Unprecedented amount of genetic information being generated from the result of Human Genome Project (HGP) and advances in genetic research is already forcing changes in the paradigm of health and disease. The ultimate goal of genetic medicine is to use genetic information and technology to develop new ways of treatment or even prevention of the disease on an individual level for 'personalized medicine'. Genetics is play ing an increasingly important role in the diagnosis, monitoring and management of common multifactorial diseases in addition to rare single-gene disorders. While wide range of genetic testing have provided benefits to patients and family, uncertainties surrounding test interpretation, the current lack of available medical options for the diseases, and risks for discrimination and social stigmatization may remain to be resolved. However an increasing number of genetic tests are becoming commercially available, including direct to consumer genetic testing, yet public is often unaw are of their clinical and social implications. The personal nature of information generated by a genetic test, its power to affect major life decisions and family members, and its potential misuse raise important ethical considerations. Therefore appropriate genetic counseling is needed for patient to be informed with the benefits, limitations and risks of genetic tests, prior to informed consent for the tests. Physician also should be familiar with the legal and ethical issues involved in genetic testing to tell patients how w ell a particular genetic risk factor relates with likelihood of disease, and be able to provide appropriate genetic counseling. Genetic counseling become a mandatory requirement as global standard for many genetic testing such as prenatal diagnosis, presymtomatic DNA diagnostic tests and cancer susceptibility gene test for familial cancer syndrome. In oder to meet the challenge of genetic medicine of 21 century in korean health care system, professional education program and certification board for medical genetics specialist including non-MD genetic counselors should be addressed by medical society and regulatory policy of national health insurance reimbursement for genetic counseling to be in place to promote the implementation of clinical genetic service including genetic counseling for proper genetic testing.
Kim, Young-Heung;Na, Seung-Il;Kim, Ji-Hyeon;Park, Yong-Jin
Journal of vocational education research
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v.37
no.1
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pp.101-118
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2018
The purpose of this study was to investigate the effect size of the difference of job satisfaction by type of employment by combining data from previous studies. For this purpose, the total of 95 articles analyzed. For the analysis of data, CMA(Comprehensive Meta-Analysis) 2.0 program was used and statistical significance was set at 5%(${\alpha}=0.05$). The main conclusions of this study are as follows. First, regular workers have higher job satisfaction than non-regular workers and the effect size of employment type is medium. Second, among five constituents of job satisfaction, the difference of wage and promotion satisfaction is greater than the difference of satisfaction in human relations, work and working environment satisfaction. Third, the job satisfaction of regular and non-regular workers differs according to the occupation areas. Fourth, there is a big difference in job satisfaction in financial, insurance, food and service occupation areas, and regular workers have higher job satisfaction than non - regular workers. On the other hand, non-regular workers have higher job satisfaction than regular workers in health, medical, social occupation areas.
Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.
Kang, Moon Hae;Park, Eun-Cheol;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Cho, Eun
Asian Pacific Journal of Cancer Prevention
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v.14
no.3
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pp.2059-2065
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2013
This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.
The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.
Objectives: The purpose of this study was to investigate career competency, tasks, and job satisfaction of public servants, public institutions, and researchers. Methods: The survey was conducted about career competency, job satisfaction, and satisfaction on work life. Next, they interviewed on the characteristics of each job by two or three dimensions. The following conclusions were obtained from July to August 2017. Results: Career competencies were GPA with 3.87, 818 points of TOEIC score, and ITQ certification. Public servants required the information on literacy skills for employment and job performance, while civil servants need more than one year of clinical experience in the dental hospital. The non-commissioned officer needed a written test and fitness training. The health insurance review and assessment center required more than one year of experience from general hospital or medical institutions. Researchers required a research career, language skill, and professors required research and teaching experiences with clinical experience more than three years. The main job tasks were as follows; for public servants, they were official document processing and community projects. For the civilian workers and military/noncommissioned officers, they were medical assistant and administrative works. The employees of the health insurance review and assessment service are examining the medical expenses and the medical examination, the researchers are experimenting, researching and writing articles, and the teaching staff are lecturing and conducting individual research. Conclusions: The results of job satisfaction survey showed that occupational satisfaction was the highest in civil servants, researchers, and teaching professions. Job security was the highest in health workers and health inspectors' evaluation centers, and time vacancy was the highest in civilian workers and military/noncommissioned officers. If you want to work in such an institution, you should prepare elements that match your basic literacy and job specific characteristics. And we should try to increase the satisfaction of work even after work.
