• 보건행정학회지
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• 제28권4호
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• pp.327-328
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• 2018

The quality of healthcare in Korea is very good, especially in life threatening disease. However, the level of healthcare research in Korea is not good relative to that of engineering. International university rankings also were showed that engineering was generally higher ranking than medicine. The reason of this phenomenon was deeply related to expenditure on research and development (R&D). Although Korea had a lot of gross domestic expenditure on R&D (GERD), 75% of GERD was from business enterprise that was related to engineering. Healthcare expenditure of R&D from business enterprise is small. Healthcare expenditure from government budget allocation on R&D (GBARD) was smaller than engineering. Higher education expenditure on R&D of GERD was also small and the quantity and quality of researcher in higher education was not enough. For Korea's healthcare to become the growth engine for future, GBARD should be invested heavily in the healthcare, a large part of the increased GBARD must be invested in higher education, and the higher education should invest to secure the higher quality researcher stably.

• Journal of Preventive Medicine and Public Health
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• 제37권1호
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• pp.88-98
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• 2004

Objectives : The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. Methods : Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k>0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. Results : The survey was used by 59.8 % of samples as a core project decision-making method. The partici- pants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. Conclusions : The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health

• 보건행정학회지
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• 제13권1호
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• pp.69-97
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• 2003

This study focuses on the determinants of the community health service utilization. Theories suggest seven models for community health service utilization, which are divided largely into two groups such as Health Service Supply Model and Health Service Demand Model: Supply Model includes Medical Implements Model, Personnel and Budget Model, Management System Model, Staffs' Behavior Model, Service Quality Model; Demand Model includes Area Model and Clients' Characteristics Model. This paper tests how the above models influence on the community health service utilization. After interviewing some administrative staffs of the Community Health Service Center at Pusan, questionnaires were made and mailed to the staffs of 198 Korean Community Health Service Center as a universe, among which from 98 centers we got response. Analyzing the data from the questionnaires, we found "the number of personnels in the health service center" and "demands for medical service" as important variables to affect the utilization of the community health service center. These two variables are typical factors representing Supply Model and Demand Model each. However, the variables selected from Management System Model, Administrative Behavior Model, Service Quality Model and Area model are not significant in a statistical sense. The paper suggests that to recruit the personnels, especially nurses, and to make out the demands of the clients for health service be the precedent conditions to increase the utilization of the Community Health Service Centers in Korea.ce Centers in Korea.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• 보건행정학회지
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• 제13권3호
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• pp.21-34
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• 2003

Patient revisit to used hospital is a key factor in determining a health care organization's competitive advantage and survival. This article examines the relationship between customer's satisfaction and his/her revisit associated with three different methods which are the Chi Square Automatic Interaction Detection(CHAID) for segmenting the outpatient group, logistic regression and neural networks for addressing the outpatient's revisit. The main findings indicate that the important factors on outpatient's revisit are physician's kindness, nurse's skill, overall level of satisfaction, hospital reputation, recommendation, level of diagnoses and outpatient's age. Among these ones, physician's kindness is the most important factor as guidelines for decision of their revisit. The decision maker of hospital should select the strategy containing the variable amount of the level of revisit and size of outpatient's group under the constraint on the hospital's time, budget and manpower given. Finally, this study shows that neural networks, as non-parametric technique, appear to more correctly predict revisit than does logistic regression as a parametric estimation technique.

• 보건행정학회지
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• 제6권2호
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• pp.131-148
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• 1996

This study was carried out by using questionnaires with 200 general doctors serving as the director of health subcenter in Kyongsangbuk-do Province as of January 1995. The results are summarized as follows. It was shown that the general characteristics consisted of 53 directors in the lst year(26.5%), 85 in the 2nd year(42.5%) and 62 in the 3rd year(31.0%). The percentage spent on their medical service showed that 73.0% of those directors spent more than 90% on their medical service. Based on their general service attitiude, 0% answered that the director of the health subcenter completes the given duties as the director, and 24.5% did that the director has the sense of responsibility and duty. Multiple answers concerning inconvenience and difficulties of the health subcenter director showed that less monthly salary accounted for 75.5%, no administrative power for 50.0%, insufficient medical instruments for 35.5%, insufficient budget for 30.0%, respect. In conclusion, in order for the health subcenter to meet the function as the primary medical clinic, it is required to arange the plans to inspire the public health doctors' service desire to that they can give the medical service as good as the private primary medical clinics, to convert existing concept of the public health doctors' placement in Myon administrative district into new concept in Gun by breaking from a uniform placement, and to consider an intensive placement according to the relevant projects so that preventive health activities can be planned and carried out.

• Journal of Preventive Medicine and Public Health
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• 제52권6호
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• pp.427-432
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• 2019

Objectives: In Indonesia, 61 million adults smoked in 2018, and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement a smoke-free policy (SFP), and the city of Jayapura enacted a local bill (1/2015) to that effect in 2015. This study aimed to evaluate compliance with this bill and to explore challenges in implementing it. Methods: We conducted a mixed-methods study. Quantitatively, we assessed compliance of facilities with 6 criteria (per the bill): the presence of signage, the lack of smoking activity, the lack of sale of tobacco, the lack of tobacco advertisements, the lack of cigarette smoke, and the lack of ashtrays. We surveyed 192 facilities, including health facilities, educational facilities, places of worship, government offices, and indoor and outdoor public facilities. Qualitatively, we explored challenges in implementation by interviewing 19 informants (government officers, students, and community members). Results: The rate of compliance with all 6 criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. Spatial patterning was absent, as shown by similar compliance rates for SFP facilities within a 1-km boundary around the provincial and city health offices compared to those outside the boundary. Implementation challenges included (1) a limited budget for enforcement, (2) a lack of support from local non-governmental organizations and universities, (3) a lack of public awareness at the facilities themselves, and (4) a lack of examples set by local leaders. Conclusions: Overall compliance was low in Jayapura due to many challenges. This information provides lessons regarding tobacco control policy in underdeveloped areas far from the central government.

