• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.49-59
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• 2022

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.180-188
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• 2011

Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.207-213
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• 2014

How to eliminate health disparity to ensure health equity is one of major issues that are handled across the world. The purpose of this study was to examine any possible differences in self-rated oral health state according to socioeconomic status and the relationship between the two based on the data of the 5th National Health & Nutrition Examination Survey of 2010~2012. As for differences in self-rated oral health state according to sociodemographic characteristics, the women considered themselves to be in poorer oral health than the men. The older respondents found themselves to be in poorer oral health, and there was a tendency that the respondents who were less educated and whose household income was smaller rated their own health as worse. When a logistic regression analysis was made to determine influential factors for self-rated oral health status, the women perceived they were in better oral health than the men did, and the better-educated respondents were more likely to consider themselves healthier. Concerning disparities in self-rated health state according to income level, there were broader differences in that regard according to an increase of income. The findings of the study illustrated that there was oral health inequity according to social stratum. It's required to make a nationwide effort to promote national oral health, and appropriate support should especially be provided for disadvantaged people at the same time in order to get rid of the gap in oral health among different social classes, as there is a yawning gap between them and the other classes.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.435-445
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• 2017

This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.

• Journal of agricultural medicine and community health
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• v.36 no.2
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• pp.130-142
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• 2011

Objectives: This study was conducted to develop a participatory learning process and apply it to community empowerment for health promotion. Methods: The participatory learning sessions were composed of three stages according to the modified Freirean model of empowerment education. Stage 1 of generating themes (listening stage) was replaced with a community health forum. Stage 2 of problem-posing was executed via a two-session small group brainstorming discussion for selecting priority community health problems and strategies to solve them. Stage 3 of act-reflect-act, the implementation of the chosen strategies, is ongoing. We tested the feasibility of the participatory learning processes in the pilot programs for health education. Then, 14 Myeon (or Dong) Health Committee members used them in Health Plus Happiness Plus projects for community empowerment to achieve health equity in Gyeongsangnam-Do, Korea. Results: In the pilot program for feasibility, more than 80% of the 95 participants gave positive responses to evaluation questionnaires after three or four participatory learning sessions. Health Committee members successfully selected various strategies relevant to their communities with facilitation, but without any teaching from outside professionals. Conclusions: We successfully applied the participatory learning process to health promotion. However, more studies are warranted to evaluate its long-term applicability.

• Health Policy and Management
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• v.29 no.3
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• pp.342-356
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• 2019

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

• Health Policy and Management
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• v.28 no.3
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• pp.226-232
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• 2018

The objectives of this study were to evaluate the current state of governance structure and management of the health system to achieve the goals of the health system in South Korea, and to propose reform plan. This study drew implications from the governance of United Kingdom, Germany, and Netherlands, based on the principle of health system proposed by World Health Organization. The presidency and the health ministry should make macroscopic decision-making. The government has to decentralize the enforcement by municipality to operate public health and national health insurance (NHI), and to distribute the centralized NHI fund by municipality. The front line health centers and community centers should provide integrated health and social services. The government has to establish diversified regulatory bodies to enhance both the patient-centered care and the efficiency and equity of health care, and to provide mechanisms for ensuring autonomy of providers. The governance of the health system should be composed of the centralization of macro decision-making, the decentralization of implementation by municipality, the integration of health and social services on the front line, and the well-balanced regulation and autonomy on both consumers and suppliers.

• Health Policy and Management
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• v.15 no.3
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• pp.17-39
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• 2005

Social solidarity, equity in financing, and efficiency in administration have been core issues in the development of Korean health insurance reformation since 1988. This study is to investigate the trend of administrative cost in Korean National Health Insurance from various aspects. For the analysis of administrative cost, the expenditures of each insurance society and the National Health Insurance Corporation are divided into 4 items of (1) insurance benefit, (2) administrative cost, (3) an agency provision accounts, (4) other expenses, and then they are reorganized. The analyses based on 5 types of the health insurance administrative cost showed that efficiency in administration has been improved generally. We, however, should consider qualitative aspects such as customer's satisfaction with health insurance administration, prompt service, control of unjust expenditure (unjust claims), and provision of medical service including health consultation in assessing efficiency of administration. And, in order to connect the administrative costs of health insurance with efficiency, we need to give a fundamentally new definition, which can contain elaborateness of expenditure in details including the structure and evaluation method of administrative costs. It may be necessary to develop new indicators or analyzing methods hereafter.

• Journal of Korean society of Dental Hygiene
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• v.24 no.1
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• pp.17-26
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• 2024

Objectives: This study aimed to analyze the relationship between the socioeconomic status and oral health of adults. Methods: Data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018) were analyzed, and 13,199 adults aged 19 years or older were selected as study subjects. Various oral health indicators were used to analyze the effect of socioeconomic status on oral health. Disparities in oral health according to socioeconomic status were analyzed using the complex sample chi-squared test and multiple logistic regression analysis. Results: A statistically significant difference was observed between income level, medical aid, and all oral health indicators, which indicated that the lower the income level, the lower the oral health level (p<0.001). Furthermore, all oral health indicators displayed statistically significant differences, with the exception of the prevalence of dental caries and education level. The lower the education level, the lower the oral health level (p<0.001). Therefore, the oral health level of adults presented significant differences according to different socioeconomic status indicators. Conclusions: To prevent oral health inequalities, the government and local governments need to intervene not only in the field of health care but also in the social determinants. Additionally, concerted efforts should be made to eliminate oral health disparities by improving policies and systems.

• Journal of the Korean Society of School Health
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• v.36 no.3
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• pp.71-81
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• 2023

Purpose: This study aimed to investigate the trends in domestic research related to health literacy in children and adolescents. Methods: Six journal articles and four dissertations or theses related to health literacy in children and adolescents were analyzed according to the following criteria: study aim, research design, study population and sample size, sampling method, health literacy variables, and characteristics of health literacy measurement instruments. Result: The majority of studies focused on general children and adolescents. Correlational studies were most prevalent, while no experimental study was identified at all. The variable most frequently explored in relation to health literacy was health promoting behaviors. Functional health literacy instruments, assessing numeracy and reading comprehension, were most commonly used to evaluate child and adolescent health literacy. Conclusion: Considering the emphasis on health literacy improvement in order to achieve health equity across the entire life cycle, there is a need for both quantitative and qualitative growth in domestic health literacy studies for children and adolescents. School-based interventions are essential for enhancing health literacy. Furthermore, it is also necessary to develop an instrument to measure health literacy of children and adolescents that can be utilized and monitored at the national level.