Choi, Minji;Joo, Hye Jin;Kim, Taehyun;Beck, Sang Sook;Chung, Woojin
Health Policy and Management
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v.32
no.2
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pp.190-204
/
2022
Background: In Korea, the population is rapidly aging, and the types of households for the elderly are also diversifying. The self-rated health of the elderly is a valuable health indicator that can comprehensively represent the overall quality of life along with physical, mental, and functional health. On the other hand, studies on the association between household type and self-rated health of the elderly are still insufficient. Thus, this study analyzed the association between household type and self-rated health by gender in Korean older adults. Methods: Using data from the analysis of the National Survey of Older Koreans 2017, 10,299 elderly people aged 65 and over were targeted. For the accuracy of the analysis data, 9,910 people were selected as the study sample by excluding proxy responses, those diagnosed with dementia, and non-response. And technical analysis, univariate analysis using the Rao-Scott chi-square test, and logical regression analysis involving survey characteristics were conducted by gender. Results: According to the adjusted model with all variables, in both men and women, the odds ratio of self-rated health 'bad' in 'couple (with ill spouse)' was significantly higher than 'couple (with spouse)'. It was 2.54 (95% confidence interval [CI], 2.05-3.15) for men and 2.11 (95% CI, 1.70-2.62) for women. In addition, the odds ratio of self-rated health 'bad' in 'living with adult children' was 1.43 (95% CI, 1.09-1.87) for men and 1.42 (95% CI, 1.15-1.75) for women, which was more significant in women than men. Conclusion: This study states that there is an association between gender, household type, and self-rated health of the elderly, and the health of a spouse and cohabitation with children have a significant effect on self-rated health. As a result, in order to improve the health status of the elderly, health promotion and health care policies involving the characteristics of the elderly's gender and household type are needed.
Yang, Bong Min;Jo, Dae Sun;Kim, Youn Hee;Hong, Ji Min;Kim, Jung Soo
Clinical and Experimental Pediatrics
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v.51
no.9
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pp.977-986
/
2008
Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.
Kim, So Young;Park, Jong-Hyock;Kang, Kyoung Hee;Hwang, Inuk;Yang, Hyung Kook;Won, Young-Joo;Seo, Hong-Gwan;Lee, Dukhyoung;Yoon, Seok-Jun
Asian Pacific Journal of Cancer Prevention
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v.16
no.3
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pp.1295-1301
/
2015
Background: Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. Materials and Methods: The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. Results: In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Conclusions: Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.
Journal of the Korea Society of Computer and Information
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v.18
no.2
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pp.157-164
/
2013
Self efficacy is a term used in psychology, roughly corresponding to a person's belief in their own competence. It has been defined as the belief that one is capable of performing in a certain manner to attain certain goals. It is believed that our personalized ideas of self-efficacy affect our social interactions in almost every way. Understanding how to foster the development of self-efficacy is a vitally important goal for positive psychology because it can lead to living a more productive and happy life. The objective of this study is to show difference of the relationship between user and non-user in smartphone by self efficacy. For this purpose, we propose a research model which consists of 3type' self efficacy. For empirical test of this model, the sample data is collected from employee in a company and divided into two groups by user and nonuser. By multi-group analysis, we show two groups are different from each other in the relationship between user and nonuser of smartphone. Results show difference of the relationship smartphone user and non-user's self-efficacy(self-control self-efficiacy and problem difficulty preference).
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