• 대한예방한의학회지
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• 제4권1호
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• pp.1-16
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• 2000

From 1998, Oriental Medical Physicians(OMP) is distributed in Public Health Sector. but long term plan for Oriental Medicine in Public Health is not existed. So, this study is designed for the activation of OMP Subjects in this study were comprised 3 groups of oriental medicine related persons, the group of which are Students of 11 Oriental Medical Schools, Oriental Medical Physicians in Public Health Sector, Specialist Croup of Oriental medicine Policy(total 1,458 persons). Data were collected from July 1st to November 30, 1999. Direct interview with key persons, systematic interview by using of interview protocol, e-mail and facsimile have been conducted. The results of survey were coded by Excel 5.0, and analysed with SAS 6.12 statistical package. Inter-group difference determined by T-test, and descriptive statistics have been examined. Major findings can be epitomized as follows. 1) OMP disposition to multifarious organizations and institutes such as Public Health Centers, Public Health Sub-centers, Public Hospitals, Private Hospitals in Remote-Vulnerable Area, Community Social Welfare Centers, Institutes for Heath Policy Research, etc, will promise an effective use of Oriental Medical Physician. 2) Average number of patients treated by OMP was 22.8, average budget for oriental medical department, in which OMP were affiliated, was 39.6 million Won per year. Direct cost per every patient visit was 7,210.9 Won, which is considered expensive for public health service. Therefore, development and transformation for Oriental Medical Service in Public Health Sector is desirable in economic and political aspects. 3) It is recommended that ${\ulcorner}Advisory\;Committee{\lrcorner},{\ulcorner}Planning\;Commission\;for\; Public\;Health\;in\;Oriental\;Medicine{\lrcorner}$ should be established for the activation and for the support of Oriental Medical Physician in Public Health Sector, 4) Most effective programmes for oriental public health doctor are health service programmes for the elderly, Home health visit, chronic degenerative disease control services(p<0.001). 5) Standard guideline for facilities and equipments of Oriental Medicine Department in Public Health Center is needed for optimal supply of resources and activation of public health activity.

• 한국체육학회지인문사회과학편
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• 제54권3호
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• pp.315-325
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• 2015

본 연구는 생활체육 및 전문체육이 균형 있게 발전하기 위한 체육재정의 확보와 지원의 효율화 방안을 제시하는데 그 목적이 있다. 연구의 방법은 체육재정과 관련된 선행연구를 고찰한 후 문헌자료를 통해 그 실태를 파악하였다. 연구의 내용 및 범위는 첫째, 중앙 및 지방정부 체육부문 예산을 검토하였고 둘째, 지방정부의 재정자립도를 파악하였으며 셋째, 지방정부의 체육부문 예산을 파악하였다. 이상의 고찰을 통해 도출한 결과는 다음과 같다. 첫째, 체육진흥기금 중 수익금 배분의 개선을 통한 체육재정의 추가적 확보가 요구된다. 둘째, 재정자립도를 기준으로 스포츠이벤트 개최 이후에 활용도를 높일 수 있는 충분한 지원이 필요하다. 셋째, 각 단체를 평가할 수 있는 공정한 평가기준을 확립하고 이에 따른 전략적 지원과 체육재정의 확보가 요구된다. 넷째, 각 지역에 대한 충분한 사전조사를 통해 양적 지원을 벗어나 실제 사용가치를 높일 수 있는 질적 지원이 이루어지도록 해야 한다. 다섯째, 체육부문별 지원 규모에 대한 심층 연구를 통하여 다양한 사업에 대한 공정한 분배가 이루어져야 한다.

• 보건행정학회지
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• 제33권3호
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• pp.370-375
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• 2023

The responsibility to ensure the health rights of detainees, particularly their medical rights, fundamentally lies with the state in all nations. However, in the correctional facilities of the Republic of Korea, these rights are currently not adequately safeguarded. Numerous detainees express dissatisfaction with the medical services provided and show a preference for voluntary external treatment. However, barriers such as prolonged application processes for external treatment and the requirement for detainees to cover their medical expenses present significant challenges. Therefore, the National Human Rights Commission of Korea has advocated for an increased medical budget in correctional facilities and a bolstered professional medical workforce to improve the medical care of detainees. Recommendations for improvements include: (1) establishing dedicated correctional hospitals for detainees, (2) setting up specialized correctional wards, (3) collaborating with military hospitals, (4) launching mobile medical buses for diverse specialties, (5) enhancing collaboration with public and private medical institutions, (6) increasing compensation for partnering external medical institutions, (7) improving the working conditions of medical officers, (8) safeguarding the defense rights of medical staff, (9) improving the working conditions of public health doctors from the Ministry of Justice in correctional facilities, and (10) pre-assigning public health specialists and military doctors to correctional facilities. By implementing these measures, it is anticipated that the quality of medical services in the Republic of Korea's correctional facilities will improve, reducing the demand for external treatments among detainees and ensuring their health and medical rights are realistically upheld.