One of the ways to achieve the principle of equal access for equal needs, availability and geographical accessibility of health care resources regardless of resident sites is important. The purpose of this paper is to measure socioeconomic inequities in distribution of health care resources among regions in the Republic of Korea (hereafter Korea). Data were extracted from regional statistics of National Health Insurance, Community Health Survey, Korea Social Science Data Archive, and Korean Statistical Information Services at the same period of 2009. The dependent variables were the number of health workforce and health care facilities in each region. The proxy indicator of regional socioeconomic status was local tax per person. To identify whether inequalities among regions, we examined the concentration index(CI) and indirectly standardized CI by controlling each region's demographics and need factors. Total observations were 232 districts in nationwide, and we analyzed separately Seoul(25 districts) and non-Seoul areas(207 districts). The standardized CI values of health care resources were positive(favoring the rich region) across the nation in almost all kinds of resources. Especially the number of specialist, dentist, dental clinics, clinics, oriental medical clinics, pharmacists, and pharmacies were statistically significantly favoring the rich region. But the CI for the number of long-term care hospitals, public health centers were negative(favoring the poor region). The tendency of CI presenting positive values were increased in Seoul area. But in the case of non-Seoul, the CI indexes were nearly zero. The results suggest that except the Seoul area, little regional socioeconomic-related inequalities were observed in the distribution of health care resources in Korea.
Background & objectives: Understanding the awareness of policy targets and implementers about safety in the local community is the crucial to establish a systematic community safety policy. The purpose of this study was to identify the perception of local citizens and civil servants regarding community safety and its related factors. Methods: For achieving this research goal, this study conducted survey targeting 538 citizens and 404 civil servants in S-si, Kyunggi-do. Self-administred and web-based survey were used to collect data from April 1st to 16th 2021. Results: Civil servants scored higher in community safety perception than citizens, and S city's safety interest, information, and participation scores were also higher than those of citizens. Based on the results of multiple regression, thought about in interest of safety in S-si, providing and sharing about safety information to citizens, and participation of community safety policy were significantly associated with perception of community safety. Conclusions: Setting safety as the top priority in S city policy and paying attention to safety by the mayor, public officials, and city council members is an important way to raise citizens' awareness of local safety. Also, efforts at the city level are needed to foster safety knowledge through systematic education on safety.
Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.
Services, despite the difficulty of its exact definition, can be defined as deeds, efforts, or performances by economical bodies, attributing to four unique characteristics - intangibility, inseparability, heterogeneity, and perishability. This study aims to research the global competition and problems of the local professional services, especially educational services and health services, and to suggest some devices for increasing the exportation of both educational services and health services. Educational services and health services were reserved in the multilateral negotiation to open the WTO parties' markets because of its national public benefits. But it is indispensable to open our local market by the bilateral FTA negotiation. Legal restrictions, therefore, related to both education and health should be erased according to the basic rule of the market competition, and it is advisable to control the national public benefit of these services by enacting the different legal systems. For recovering from minus balance of payment in the educational services or health services, furthermore, it is necessary to drive rather some offensive exporting policies than the defensive policy against supply from the foreign countries. In conclusion, the korean Foreign Trade Act and other relative acts should be revised, and both educational services and health services should be contained within the definition of "the international trade" for the governmental benefits of supporting the services exportation.
Background: Financial efficiency in monetary units and operational efficiency in non-monetary units are separately classified and evaluated. This is done to prevent the duplication of monetary units and non-monetary units in inputs and outputs. In addition, analyses are conducted to determine the factors that affect each aspect of efficiency. To prevent duplication of monetary and non-monetary units in inputs and outputs, financial efficiency, consisting of monetary units, and operational efficiency, comprising non-monetary units, are separately classified and evaluated. Furthermore, an analysis is conducted to identify the factors that affect each aspect of efficiency. Methods: This study conducted a panel analysis of 34 regional public hospitals and influencing factors on efficiency for 5 years from 2015 to 2019. Financial efficiency and operational efficiency were calculated through data envelopment analysis. Moreover, multiple regression analysis was conducted to identify the factors that influence both financial efficiency and operational efficiency. Results: The factors that affect financial efficiency include the number of medical institutions within the treatment area and the ratio of patients receiving medical care. Additionally, operational efficiency is influenced by the type of medical institution, the number of medical institutions within the treatment area, and the number of nursing positions per 100 beds. Conclusion: In order for regional public hospitals to faithfully fulfill their functions and roles as regional base public hospitals, several measures are necessary. Firstly, continuous monitoring and reasonable support are required to ensure efficient operation and performance. Secondly, a financial support plan tailored to the characteristics of local medical centers is needed. Additionally, local medical centers should strive to enhance their own efficiency.
The development of transport is being easily shared with people all over the world. It is necessary to appropriately and effectively revise the domestic quarantine law because the fatal infectious diseases are at risk of being easily shared. Today, Korea has an advanced quarantine system approved by World Health Organization, but it maintains partnerships with related ministries (Ministry of Foreign Affairs, Ministry of Justice, local medical institutions) and to introduce new medical technology (electronic quarantine) is important. And since the prevention of quarantine infectious diseases and prevention of the spread, in order to maintain international cooperation with the International Health Regulations, the quarantine law and the system should be amended and improved effectively and it is also a way to prepare for the outbreak of new quarantine infectious diseases. In the past, Korea has experienced great confusion during the past outbreak of swine flu and Middle East respiratory syndrome coronavirus. To prevent similar cases from recurring in the past, the revision of the quarantine law and the improvement of the system should be done to cope with the changing environment (new infections, increased number of overseas travelers, etc.).
