• Health Policy and Management
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• v.25 no.1
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• pp.40-52
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• 2015

Background: The purpose of this study was to analyze the increase in Grade of Nursing Management Fee of medical institutions and establish a reasonable government policy by examining which factors affect the increase of nurse staffing. Methods: Analyzing data collected from the Health Insurance Review & Assessment Service resource management department with targets of 1,104 medical institutions. The study period was 5 years from June 30, 2008 to June 30, 2013. SAS ver. 9.2 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. The data was analyzed by a chi-square test and also conducted muiltivariate logistic regression analyses for variables of basic characteristics, human resource characteristics, and material resources. Results: Adjusted odds ratio (AOR) of the rise in Grade of Nursing Management Fee among other hospitals compared to hospitals owned by government or universities was 0.264. The AOR in hospitals established after November 2006 compared to those before June 1995 was 2.383. The AOR in Gangwon, Chungcheng South, and Jeolla South Provinces compared to Seoul was 0.084, 0.036, and 0.194, respectively. The AOR in hospitals with more than 6.75 specialists per 100 beds compared to those with less than 6.75 specialists per 100 beds was 7.514. The AOR in hospitals with more than 17.48 nurse per 100 beds compared to those with less than 17.48 nurse per 100 beds was 3.300. The AOR in hospitals with 50% to 75% bed utilization, 75% to 90% bed utilization and more than 90% bed utilization compared to those with less than 50% bed utilization was 5.428, 9.884, and 10.699, respectively. The AOR in hospitals with one magnetic resonance imaging (MRI) and more than two MRI compared to those with no MRI was 2.018 and 2.942, respectively. Conclusion: This result has showed policies to induce the rise in Grade of Nursing Management Fee among old hospitals and the incentive system for local medical institutions are needed. Also we need to develop a governmental policy for medium-small hospitals with low operation rate of beds and insufficient medical personnel and number of equipment in hospitals.

• Journal of Multimedia Information System
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• v.7 no.2
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• pp.147-156
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• 2020

The author Nakajima was involved in the field of disaster communications and emergency medical care as guest research scientist at the Fukushima Nuclear Accident Independent Investigation Commission established by the National Diet of Japan and reviewer of the Commission's report, and Kurokawa was the chairman of this Commission. Looking back over a decade, we are on the liability issue of bureaucrats and telecom operators, so it's becoming clear what was hidden at the time. The battery of NTT DoCoMo's mobile phone repeaters had a capacity of only about 24 hours, and communication failures increased after one day. The Government also failed to issue an announcement of "Vent from reactor" under the Telecommunications Act Article No. 129. This mistake lost the opportunity to use the third-party telecommunications (e.g. taxi radios). Furthermore, as a result of LASCOM (telecommunications satellite network for local governments via GEO) and a variety of unexpected communication failures, the evacuation order "Escape!" could not be notified to the general public well. As a result, the general public was exposed to unnecessary radiation exposure. Such bureaucratic slow action in emergencies is common in the response to the 2020 coronavirus.

• Health Policy and Management
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• v.32 no.2
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

• Korea Journal of Hospital Management
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• v.11 no.3
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• pp.56-72
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• 2006

This study aims to deal with hospital staff's recognition on the opening of the medical services market, their attitude to the opening - agreement and disagreement, and their intention to use a foreign hospital or to consult its doctors again. It was conducted for 450 employees of one university hospital located in Gyeonggi Province, Korea with systemized questionnaires. The main results of this study are as follows: First, Medical technicians showed the highest level recognition on the opening of the medical services market. Second, The percentage of agreement to the opening was the highest for medical technicians and lowest for doctors while that of agreement was the highest for doctors and lowest for nurses. For residents, among doctors, the percentage of disagreement was the lower than that of agreement. Third, the intention to use a foreign hospital and to consult its doctor again was the lowest for medical engineers and the highest for doctors. Fourth, The most urgent task for local hospitals to accomplish in response to the opening was the improvement of the diagnosis and treatment technologies for nurses, and the improvement of the service provided by the hospital staff for the others. For doctors, in particular, the improvement of the diagnosis and treatment technologies was just the fourth urgent task. In conclusion, the result varies to the type of occupation. Apparent difference was found for doctors, in particular, that seem to be directly affected by the opening of medical services market. Local hospitals and doctors, therefore, should make efforts together to improve the diagnosis and treatment technologies. All the hospital employees of every type of occupation, meanwhile, need to prepare for the opening with medical service of improved quality.

