• 제목/요약/키워드: Health policy evaluation

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Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

  • Kim, Taejae;Do, Young Kyung
    • Journal of Preventive Medicine and Public Health
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    • 제53권2호
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    • pp.82-88
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    • 2020
  • Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

한국 담배규제 정책의 평가: 담배규제정책 전문가 의견 조사를 토대로 (Evaluation of Tobacco Control Policy in Korea: Development and Application of the Korean Tobacco Index for Policy Monitoring and Evaluation)

  • 황지은;오유미
    • 보건행정학회지
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    • 제24권4호
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    • pp.342-348
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    • 2014
  • Background: Due to lack of regular and systematic evaluation tool, Korea's tobacco control policy has not been examined its overall process of implementation including efficiency and adequacy of the policies. This study developed policy monitoring and evaluation model to assess policy implementation and effectiveness of tobacco control in Korea. Methods: Based on World Health Organization operational manual for assessment, MPOWER (monitor tobacco use and prevention policies, protect from tobacco smoke, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising promotion and sponsorship, and raise taxes on tobacco) related policies were reviewed by rating policy efforts, programme management, people (human resources and their development), provision of organization, provision of fund and partnerships (range, 0 to 5). Results: As a result of the experts' assessment, overall Korean tobacco control policies scored 2.61 points, which is poor. In relation to each 'MPOWER' policies, 'W' scored the highest points (2.93), followed by 'O' (2.91), 'M' (2.87), 'P' (2.86), and 'E' (2.23). 'R' scored the lowest points of 1.87, meaning government efforts in tobacco price policy is insufficient. Conclusion: This study concludes that Korean tobacco control policy should strengthen tax and price measures, while programme infrastructure, people, and funds for policy enforcement should be secured. Furthermore, rather than focusing on one specific measure, a balanced approach reflecting various aspects of tobacco controls should be considered in order to decrease smoking rates and prevent smoking initiation.

보건소 건강증진사업 평가지표 개발 (Development of Program Evaluation Indicator : Community Health Center's Health Promotion Program)

  • 송현종;진기남
    • 보건행정학회지
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    • 제13권4호
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    • pp.1-27
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    • 2003
  • The purpose of this study was to develop the evaluation indicator for the health promotion programs of the Community Health Centers and to test its validity. The modified logic model was used as the evaluation model based on the literature reviews. Using this model, four dimensions, eleven sub­dimensions, and forty­one individual indicators were developed. These evaluation indicators are superior in reflecting the distinctiveness of the community health promotion programs, and also flexible enough to accommodate diverse programs. These indicators also emphasize the role of process evaluation, and the diversity of outcomes. To test content validity, survey method of experts in the community health promotion field was conducted. Eleven in three expert groups(professionals, practitioners in Community Health Centers, and policy makers) generally agreed with the validity of evaluation indicators. To examine criteria and construct validity, these indicators were used to evaluate the health promotion programs conducted by the 18 Key Community Health Centers. The data came from the interview surveys of the main health promotion practitioner and 30 visitors from each center. The ranks of these eighteen Community Health Centers were computed from these data. There was no significant difference in ranking either by these indicators or by the existing indicators, which was developed by Technical Support and Evaluation Team for criteria validity. There was no statistically significant difference in ranking between input, process and outcome dimensions. Based on these study results, evaluation indicators developed in this study are valid to evaluate Community Health Center's health promotion program. It can be used both by the Community Health Center for internal evaluation, and by the stakeholders for external evaluation.

Measures for a closer-to-real estimate of dietary exposure to total mercury and lead in total diet study for Koreans

  • Koh, Eunmi;Shin, Hyehyung;Yon, Miyong;Nam, Ji Woon;Lee, Yoonna;Kim, Dohee;Lee, Jeeyeon;Kim, Meehye;Park, Sung-Kug;Choi, Hoon;Kim, Cho-Il
    • Nutrition Research and Practice
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    • 제6권5호
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    • pp.436-443
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    • 2012
  • Previous Korean total diet studies (KTDSs) have estimated dietary exposure to toxic chemicals based on 110-120 representative foods selected from over 500 foods appeared in the Korea National Health & Nutrition Examination Surveys (KNHANES), which would result in a possible underestimation. In order to find measures for a closer-to-real estimate of dietary exposure to heavy metals, this study examined the feasibility of mapping foods to the representative foods in the KTDS by comparing estimates. In mapping, those foods not analyzed in the 2009 KTDS (443 out of 559 foods appeared in the 2007 KNHANES) were mapped to the 114 representative foods used in the 2009 KTDS based on the closeness in regards to biological systematics and morphological similarity. Dietary exposures to total mercury and lead were re-estimated using the content of total mercury and lead in 114 foods analyzed in the 2009 KTDS, food intake, and individual's own body weight for respondents in the 2007 KNHANES instead of mean body weight of Koreans used in the 2009 KTDS. The re-estimates of exposure with mapping were approximately 50% higher than the original estimates reported in the 2009 KTDS. In addition, mapping enabled the comparison of percentile distribution of the exposure among populations of different age groups. In conclusion, estimates via mapping resulted in a more comprehensive estimation of dietary exposure to heavy metals present in foods that Koreans consume.

