• Journal of Preventive Medicine and Public Health
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• 제50권4호
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• pp.217-227
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• 2017

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

• 자원ㆍ환경경제연구
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• 제15권2호
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• pp.147-175
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• 2006

본 연구는 환경오염물질로부터의 건강위험에 대한 소비자들의 반응을 분석하는 데 중요한 세 가지 요소인 위험인지(perceptions), 자기보호행동(behavior) 그리고 가치평가(valuation)를 체계적으로 분석하고자 시도하였다. 소비자들의 수돗물 음용과 관련한 건강 위해 가능성에 대한 염려와 우려 수준에 영향을 미치는 요인들을 분석하고, 나아가서 건강상 안전한 음용수에 대한 소비자들의 선호를, 정책적으로 논란이 되고 있는 유해물질인 비소를 사례로 조건부행동접근법(contingent behavior method)을 적용하여 측정하였다. 전라북도 지방에 거주하는 500명의 소비자들을 대상으로 한 실증분석의 결과는, 대부분의 응답자들이 수돗물에 잔류된 유해물질로 인한 건강위험에 대해 상당히 우려하고 있었으며, 이러한 우려와 염려의 심각성이 산발적이고 임의적이라기보다는 나이, 성별 그리고 가족수 등 응답자들의 인구통계학적 특성에 따라 이질적이지만 체계적으로 반응하였다. 그리고 이러한 주관적인 위험인식은 또한 안전한 음용수에 대한 구매의도에도 영향을 미쳤다. 아울러 응답자들에게 제시된 객관적 건강위험정보는 단독으로는 영향을 미치지 않았지만, 실제 위험회피행동 여부를 나타내는 변수와의 상호작용이 허용되자 안전한 음용수의 선택에 유의한 영향을 미쳤다. 물론 실제 시장구매상황에서 익숙한 가격의 차이 역시 안전한 음용수에 대한 진술된 선호를 설명하는데 매우 중요한 변수였다. 또한 가상선택에 참여하지 않은 무응답자들을 제외할 경우 표본선택편의의 가능성이 통계적으로 유의하였고, 이러한 표본선택편의는 특히 가격변수의 계수추정치에 영향을 미쳤으며, 결과적으로 건강위험 감소에 대한 지불의사 추정치에도 영향을 미치는 것으로 나타났다.

• Nutrition Research and Practice
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• 제10권1호
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• pp.56-66
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• 2016

BACKGROUND/OBJECTIVES: Despite successes recorded in combating iodine deficiency, more than 2 billion people are still at risk of iodine deficiency disorders. Rural landlocked and mountainous areas of developing countries are the hardest hit, hence the need to explore and advance novel strategies such as biofortification. SUBJECTS/METHODS: We evaluated adoption, purchase, and consumption of iodine biofortified vegetable legumes (IBVL) using the theory of protection motivations (PMT) integrated with an economic valuation technique. A total of 1,200 participants from three land-locked locations in East Africa were recruited via multi-stage cluster sampling, and data were collected using two, slightly distinct, questionnaires incorporating PMT constructs. The survey also elicited preferences for iodine biofortified foods when offered at a premium or discount. Determinants of protection motivations and preferences for iodine biofortified foods were assessed using path analysis modelling and two-limit Tobit regression, respectively. RESULTS: Knowledge of iodine, iodine-health link, salt iodization, and biofortification was very low, albeit lower at the household level. Iodine and biofortification were not recognized as nutrient and novel approaches, respectively. On the other hand, severity, fear, occupation, knowledge, iodine status, household composition, and self-efficacy predicted the intention to consume biofortified foods at the household level; only vulnerability, self-efficacy, and location were the most crucial elements at the school level. In addition, results demonstrated a positive willingness-to-pay a premium or acceptance of a lesser discount for biofortification. Furthermore, preference towards iodine biofortified foods was a function of protection motivations, severity, vulnerability, fear, response efficacy, response cost, knowledge, iodine status, gender, age. and household head. CONCLUSIONS: Results lend support for prevention of iodine deficiency in unprotected populations through biofortification; however 'threat' appraisal and socio-economic predictors are decisive in designing nutrition interventions and stimulating uptake of biofortification. In principle, the contribution is threefold: 1) Successful application of the integrated model to guide policy formulation; 2) Offer guidance to stakeholders to identify and tap niche markets; 3) stimulation of rural economic growth around school feeding programmes.