• Journal of Preventive Medicine and Public Health
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• v.30 no.1 s.56
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• pp.195-207
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• 1997

High price equipment is one of the major factors that increases national health expenditure in developed countries. Computerized Tomography(CT), one of the important high price equipment, has been concerns of health service researchers and policy makers in many countries. In Korea, CT, first introduced in 1984, have spreaded nationwide with rapid speed. Though the Committee for Approving Import of High Price Medical Equipment, founded in 1981, tried to regulate the introduction of high price medical equipment including CT, the effort resulted in failure. The exact situation of diffusion of the high price equipment, however, was not yet investigated. We aimed at the description of the diffusion of CT in Korea and analysis of influencing factors on hospitals for the adoption of CT. We mainly used the database of CT, made in 1996 by the National Federation of Medical Insurance for the purpose of insurance payment for CT. Also characteristics of hospitals were gathered from yearbooks published by the central and local governments and by the Korean Hospital Association. We calculated the cumulative number of the CT per one million population year by year. In turn, multiple linear logistic regression was done to find out the contributing factors for the adoption of CT by each hospital. In the logistic regression model, it is regarded as dependent factor whether a hospital retained CT or not in 1988 and 1993. The major categories of the independent factors were hospital characteristics, environmental factors and competitive conditions of hospitals at the period of the adoption. The results are as follows: Number of CT scanners per one million persons in Korea marked more higher level compared with those of most OECD countries. Major influencing factors on the adoption of CT scanners were hospital characteristics, such as hospital referral level, and competitive condition of hospitals, such as number of CT scanners per 10,000 persons in each district where the hospital was located. In Korea, CT diffused with rather rapid speed, comparable with those of the United States and Japan. The major factors contributing on the adoption of CT for hospitals were competitive condition and hospital characteristics rather than regional health care need for CT. In conclusion, a kind of regulating mechanism would be necessary for the prevention of the indiscreet adoption and inefficient use of high price equipment including CT.

• Korean Journal of Acupuncture
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• v.34 no.2
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• pp.71-81
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• 2017

Objectives : The purpose of this paper is to clarify the social characteristics of the authors of Huangdi Neijing such as status, class, and political ideology. Methods : We analyze the Neijing text and the social order and historical situations in the Han dynasty. Results : Some authors of the Neijing were the local medical officers whose salary was 100~400shi. Their positions were medical craftsmen(yigong) or chief medical craftsmen(yigongchang). They would have published the Neijing after the administrative reforms(146-145 BCE) that began after the suppression of the Rebellion of the Seven Kingdoms. The bureaucrat yigong(chang) would have expected to participate in the public health policy of the empire or kingdom as an acupuncture expert. They would have also expected to contribute to the welfare and health of the privileged intellectual group and the public, hoping to ascend in status and class. Conclusions : By investigating the social characteristics of the authors who composed the Neijing, its various aspects would be newly understood.

• Journal of Korean Society of Rural Planning
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• v.28 no.1
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• pp.27-35
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• 2022

This study aims to establish the indicator system of the quality of life of rural residents and to estimate the weights among criteria or sub-criteria that constitute the indicator system of the quality of life using AHP(Analytic Hierarchy Process) method. Indicator system consists of four criteria, that is, health care, eduction & culture, living environment, and income and jobs. Each criterion include three sub-criteria that make up corresponding criterion. The results show that income and jobs was most highly evaluated among the four criteria. It was followed by health care, living environment, and eduction & culture. Among the total 12 sub-criteria, annual income was most highly evaluated, followed by medical service level, job satisfaction, and public transportation environment in terms of global weight which was deduced from expert questionnaire survey. This study implies that rural development policy needs to focus on increasing rural residents' income by creating good quality occupations and increasing the level of medical services, and expanding public transportation services in rural areas. This study has failed to collect local residents' opinions regarding their quality of life in spite of the efforts to reflect the opinions from various expert groups, which is the limitation of this study.

