no.2
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• Health Policy and Management
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• v.30 no.2
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• pp.192-198
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• 2020

Background: Korea National Health Insurance Service (NHIS) is operated as a social insurance system in which people pay a portion of their monthly income as insurance premiums and receive benefits when they experience illness or injury. Since 2005, the national health insurance remained surplus accumulating cumulative reserves each year. However, as of 2018, NHIS revenue recorded 62.11 trillion won and spending of 62.29 trillion won. The deterioration of NHIS finances is expected to accelerate with the aging population, income growth, new medical technology development, and enhanced security policies. Methods: To examine the financial health and sustainability of NHIS, we estimated the future revenue and spending until 2030 using the data from Korea Health Insurance Review and Assessment Service statistical yearbook. 2004-2018 average percentage change in NHIS revenue and spending was calculated. We estimated the future NHIS financial status using two methods. In the first method, we calculated the revenue and spending of the future NHIS by applying the 2004-2018 average percentage change to the subsequent years consecutively. In the second method, we estimated the future NHIS financial status after adjusting for the predicted demographic changes such as the aging population and declining birth rate in South Korea. Results: The estimates from this study suggest that the NHIS's cumulative reserves will run out by 2024. Conclusion: In terms of spending on current health insurance, there should be a search for ways of more efficient spending and funding options.

• Journal of Digital Convergence
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• v.16 no.5
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• pp.33-42
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• 2018

This paper is based on the suggestions of the prior research on the buyer feedback, the selection of various product options, and the payment procedure improvements for Korea ON-line E-Procurement System(KONEPS), and this is to confirm the necessity of improvement and satisfaction from the viewpoint of the workers of the public and subordinate organizations the purchasing and using of the computer equipment in the actual KONEPS(Korea ON-line E-Procurement System). Based on the basic questionnaires and in-depth interviews, this paper conducts the qualitative case studies on IT and non - IT workers who had purchasing experiences for equipment at public institutions and government agencies in Gyeongbuk province. As results of the study, it was confirmed that the improvement is necessary for the buyer feedback and option selection part, and that there is a difference among the work experience for the simplification of the payment procedure and the satisfaction. In addition, the biggest contribution in the provided research is to categorize and to analyze the opinions on the use of public and relevant subordinate research participants. Additional work will be needed for a large number of workers in public and subordinate organizations who have purchasing experiences for handling various procurement products and those working in the metropolitan area and other public and subordinate agencies.

• Journal of Digital Convergence
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• v.11 no.4
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• pp.177-188
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• 2013

This study examines how managerial ownership structure affects the borrower's choice of private versus public debt using 2,608 firm-year data for 2006-2008. This paper investigates the relationship between managerial ownership structure and debt choice. Managerial ownership is measured using number of stocks and unexercised stock-options and debt is classified public and private debt. The results find that there is a positive association between managerial ownership and the private debt dependence and also find that when firms finance additional funds, higher managerial ownership leads managers to choose private debt not public debt. Since private debt can be classified into bank debt and non bank debt, this paper examines the relationship between managerial ownership and a choice of bank debt. The results indicate that managers with higher ownership are more likely to use bank debt over public debt and non bank debt. By examining the relation between managerial ownership and a debt choice, this paper has following contributions. First, this study shows that managerial ownership affects the choice of the source of financing using three different proxies of managerial ownership. Second, this study classified private debt into bank debt and non-bank debt and provide the evidence of preference toward private debt especially bank debt among other financing sources. Finally, there are extensive studies related to capital structure and managerial ownership, but there is little empirical research on the debt choice and managerial ownership. Thus, this paper adds to literature by exploring the effects of managerial ownership on a debt choice.

• Land and Housing Review
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• v.5 no.3
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• pp.137-149
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• 2014

The authors derived rental housing policy measures that are appropriate for the current conditions of Korean housing supply and demand based on the confirmation of the issues of Korean rental housing system and reviewing implications from review of cases of foreign countries and these measures can be categorized into linkage with the urban regeneration and multi-functional development, acquisition of financial resources, operational management, policy and institutional aspects. For the expansion of supply of rental housing, it is essential to link the rental housing policy with urban regeneration. To pursue regeneration of underdeveloped areas and expansion of supply of rental housing in line with urban regeneration, more development sites should be added. Further, the rental home policy must be integrated into a new paradigm that includes securing commercial viability and providing various residential conveniences through multi-functional development. In addition, diversification of developers of real estates turning away from the existing framework of policy that has been focused only on the state-led housing supply so that local governments and private sector players can take part in. Next, new options for funding the supply of rental housing must be sought. First, raising financial resources sequentially through cyclical development approach could be considered. Or, various funding schemes including utilizing Tax-increment financing (TIF) based on the local tax revenues that will be accrued after the development projects and supply of rental housing. Or there should be various schemes to raise funds including utilization of TIFs that are based on the revenues that will be realized after the development projects and supply of rental housing, or utilizing REITs where funds can be provided through private sector investments. Also, getting out from the planning practice that focused only on physical expansion of supply of rental housing, continual operational management must be performed even after the development. These activities must be supported through establishment of control tower at the national level and continuous attention must be paid even after the development by developing specialized operational management companies that are led by private sector players. Finally, in addition to the hardware support that is focused on the public rental housing only, software support such as conditional provision of housing voucher or tax exemption for low-income classes should be provided, too. In other words, a shift from policies that are supplier-centric to ones that are customer-centric must take place.

