• 대한예방한의학회지
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• 제12권3호
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• pp.141-155
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• 2008

Traditional, complementary, and alternative medicine(CAM) constitutes a major source of health care in developing countries. Its therapies, products and practices are increasing used in industrialized countries, typically by around 50% of the population. However, controls on the provider of CAM services and supply and promotion of complementary medicines are weak in these countries. These trends evoke important public health questions relating to benefits and detriments, safety and quality from medical, financial, and social perspectives. In the western counties, investment in research is increasing, and some guideline is now available for ensuring their quality, efficacy, and safety according to the criteria of evidence-based medicine as legally demanded. National policies and legislation are being developed in many countries and often include partnerships between biomedical and traditional health practitioners. The purposes of the study were to review the policies on CAM, to examine the responses of the government to cope with use of CAM in industrialized countries. Lastly, some implications and recommendation are suggested.

• 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.

• 대한지역사회영양학회지
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• 제9권6호
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• pp.742-752
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• 2004

The purpose of this study is to offer information related to recommended dietary allowances for young children and food guidelines for preschool children in Sweden. Sweden, located in Europe, is the most developed country for young child care system. Swedish nutrition policy background, Swedish recommended dietary allowances for young children, and food guidelines of early childhood education center in Sweden were used. The number of Swedish child care centers increased from 70,000 in 1970 to 700,000 in 2000. The Swedish Institute of Public Health promoted children's indoor and outdoor activity. The aim of the Swedish public health contains children's safety, good food habits, and eating food safely. Swedish Food Administration made recommended dietary allowance and food guidelines for children care centers. The aim of food guidelines was to increase energy, calcium, iron, and dietary fiber intake. Swedish RDA contains minimum and maximum intake as well as mean intake for macro and micro nutrients. The fat intake ratio of energy is increased for younger children. For preschool children, the food guideline is determined by dietary allowances for breakfast, lunch, and snack respectively. Food guideline contains meal time schedule, menu for each meal using food model, amount of food for age group, and recommended dietary allowance for each meal. It is recommended for Korean early childhood education center: 1) Korean RDA for young children should be made range of intake, minimum and maximum intake. 2) Food guideline should be make for Korean child care center. 3) Korean child care centers should offer an afternoon snack twice for children who return home late. 4) Nutrition education program for preschool teachers should be developed for children's good eating habits and health promotion.

• 대한한의학회지
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• 제40권3호
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• pp.59-75
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• 2019

Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

• 한국학교보건학회지
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• 제23권2호
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• pp.172-180
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• 2010

Purpose: To analyze the current status of health education and problems of elementary, middle, and high schools by national health education guideline. Methods: Study subjects were 991 school health teachers of elementary, middle, and high schools in one province and the data was collected by mail. The data was analyzed by $x^2$-test and Fisher's exact test. Results: The rates of school health education implementation were 99.6% in elementary school, 98.1% in middle school, and 96% in high school. The rates of school health education were reported much higher than former studies. The most barrier in providing school health education was 'health room management during health education'. During health education by school health teachers, the health rooms were managed by other teachers in elementary schools or by locking the health room with announcement memo in middle and high schools. Conclusion: To improve the school health education, higher school health teacher placement and administrative supports for health clinic were recommended.

• 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.

• 보건행정학회지
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• 제22권1호
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• pp.145-162
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• 2012

The purpose of this study is to understand magnitude and its related factors of user's cost-sharing for non-covered services in long-term care facilities. We corrected data for 1,016 subjects, based on the long-term care benefits cost specification. Eighteen subjects were excluded from the data analysis due to missing data on family care-givers characteristics. Finally, 998 subjects were included in the study. The average cost of non-covered services per month was 209,093 won and distributed from 0 to 1,011,490 won. There was a significant difference by the characteristics of family care-givers and long-term care facilities. The monthly average cost for meal materials per person was 199,181 won(0~558,000), average cost of additional charge caused by using private bed was 232,992 won (50,000~600,000), and costs for haircut and cosmetics were 8,599 won. For the rest, there were various programs costs(93,328 won), diaper and its disposal cost(109,628 won), purchase cost for daily necessaries(24,435 won) and etc. The related factors for the magnitude of non-covered services expenditures were education level of family care-givers, occupancy rate and location of LTC facilities, and the costs of using private bed, haircut and cosmetics, and various programs among non-covered services. These findings suggest that present level range of LTC facilities users' cost-sharing is wide and it is urgent to prepare the standard guideline for cost and level in non-covered services.

• Journal of Radiation Protection and Research
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• 제47권1호
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• pp.1-7
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• 2022

Background: In Japan, new regulations that revise the dose limit for the lens of the eye (hereafter the lens), operational quantities, and measurement positions for the lens dose were enforced in April 2021. Based on the international safety standards, national guidelines, the results of the Radiation Safety Research Promotion Fund of the Nuclear Regulation Authority, and other studies, the Working Group of Radiation Protection Standardization Committee, the Japan Health Physics Society (JHPS) developed a guideline for radiation dose monitoring for the lens. Materials and Methods: The Working Group of the JHPS discussed the criteria of non-uniform exposure and the management criteria set not to exceed the dose limit for the lens. Results and Discussion: In July 2020, the JHPS guideline was published. The guideline consists of three parts: main text, explanations, and 26 examples. In the questions, the corresponding answers were prepared, and specific examples were provided to enable similar cases to be addressed. Conclusion: With the development of the guideline on radiation dose monitoring of the lens, radiation managers and workers will be able to smoothly comply with revised regulations and optimize radiation protection.

• 보건행정학회지
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• 제20권2호
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• pp.1-16
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• 2010

Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

• 간호행정학회지
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• 제13권3호
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• pp.352-361
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• 2007

Purpose: The purpose of this study was to develop roles and organizational policy of advanced practice nurses (APNs) in an acute hospital setting. Method: The design of the study was to descriptive-exploratory. Sample consisted of 43 participants who included 13 nurses, 18 nurse managers and 12 physicians. Survey, interview and focus group interview were performed to obtain the data. Results: The expected roles of APNs were education and counseling, direct management patient care with advanced skills, research, and collaboration and coordination among several departments. The expected outcomes were patient satisfaction, improved access to care, decreased the rate of complications, and speedy provision of services. Based on research, a proposal of APNs roles and organizational policy in a hospital setting was developed, which included definition of APNs, qualification, roles and specific roles, specialty areas, accountability, recruitment and affiliation, privileges, and expected outcomes. Conclusion: This study gives a guideline on how to introduce and use APNs in acute care tertiary settings.