• Health Policy and Management
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• v.34 no.2
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• pp.106-119
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• 2024

Drug shortage is a persistent phenomenon that poses a public health risk worldwide and occurs due to a range of causes. The purpose of this study is to review key policies to prepare for and respond to drug shortages in selected countries, such as the United States, Canada, and some European countries in order to draw implications. This study reviewed the reports and articles derived from search engines and Google Scholar by using keywords such as drug shortage and stock-out. Over the last decade or so, the United States have strengthened requirements on advance notification for disruption and interruption of drug manufacturing, established the Inter-agency Drug Shortages Task Force to promote the communication and coordination of responses, and expedited drug regulatory processes. Similarly, Canada established the Multi-Stakeholder Steering Committee on drug shortages by involving representatives from central and local governments and private sectors. Canada also adopted a tiered approach to the communication of drug shortages based on the assessment of the severity of the shortage problem and released a detailed information guide on communication. In 2019, the joint task force between the European Medicines Agency and the Heads of Medicines Agencies issued guidelines on drug shortage communication in the European Economic Area. The countries reviewed in this paper focus on communication across different stakeholders for the monitoring of and timely response to drug shortages. The efforts to protect public health from the negative impact of the drug shortage crisis would require multi-sectorial and multi-governmental coordination and development of guidelines.

• Ocean and Polar Research
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• v.29 no.4
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• pp.319-326
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• 2007

Coastal marine ecosystems continue to suffer unrelenting pressures from human population growth, increased development, and climate change. Moreover, these systems' capacity for self-repair is declining with such increases in anthropogenic production of various pollutants. What is the present health status or condition of the coastal ecosystem? If our coastal areas are unhealthy, which conditions are considered serious? To answer such questions, the United States, Canada, and Australia are currently assessing coastal ecosystem health using systematic monitoring programs as well as identifying and implementing management plans to improve the health of degraded coastal ecosystems. To evaluate marine environments, Korea is currently using a limited number of factors to estimate water quality. In fact, we are ill-prepared for assessing coastal ecosystem health because no biologically specific criteria are in place to measure the responses to various pollutants. We should select ecosystem-specific indicators from physicochemical stressors and evaluate the subsequent biological responses within each ecosystem. Furthermore, a set of practical indicators should be generated by considering the characteristics and uses of a local coastal area and the key issues at hand. The values of indicators should be presented as indices that allow understanding by the general public as well as by practitioners, policy makers, environmental managers and other stakeholders.

• Health Policy and Management
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• v.30 no.3
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• pp.418-429
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• 2020

Background: This study aims to analyze the cost and the length of stay (LOS) of acute myocardial infarction (AMI) patients with coronary artery stenting according to the characteristics of individuals and institutions. Methods: The data was collected from Korean National Health Insurance Service's customized database in 2010 and 2015. Chi-square test, t-test, analysis of variance, and multilevel analysis were performed. Results: The intraclass correlation coefficients for cost were 7.02% in 2010, 5.61% in 2015 and for LOS were 3.17%, 1.40%, respectively. The average costs were 9,067,000 won in 2010 and 9,889,000 won in 2015 (p<0.0001). However, the cost in 2015 was lower than the cost applying increased fee. The costs increased in aged 50-59 years, 60-69 years, and aged ≥70 years versus in aged under 49 years. The cost was higher in Charlson comorbidity index (CCI) 3 to 4 and ≥5 than in CCI 0. The costs were lower in male, medical aid recipients, metropolises, and local hospitals in other regions in 2010. LOS decreased from 8.1 days in 2010 to 7.4 days in 2015. It decreased in male, high income group, and the group of admission via emergency room. However, it increased in higher ages and medical aid recipients, and it also increased when CCI rose. The Internal Herfindahl Index was related to LOS in 2010. Conclusion: The variation of hospital level was small compared to the patient level. Therefore, it is important to implement applicable policies at the patient level in order to reduce cost and LOS of AMI patients.