• Journal of Preventive Medicine and Public Health
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• v.41 no.4
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• pp.255-264
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• 2008

Objectives: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. Methods: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. Results: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. Conclusions: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

• Health Policy and Management
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• v.21 no.1
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.276-288
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• 1999

Objectives: This study was performed to determine the relationships among health concern, health practice and health status of the disabled. Methods: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. Results: Health concern had a significant and positive relationship with health practice(p<0.05) and health practice also had a significant and positive relationship with self-rated health status(p<0.05) in men and women. To determine the structural model of the Health concern, health practice, health status and sociodemographic variables, the covariance structural analysis was used. In men, age, economic status, medical security type, educational level and type of disability had significant direct effects on Health concern(T>2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect or health status(T>2.0). In men and women, health practice was significantly increased with increasing health concern and the more health practice, the higher health status(T>2.0). Conclusions: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.

• Journal of Preventive Medicine and Public Health
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• v.55 no.5
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• pp.464-474
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• 2022

Objectives: We introduced the cohort studies included in the Korean Cohort Consortium (KCC), focusing on large-scale cohort studies established in Korea with a prolonged follow-up period. Moreover, we also provided projections of the follow-up and estimates of the sample size that would be necessary for big-data analyses based on pooling established cohort studies, including population-based genomic studies. Methods: We mainly focused on the characteristics of individual cohort studies from the KCC. We developed "PROFAN", a Shiny application for projecting the follow-up period to achieve a certain number of cases when pooling established cohort studies. As examples, we projected the follow-up periods for 5000 cases of gastric cancer, 2500 cases of prostate and breast cancer, and 500 cases of non-Hodgkin lymphoma. The sample sizes for sequencing-based analyses based on a 1:1 case-control study were also calculated. Results: The KCC consisted of 8 individual cohort studies, of which 3 were community-based and 5 were health screening-based cohorts. The population-based cohort studies were mainly organized by Korean government agencies and research institutes. The projected follow-up period was at least 10 years to achieve 5000 cases based on a cohort of 0.5 million participants. The mean of the minimum to maximum sample sizes for performing sequencing analyses was 5917-72 102. Conclusions: We propose an approach to establish a large-scale consortium based on the standardization and harmonization of existing cohort studies to obtain adequate statistical power with a sufficient sample size to analyze high-risk groups or rare cancer subtypes.

• Journal of Society of Preventive Korean Medicine
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• v.8 no.2
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• pp.99-113
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• 2004

Problems and current situation of public health globally and domestically were analyzed in this study and based on these findings, ways to improve from western medicine and Oriental medicine can be deduced as follows: 1. Current problems of public health in Korea and the world 1) Increase of diseases resulted from daily habits and infectious diseases, many are at the brink of being ill. Quality of life from extended life span and unbalanced health care must be solved. 2) Natural and societal factors including host factors, public health service, and other external and internal factors play an important role in deciding healthy and being ill. 3) Some of the limits and problems of modem medicine include insufficient academic knowledge and incomplete theory, as well as misled approach to the treatment. Human itself isn't perfect organism and other realistic problems hinder one's well-being. 4) Regardless of western medicine or Oriental medicine, patients were approached as someone with diseases and disorders, and wholistic approach was disregarded. Lack of clinical training, absence of clear educational philosophy and goal are some of the reasons why the education isn't under concrete system 2. Important factors for the medical education and proper direction for the education of Oriental medicine 1) Important factors for medical education - Education should not be limited on the human health and illness, but also cover qualities such as well-being, social welfare, service, and happiness. Every aspects of human life must be considered and attended for more productive outcome. - Basic understanding of humanity must be included in the educational curriculum - Foundation of human diseases and pain are associated with inner life and surrounding causes including family, society, nature, race, culture, religion, politics, and etc., thus the education must be approached to recognize aforementioned criteria. 2) Proper direction for the education of Oriental medicine - Values of Oriental medicine for medical principles and importance of lifehood must be educated. - Educational goal, limits, and levels must be established for the school of Oriental medicine - Respect for life must be the top priorities of educational direction which should lead to solution based education for the human health. Latest medical theory and technology should be accommodated as well as prevention, treatment, and balancing of basic courses and clinical training for optimal education.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.69-78
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• 2016

Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

• Journal of Korean Society of Disaster and Security
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• v.5 no.1
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• pp.1-6
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• 2012

