• 제목/요약/키워드: Health Services Management

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보건소 기능의 중요도에 따른 자원배분의 적절성 평가 (The evaluation of the appropriateness of resource allocation in a community health center)

  • 전기홍;송미숙;정지연;김찬호
    • 보건행정학회지
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    • 제7권2호
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    • pp.19-45
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    • 1997
  • This study was performed to evaluate the appropriateness of resource allocation based on the ranking of health center function. Through the Delphi processes, health center functions were ranked in order of importance as follows; planning and research, followed by health education, health promotion, management of chronic diseases, health screening tests, welfare activities, mental health services, medical personnel management, medical services, prevention of communicable diseases, maternal and infant health services, housekeeping, management of oral hygiene, nutrition services, surveillance for community health services, family planning, and administration of the health center. In relation to the above priorities, the allocation of manpower was not appropriate. Even though the expert groups emphasized on functions such as planning and research, health education, and health promotion, they inputted more personnel for administration of a health center, maternal and infant health services, and medical services which were evaluated with lower importance. The budget allocation showed the same trends as the above. Although the functions such as planning and research, health education, and health promotion, and management of chronic diseases were evaluated highly, the budget was allocated accordingo to the the results of the former fiscal year rather than on the importance of function. However the budget for nutrition services, surveillance for the community health services, family planning, and administration of a health center was allocated according to priority. Based upon the above findings, community health center should be given the opportunity to make their own ranking of health center function and to allocate their resources including personnel and budget in order to improve the responsibilities and roles of the community health center.

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Association of Risk of Gastric Cancer and Consumption of Tobacco, Alcohol and Tea in the Chinese Population

  • Tong, Gui-Xian;Liang, Han;Chai, Jing;Cheng, Jing;Feng, Rui;Chen, Peng-Lai;Geng, Qing-Qing;Shen, Xing-Rong;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8765-8774
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    • 2014
  • This study aimed at summarizing epidemiological research findings on associations between tobacco, alcohol and tea consumption and risk of gastric cancer (GC) in the Chinese population. The review searched PubMed, Embase, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) databases and reference lists of review papers for all studies published in English or Chinese languages. Information extracted, via two independent researchers, from retrieved articles included first author, year of publication, study design, sample size, source of controls and adjusted odds ratio (OR) or relative risk (RR) with the corresponding 95% confidence intervals (CIs) for each category. Statistical analyses used software STATA version 12.0. The systematic search found 89 articles containing 25,821 GC cases and 135,298 non-cases. The overall random effects in terms of pooled OR and 95%CI for tobacco, alcohol and tea consumption were 1.62 (95%CI: 1.50-1.74), 1.57 (95%CI: 1.41-1.76) and 0.67 (95%CI: 0.59-0.76) respectively; while the heterogeneity among included studies ranged from 80.1% to 87.5%. The majority of subgroup analyses revealed consistent results with the overall analyses. All three behavioral factors showed statistically significant dose-dependent effects on GC (P<0.05). The study revealed that tobacco smoking and alcohol drinking were associated with over 1/2 added risk of GC, while tea drinking conferred about 1/3 lower risk of GC in the Chinese population. However, these results should be interpreted with caution given the fact that most of the included studies were based on a retrospective design and heterogeneity among studies was relatively high.

Association Between Pancreatitis and Subsequent Risk of Pancreatic Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Geng, Qing-Qing;Chai, Jing;Cheng, Jing;Chen, Peng-Lai;Liang, Han;Shen, Xing-Rong;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.5029-5034
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    • 2014
  • This study aimed to summarize published epidemiological evidence for the relationship between pancreatitis and subsequent risk of pancreatic cancer (PC). We searched Medline and Embase for epidemiological studies published by February $5^{th}$, 2014 examining the risk of PC in pancreatitis patients using highly inclusive algorithms. Information about first author, year of publication, country of study, recruitment period, type of pancreatitis, study design, sample size, source of controls and attained age of subjects were extracted by two researchers and Stata 11.0 was used to perform the statistical analyses and examine publication bias. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with the random effects model. A total of 17 articles documenting 3 cohort and 14 case-control studies containing 14,667 PC cases and 17,587 pancreatitis cases were included in this study. The pooled OR between pancreatitis and PC risk was 7.05 (95%CI: 6.42-7.75). Howeever, the pooled ORs of case-control and cohort studies were 4.62 (95%CI: 4.08-5.22) and 16.3 (95%CI: 14.3-18.6) respectively. The risk of PC was the highest in patients with chronic pancreatitis (pooled OR=10.35; 95%CI: 9.13-11.75), followed by unspecified type of pancreatitis (pooled OR=6.41; 95%CI: 4.93-8.34), both acute and chronic pancreatitis (pooled OR=6.13; 95%CI: 5.00-7.52), and acute pancreatitis (pooled OR=2.12; 95%CI: 1.59-2.83). The pooled OR of PC in pancreatitis cases diagnosed within 1 year was the highest (pooled OR=23.3; 95%CI: 14.0-38.9); and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%CI: 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively. Pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC; and the risk decreased with increasing duration since diagnosis of pancreatitis.

Association Between Gestational Diabetes Mellitus and Subsequent Risk of Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Cheng, Jing;Chai, Jing;Geng, Qing-Qing;Chen, Peng-Lai;Shen, Xin-Rong;Liang, Han;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4265-4269
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    • 2014
  • Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.

보건의료발전계획 수립의 시급한 필요성 (The Urgent Need to Establish the Plan for Development of Health and Medical Services)

  • 박은철
    • 보건행정학회지
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    • 제29권3호
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    • pp.245-247
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    • 2019
  • Although 19 years have passed since the enforcement of the Framework Act on Health and Medical Services, the Plans for Development of Health and Medical Services has not been established. This Plan is a 5-year basic long-term plan that covers the whole of health and medical services. This Plan should point to the direction of 30 long-term plans of healthcare, and this Plan should serve as a combination and coordination of 30 long-term plans and 22 related laws. The United States, the United Kingdom, and Japan have established long-term healthcare plans (4-, 10-, and 20-year plans, respectively). The long-term health plan of the United States has been approached bottom-up, those of the United Kingdom and Japan have been approached top-down. The rapid environmental changes that Korea is and will be experiencing emphasize urgently the need for establishing the Plan for Development of Health and Medical Services.

의료서비스 선택과 비급여 의료비 부담: 일본 혼합진료금지제도 고찰 (Choices of Medical Services and Burden of Health Care Costs: Japanese Prohibition of Mixed Treatment in Health Care)

  • 오은환
    • 보건행정학회지
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    • 제31권1호
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    • pp.17-23
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    • 2021
  • With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.