Background: This study aims to explore the effects of quality of care, image, and role performance perceived by community residents on medical service satisfaction to public hospitals. Methods: The subjects of this study were selected in the community residents around 39 district public hospitals. The questionnaire were included 4 factors and 16 items. The data were collected utilizing call-interview by a survey company. Results: The community satisfaction was positively correlated with quality of care, image, and role performance of public hospitals (p<0.001). As the results of multiple logistic regression, the significant variables of community satisfaction were quality of care (odds ratio [OR], 1.353; 95% confidence interval [CI], 1.211 to 1.511), image (OR, 1.487; 95% CI, 1.280 to 1.727), role performance (OR, 1.240; 95% CI, 1.085 to 1.416) among subjects having use experience of public hospitals. The significant variables of community satisfaction were quality of care (OR, 1.240; 95% CI, 1.175 to 1.309), image (OR, 1.328; 95% CI, 1.232 to 1.432), age (OR, 3.051; 95% CI, 1.385 to 6.724), monthly incomes (OR, 0.420; 95% CI, 0.198 to 0.892) among subjects not-having use experience of public hospitals. Conclusion: Public hospitals have to effort to improve image and satisfaction of community through providing quality of care, and role performance. It is possible to support them by the central and local government.
Objectives: This study examined the impact of a smoke-free policy on indoor air quality at indoor recreation facilities by assessing $PM_{2.5}$ concentrations before and after the implementation of the new policy. Methods: Using real-time monitors, $PM_{2.5}$ concentrations were measured in 50 billiard rooms and 50 golf simulator rooms in Seoul, Korea. The characteristics of the indoor recreation facilities, smoking status, and atmospheric conditions were recorded at the same time.After the enforcement of a smoke-free policy, $PM_{2.5}$ concentrations, installation of smoking room, and smoking status were examined when the facilities were revisited. Results: Almost a half of the billiard rooms and over 80% of golf simulator rooms were located underground. Seventy percent of the billiard rooms and one hundred percent of the golf simulator rooms were equipped with a local exhaust ventilation system. After the implementation of the smoke-free policy, 46% of the billiard rooms and 20% of the golf simulator rooms newly installed a smoking room. In the billiard rooms with a newly-installed smoking room, the $PM_{2.5}$ concentrations decreased from 97.9 to $45.6{\mu}g/m^3$ after the implementation of the smoke-free policy. The same change of 29.0 to $ 26.3{\mu}g/m^3$ was not statistically significant in golf simulator rooms. Indoor $PM_{2.5}$ concentrations were correlated with outdoor $PM_{2.5}$ concentrations, number of smokers, and number of people in the room. Conclusions: The smoke-free policy for indoor recreation facilities was not effective at making the indoor spaces free from second hand smoke. Although a few billiard rooms installed a smoking room, indoor $PM_{2.5}$ concentrations were still higher than those of outdoor $PM_{2.5}$ or atmospheric $PM_{2.5}$. Stricter enforcement of the smoke-free policy should be achieved to prevent secondhand smoke exposure.
Since 1996, the Health Promotion Programme spearheaded by the Korean Central Government has been actively developing and recently, the Healthy City Project led by the local autonomous entities have also been actively promoted. Healthy City is one in which the health and well-being of the citizens are given the utmost importance in the decision-making of the city. While the Health Promotion Programme focuses on changing the "health behavior" of the people, the Healthy City Project, a policy to improve the existing inequality of public health services, deals with more essential health factors and requires political support as well as a new organization. The Healthy City paradigm based on the New Public Health started in England and ever since the Healthy City Model Project spearheaded by the EURO WHO began in 1986, the Alliance for Healthy Cities centered in the West Pacific region supported by the WHO in Oct 2003 was inaugurated. 19 Korean cities are full members of the Alliance for Healthy Cities and 2 laboratories are associate members. The Ministry of Health and Welfare has held the Healthy City Forum consisting of related officials, experts and representatives of civic bodies on 6 occasions since Dec 2005. The need for adequate administrative and financial support from the Central Government to the local autonomous entities governing the Healthy Cities was raised. It is hoped that this Healthy City Project will bring about the improved health conditions of the people as well as promote the equality of the public health services.
Objectives : The purpose of this study is to analyze the factors affecting the enactment of local municipalities' ordinance for supporting Korean Medicine infertility treatment in the metropolitan area. Methods : For Seoul, Incheon, and Gyeonggi Province, data on the enactment of Korean Medicine infertility treatment and socio-demographic data of the local municipalities were collected through the Enhanced Local laws and regulations Information System and on-line statistical database. Logistic regression analysis was performed to analyze the factors affecting the enactment of the ordinance, The enactment of the ordinance was dependent variable, and the budgeting of local municipalities, the number of population, the number of births, the number of Korean Medicine doctors, and the total fertility rate were used as independent variables. Results : Up to 2000, the ordinances for supporting Korean Medicine infertility treatment were enacted in 16 local municipalities and the budget for that was supported by 18 local municipalities. Regarding the effect on the enactment of the ordinances, it was found that budgeting of Korean Medicine infertility treatment had a positive (+) effect, and the metropolitan government's budgeting and the total fertility rate had a negative (-) effect. Conclusions : This study suggests that the ordinance for Korean Medicine infertility treatment is a policy tool derived based on the problem of low fertility faced by each local municipality rather than the political influence of health provider's groups.
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