This study analyzed the direct costs of fall accidents, which have the highest accident rate, for domestic construction industry workers. Firstly, the average insurance payment per person due to fall accidents in the construction industry is around 19 million won (18,971,000 won). Given that the average number of workers suffering fall accidents over ten years is 5,863, the total cost of losses from fall accidents is about 1.1 trillion won (111,360,000,000 won). Secondly, a cost-based economic feasibility analysis was done to develop nonstructural preventive measures for fall accidents. Since there was no data expressing the costs and effects of preventive measures in terms of monetary value, the economic feasibility analysis was attempted with a focus on how much the newly introduced preventive measures can reduce the accident loss costs due to fall accidents. Thirdly, if the accident loss size is grasped and the preventive measures for the causes of fall accidents are developed and strictly implemented, the insurance fee that can reduce the accident loss costs can be determined. Further study is needed to estimate the benefit of the accident loss cost reduction seen from the cost-based approach method.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.144-153
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• 2003

1) Background: The hospitals of modem society, like any other business entities, have to constantly strive to secure their survival from aggressive changes and competition outside. In this unstable environment, effective leadership is one of the most effective strategies for securing organization's growth as well as stability. This study investigated types of leadership (transformational or transactional) that is dominant in medical record departments and compared it's effects on organizational commitment and job satisfaction of their organizational members by types. 2) Method: A questionnaire was developed and mailed to all medical record administrators working at general hospitals throughout the country except department directors (N=450). Of these, 150 useable questionnaires were returned and analyzed by t-test, multiple regression analysis using SPSS. 3) Results: The organizational commitment and job satisfaction were a little bit higher than moderate level, and that of leadership perceived by medical record administrators was also in moderate level throughout types. Significant characteristics (positively) related to organizational commitment and job satisfaction by univariate analysis were marital status (married), position (middle management) and both type of leadership. However transformational leadership was the only significant factor in leadership styles after considering all the factors related to organizational commitment and job satisfaction together by multivariate analysis. 4) Conclusion: The average organizational commitment and job satisfaction of medical record administrators was just in moderate level. Efforts should be made to increase them by improving leadership capacity of medical record directors, primarily by using transformational leadership approach.

• Korean Journal of Health Education and Promotion
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• v.33 no.4
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• pp.55-65
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• 2016

Objectives: Members of Korean Healthy Cities Partnership(KHCP) has increased rapidly since 2006 and adopted Active Living Environments(ALE) as common theme in 2015. Academic definition and categorization, needs assessment and operational planning for making active living environments were required from KHCP. Methods: Literatures review, survey to members of KHCP, specialist discussion and consultation with members of KHCP have been done from October of 2015 to February of 2016. Results: ALE included humane(social networks), physical and political resources. Three categories and 13 items for ALE were identified. Present actions among member cities were variable and especially immature in physical environments. Indicators for ALE were not secured stably. Requirements for policy and physical environmental approach and adolescent programme were high. Priority areas for education and technical assistance were master planning, guideline and case, program and policy development, partnership development, and networking among cities. Representative projects among member cities were somewhat different from ideal models. Conclusions: Policy and environmental approaches needs to be reinforeced systemically for members of KHCP including securing stable indicators. More education and technical assistance also needed sustainably.

• Journal of Environmental Health Sciences
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• v.37 no.4
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• pp.250-257
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• 2011

Objectives: This study was aimed at re-assessing the environmental burden of disease attributable to waterrelated diseases using available local data from Korea. Methods: The general methods and the operational definitions for water, sanitation and hygiene applied to the study were based on an environmental burden of disease study conducted by WHO. Eleven water-related diseases were selected. The attributable fraction for diarrhea was calculated by assessing local exposure levels to drinking water, sanitation and hygiene according the scenario-based approach. The attributable fractions for the other ten diseases were derived from the results of the environmental burden of diseases study. The attributable DALYs were measured by using the attributable fractions and local health statistics. Results: The total environmental burden of disease attributable to water, sanitation and hygiene for Korea was 0.9210 DALY per 1000 capitals. Of the total burden of disease, the attributable burden of diarrhea was 0.8863 (96.1%), the attributable burden of malaria and malnutrition was 0.0236 and 0.0063 DALY per 1000 capitals, respectively. There was little burden of disease measured for other diseases. Conclusions: This study is meaningful in re-assessing the environmental burden of disease using available local exposure data and health statistics. Quantitative analysis of the environmental risk factors and a health impact assessment would be helpful to prioritize health policies or interventions in the future.