문재인 대통령의 보건의료 공약과 과제 (Election Pledge and Policy Tasks of President Moon Jae-in in Healthcare Sector)

  • 신성식
    • 보건행정학회지
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    • 제27권2호
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    • pp.97-102
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    • 2017
  • On May 10, 2017, Moon Jae-in's Government launched. The election pledges of Moon's Government in healthcare sector were extracted from those of president election camp and Democratic Party. The main pledges were enhancing the coverage of healthcare costs, management of healthcare costs for elderly, restructuring the health insurance contribution system, and improving the public nature of healthcare system. There are many policy tasks to realize the electoral pledge, especially, financial task is main. The National Planning and Advisory Committee are setting the policy priorities and making the detailed plans. Although this paper deals the initial evaluation of main election pledges, the precise evaluation is needed for the final plan of healthcare policy.

보건의료 경제성 평가 방법론 고찰 -연구 설계와 비용 추정을 중심으로- (Critical Review of health care economic evaluation methodology : With a special reference to study design and cost estimation)

  • 이건세;;이상일;구혜원
    • 보건행정학회지
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    • 제14권2호
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    • pp.58-77
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    • 2004
  • Cost containment has become high political issues since financial crisis of the Korean Health Insurance fund in 2000. Korean Government has developed and implemented several measures to reduce the pharmaceutical expenditures. Pharmaceutical economic evaluation can be a tool in decision to allocate scare resource efficiently. In order to increase the quality of economic evaluation for pharmaceuticals, the Korean Health Insurance Review Agency(HIRA) is considering the development of a guideline for economic evaluation. It mandates that pharmaceutical companies could submit the result of an economic evaluation when demanding reimbursement of new pharmaceutical drugs. The purpose of this study is to provide a critical review of the economic evaluations of health care technologies published in the Korean context whether they have been performed according to current guidelines and therefore whether their results are directly useful for decision making. We found there exist important problems and deviation from, good practice' both in the general features of the studies, like the study design and perspective, and in terms of cost measurement and valuation. There are needs to develop clear guidelines and to educate and train researchers in performing economic evaluations.

환경성 질병부담을 활용한 생활공감 환경보건기술개발사업 건강 편익 평가 및 제언 (Evaluation of Health Benefit from the Environmental Health Action Program Based on the Environmental Burden of Disease)

  • 최용수;변가람;이종태
    • 한국환경보건학회지
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    • 제48권2호
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    • pp.123-129
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    • 2022
  • Background: The Environmental Health Action Program was a national project carried out from 2012~2021. It was aimed at developing public technologies to protect people's health from various environmental hazards. Objectives: One of the final goals of the project was "creating health benefits worth more than 179.2 billion won by reducing the environmental burden of disease." This study aims to evaluate whether the program sufficiently achieved the planned benefits. Methods: In order to secure consistency in evaluation, we applied the same equation used in the goal-setting process. It is comprised of six parameters to estimate the benefit: 1. The amount of medical expenses for environmental diseases; 2. The attributable proportion of environmental risk factors' 3. The rate of reduction in medical expenses for environmental diseases; 4. R&D project contribution; 5. The proportion of successful policy reflection; and 6. The contributions of the project. The corresponding variables were estimated at the end of the project, and the health benefits of the project were recalculated using the newly estimated variables. Results: It was estimated that a total of 195 billion won in health benefits occurred or will occur from 2015 to 2026. The main contributors for achieving the target were an increase in medical expenses for environmental diseases, a high score in the R&D project contribution, and the proportion of successful policy reflection. Conclusions: Technically, the equation used in the project is about medical expenses for environmental diseases rather than about the environmental burden of disease. There are several benefits of using the environmental burden of disease in the evaluation of public health policies. In further studies, developing a policy evaluation framework using indicators such as population attributable fraction would be needed.