• Health Policy and Management
• /
• v.31 no.3
• /
• pp.261-271
• /
• 2021

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

• The Journal of Health Technology Assessment
• /
• v.6 no.2
• /
• pp.95-99
• /
• 2018

As technologies develop, the digital health sector is gradually expanding. Internationally, the global summit for Digital Health named Global Digital Health Partnership (GDHP) was launched in 2018. Many countries are participating in GDHP and share their policy experiences on digital health and find the ways to cooperate with participating countries (13 countries, including South Korea, and Hong Kong). This article reviewed the international trends in digital health policy environment and evidence assessment focusing on GDHP activities, and derived implications for health technology assessment of digital health. Consequently, to assess the intervention effects of digital health is very complex and the assessment should be considered multidimensional aspects (social, clinical, and technical). In addition the patient experience should be assessed qualitatively. Health technology assessment (HTA) should assess the effect of digital health policies to changes in health care systems resulting from the application of advanced technologies related to the 4th Industrial Revolution. Digital health is also related to new HTA, HTA of existing technologies, and R&D on the promising health technology. Therefore, it is necessary to review the trends of the technology's management policy consistently through the HTA of digital health.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.33 no.1
• /
• pp.50-59
• /
• 2023

Objectives: This study was designed to examine the effect of risk assessment on employee safety behavior in manufacturing workplaces. In addition, this study attempted to explore factors related to the occupational safety and health system in the workplace affect the risk assessment of manufacturing sites. Methods: This research is a cross-sectional study using the Korea Occupational Safety and Health Agency's 2018 Occupational Safety and Health data. The sample for study is 1,967 manufacturing workplaces. Data were analyzed using descriptive statistics, t-test, ANOVA, chi-square test, and hierarchical multiple regression analysis using SPSS (ver.25.0). Results: As a result of the multiple hierarchical regression analysis, it was found that risk assessment had an effect on employee safety behavior (t=4.435, p=<.001). Furthermore, the size of the workplace affected employee safety behavior (t=2.494, p=<.001). In addition, the presence of safety and health management organizations affected employee safety behavior (t=4.301, p=<.001). The factors of the safety and health organization (𝑥²=35.245, p=<.001), the occupational safety and health committee (𝑥²=149.440, p=<.001), and the supervisor (𝑥²=16.472, p=<.001) were identified as factors that increased the possibility of risk assessment in the manufacturing workplaces. Conclusions: In this study, it was found that risk assessment is a factor that increases the level of workers' safety behavior in manufacturing workplaces. Therefore, it is necessary to provide institutional support for activating risk assessment at manufacturing workplaces.

• Journal of Environmental Health Sciences
• /
• v.37 no.1
• /
• pp.12-21
• /
• 2011

The objective of this study is to review retrospective exposure assessment methods used in wafer fabrication operations to determine whether adverse health effects including mortality or cancer incidence are related to employment in particular work activities and to recommend an appropriate approach for retrospective exposure assessment methods for epidemiological study. The goal of retrospective exposure assessment for such studies is to assign each study subject to a workgroup in such a way that differences in exposure within the workgroups are minimized, as well as to maximize the contrasts in exposure between workgroups. To reduce the misclassification of exposure and to determine if adverse health effects including mortality or cancer incidence are related to particular work activities of wafer fabrication workers, a minimum requirement of work history information on the wafer manufacturing eras, job and department at which they were exposed should be assessed. Retrospective assessment of the task that semiconductor workers performed should be conducted to determine not only the effect of a particular job on the development of adverse health effects including mortality or cancer incidence, but also to adjust for the healthy worker effect. In order to identify specific hazardous agents that may cause adverse health effects, past exposure to a specific agent or agent matrices should also be assessed.

• Korean Journal of Clinical Pharmacy
• /
• v.20 no.3
• /
• pp.242-247
• /
• 2010

Controlling inappropriate antibiotics prescribing for acute upper respiratory infections(URI) is a very important for prudent use of antibiotics and resistance control. Health Insurance Review and Assessment Service (HIRA) introduced Prescribing Evaluation Program and publicly reported antibiotics prescribing rate for URI of each health institution. We performed segmented regression analysis of interrupted time series to estimate the effect of public report on antibiotics prescribing rate using national health insurance claims data. The results indicate that just before the public report period, clinics' monthly antibiotics prescribing rate for URI was 66.7%. Right after the public report, the estimated antibiotics prescribing rate dropped abruptly by 12.3%p. There was no significant changes in month-to-month trend in the prescribing rate before and after the intervention.