• Journal of Environmental Impact Assessment
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• v.4 no.3
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• pp.87-94
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• 1995

At both international and national levels, such as in the Rio Declaration and the EU's Fifth Environmental Action Plan, governments have committed themselves to the adoption of the precautionary principle (UNCED 1992, CEC 1992). These commitments mean that the existence of uncertainty in appraising policies and proposals for development should be acknowledged. Uncertainty arise in both the prediction of impacts and in the evaluation of their significance, particularly of those cumulative impacts which are individually insignificant but cumulatively damaging. The EC network of EIA experts, stated at their last meeting in Athens that indirect effects and the treatment of uncertainty are one of the main deficiencies of current EIA practice. Uncertainties in decision-making arise where choices have been made in the development of the policy or proposal, such as the selection of options, the justification for that choice, and the selection of different indicators to comply with different regulatory regimes. It is also likely that a weighting system for evaluating significance will have been used which may be implicit rather than explicit. Those involved in decision-making may employ different tolerances of uncertainty than members of the public, for instance over the consideration of the worst-case scenario. Possible methods for dealing with these uncertainties include scenarios, sensitivity analysis, showing points of view, decision analysis, postponing decisions and graphical methods. An understanding of the development of cumulative environmental impacts affords not only ecologic but also socio-economic investigations. Since cumulative impacts originate mainly in centres of urban or industrial development, in particular an analysis of future growth effects that might possibly be induced by certain development impacts. Not least it is seen as an matter of sustainability to connect this issue with ecological research. The serious attempt to reduce the area of uncertainty in environmental planning is a challenge and an important step towards reliable planning and sustainable development.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

• Environmental and Resource Economics Review
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• v.12 no.2
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• pp.347-382
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• 2003

The paper presents available options that Korea can adopt in an effort to promote eco-industrial development in a near future. What is missing and the reasons why Korea is behind the other countries in the area are: 1) Lack of holistic view and the integrated approach toward economy and environment in policy implementation, 2) Lack of understanding, among entrepreneurs, of the concept of productivity per input resource, and the fact that not only labor and capital productivity but also the total productivity enhancement is vital for industry's competitive edge; There has been no driving force in the market to develop economies of system integration to turn industrial wastes to valuable input resources, 3) Unsupportive regulatory system regarding the trade of by products, and 4) Lack of financing and incentive mechanism. 5) Lack of information forum. Regulatory reform should be taken for the direction that in effect increase the price of disposal and motivate firms to seek symbiotic relationship with other firms, and facilitate trade by-product between firms. Financing and incentive mechanism should be introduced in order for the industry to find easy access to the opportunities for organizing the network to transform wastes in negative value to the value added resources. Also information network should be established to provide a market for by-product exchange and public education to improve industry's environmental performance.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.1-5
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• 2007

Unprecedented amount of genetic information being generated from the result of Human Genome Project (HGP) and advances in genetic research is already forcing changes in the paradigm of health and disease. The ultimate goal of genetic medicine is to use genetic information and technology to develop new ways of treatment or even prevention of the disease on an individual level for 'personalized medicine'. Genetics is play ing an increasingly important role in the diagnosis, monitoring and management of common multifactorial diseases in addition to rare single-gene disorders. While wide range of genetic testing have provided benefits to patients and family, uncertainties surrounding test interpretation, the current lack of available medical options for the diseases, and risks for discrimination and social stigmatization may remain to be resolved. However an increasing number of genetic tests are becoming commercially available, including direct to consumer genetic testing, yet public is often unaw are of their clinical and social implications. The personal nature of information generated by a genetic test, its power to affect major life decisions and family members, and its potential misuse raise important ethical considerations. Therefore appropriate genetic counseling is needed for patient to be informed with the benefits, limitations and risks of genetic tests, prior to informed consent for the tests. Physician also should be familiar with the legal and ethical issues involved in genetic testing to tell patients how w ell a particular genetic risk factor relates with likelihood of disease, and be able to provide appropriate genetic counseling. Genetic counseling become a mandatory requirement as global standard for many genetic testing such as prenatal diagnosis, presymtomatic DNA diagnostic tests and cancer susceptibility gene test for familial cancer syndrome. In oder to meet the challenge of genetic medicine of 21 century in korean health care system, professional education program and certification board for medical genetics specialist including non-MD genetic counselors should be addressed by medical society and regulatory policy of national health insurance reimbursement for genetic counseling to be in place to promote the implementation of clinical genetic service including genetic counseling for proper genetic testing.