• Journal of Environmental Impact Assessment
• /
• v.9 no.3
• /
• pp.185-202
• /
• 2000

Uncertainty and variability in Life Cycle Assessment(LCA) have been significant key issues in LCA methodology with techniques in other research area such as social and political science. Variability is understood as stemming from inherent variations in the real world, while uncertainty comes from inaccurate measurements, lack of data, model assumptions, etc. Related articles in this issues were reviewed for classification, distinguish and elaboration of probabilistic/stochastic health risk analysis application in LCA. Concept of focal zone, streamlining technique, scenario modelling and Monte Carlo/Latin Hypercube risk analysis were applied to the uncertainty/variability analysis of health risk in LCA. These results show that this general framework of multi-disciplinary methodology between probabilistic health risk assessment and LCA was of benefit to decision making process by suppling information about input/output data sensitivity, health effect priority and health risk distribution. There should be further research needs for case study using this methodology.

• The Korean Journal of Health Service Management
• /
• v.6 no.1
• /
• pp.185-193
• /
• 2012

This study is to observe the effect of oral health of elderly on overall health status and social activity to provide basic data for oral health improvement program for the elderly and development of related policies. The survey was conducted from July 25th to July 29th, 2011, and used 145 copies for this research analysis. As a result of correlation analysis, it is observed that all of 4 sub factors of Geriatric Oral Health Assessment Index have significant static correlation with overall health status of elderly and social activity also has significant static correlation with oral health. As a result of regression analysis, the functional limitation out of sub factors showed significant positive effect on health status and psychological effect has significant positive effect on social activity. Based on the above result, it is observed that, at the time of rapidly entering to an aging society, the life quality related to oral health of elderly which is part of overall health and overall health status and social activity areas that are recognized by the elderly have significant correlation. And, it is important to understand the factors of oral health affecting health status and social activity. Based on the result of this study, more researches on the development of oral health program and development of assessment tool that can be easily employed should be made.

• Journal of Environmental Impact Assessment
• /
• v.10 no.3
• /
• pp.211-221
• /
• 2001

Recognizing interaction between the environment and humans, the EIA(environmental impact assessment) movement has sought to promote more environmentally sound and informed decisions for the sake of human welfare. Therefore, most EIA programs require the consideration of human health impacts. Yet relatively few EIA documents adequately address those impacts. This study was carried out to investigate the role of EIA for reuniting the environment and human health, for preventing and reducing significant health risks, and for improving human health impact assessment by means of risk assessment. Risk assessment consists of 4 components; hazard identification, dose-response assessment, exposure assessment and risk characterization. Since most people spent their times in indoor, indoor air quality modelling can be used in exposure assessment and risk assessment. In this study, indoor $NO_2$ concentration and personal $NO_2$ exposure were estimated by Box Model using mass balance equation and time weighted average, respectively. The estimated indoor $NO_2$ concentration and the personal $NO_2$ exposure were compared by those measured, respectively. Subsequntly, health effect was assessed with these results. Consequently, exposure assessment and risk assessment using indoor air quality model may be considered to be applicable to EIA.

• Journal of Environmental Health Sciences
• /
• v.47 no.2
• /
• pp.155-165
• /
• 2021

Objectives: Acute exposure to high concentrations of chemicals can occur when a chemical accident takes place. As such exposure can cause ongoing environmental pollution, such as in the soil and groundwater, there is a need for a tool that can assess health effects in the long term. The purpose of this study was assessing the health risks of residents living near a chemical accident site due to long-term exposure while considering the temporal concentration changes of the toxic chemicals leaked during the accident until their extinction in the environment using a multimedia environmental dynamics model. Methods: A health risk assessment was conducted on three cases of formaldehyde chemical accidents. In this study, health risk assessment was performed using a multimedia environmental dynamics model that considers the behavior of the atmosphere, soil, and water. In addition, the extinction period of formaldehyde in the environment was regarded as extinction in the environment when the concentration in the air and soil fell below the background concentration prior to the accident. The subjects of health risk assessment were classified into four groups according to age: 0-9 years old, 10-18 years old, 19-64 years old, and over 65 years old. Carcinogenic risk assessment by respiratory exposure and non-carcinogenic risk assessment by soil intake were conducted as well. Results: In the assessment of carcinogenic risk due to respiratory exposure, the excess carcinogenic risk did not exceed 1.0×10-6 in all three chemical accidents, so there was no health effect due to the formaldehyde chemical accident. As a result of the evaluation of non-carcinogenic risk due to soil intake, none of the three chemical accidents had a risk index of 1, so there was no health effect. For all three chemical accidents, the excess cancer risk and hazard index were the highest in the age group 0-9. Next, 10-18 years old, 65 years old or older, and 19-64 years old showed the highest risk. Conclusion: This study considers environmental changes after a chemical accident occurs and until the substance disappears from the environment. It also conducts a health risk assessment by reflecting the characteristics of the long-term persistence and concentration change over time. It is thought that it is of significance as a health risk assessment study reflecting the exposure characteristics of the accident substance for an actual chemical accident.

• Health Policy and Management
• /
• v.21 no.1
• /
• pp.44-60
• /
• 2011

Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.