• Korean Medical Education Review
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• v.25 no.3
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• pp.192-197
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• 2023

Physicians should be able to address health-related issues of patients and populations from a multidimensional perspective. Therefore, medical schools have a social responsibility to develop and implement curricula that enable trainees to acquire the competencies needed to improve all aspects of patient care and healthcare delivery. This study explored the concept of health systems science concept as the third pillar of medical education (the other two are basic science and clinical medicine) in the Korean context, as well as related educational needs. The theoretical foundation of health systems science is the biopsychosocial conceptual model, which emphasizes the biological, psychological, and social factors surrounding patients. We concluded that the three domains (core functional, foundational, linking) and 12 subcategories of health systems science proposed by the Association of American Medical Colleges could be applied to Korean medical education. Health systems science education must be emphasized to solve the various healthcare problems facing Korea today and to train physicians to provide medical services in line with society's needs. Introducing a health systems science curriculum will be challenging in the Korean medical environment, which has traditionally emphasized basic science and clinical medical education. Health systems science education should begin in the basic medical education phase, where physicians' professional identity is formed, and continue through graduate medical education. It is essential to understand related educational needs, develop curricular content, conduct faculty development programs, and provide financial resources for the development of an integrated curriculum.

• Journal of Pharmacopuncture
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• v.27 no.2
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• pp.110-122
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• 2024

Objectives: This study analyzed the Korea Health Panel Annual Data 2019 to investigate factors related to the use of non-insured Korean medicine (KM) treatment in individuals with chronic diseases. The non-insured KM treatments of interest were herbal decoction (HD) and pharmacopuncture (PA). Methods: Among adults aged 19 or older, 6,159 individuals with chronic diseases who received outpatient KM treatment at least once in 2019 were included. They were divided into three groups according to the KM treatment used: (1) basic insured KM non-pharmacological treatment (BT) group (n = 629); (2) HD group (n = 256); (3) PA group (n = 184). Logistic regression analysis was used to explore factors associated with favoring HD or PA use over BT. Potentially relevant candidate factors were classified using the Andersen Behavior Model. Results: Compared to BT, the 1st to 3rd quartiles of income compared to the 4th quartile (odds ratio: 1.50 to 2.06 for HD; 2.03 to 2.83 for PA), health insurance subscribers compared to medical aid (odds ratio: 2.51; 13.43), and presence of musculoskeletal diseases (odds ratio: 1.66; 1.91) were significantly positively associated with HD and PA use. Moreover, the presence of cardiovascular disease (odds ratio: 1.46) and neuropsychiatric disease (odds ratio: 1.97) were also significantly positively associated with HD use. Conclusion: The presence of some chronic diseases, especially musculoskeletal diseases, was significantly positively associated with HD and PA use, while low economic status was significantly negatively associated with HD and PA use, indicating the potential existence of unmet medical needs in this population. Since chronic diseases impose a considerable health burden, the results of this study can be used for reference for future health insurance coverage policies in South Korea.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.4
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• pp.427-437
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• 2020

The purpose of this study was to investigate the effects of public preventive dental healthcare services named the "Dental Preventive Health Services for Children" (DPHSC) on oral health-related quality of life (OHRQoL) in Korean children. Of the total 20,802 beneficiaries in 2018, 110 10-year-old elementary school students were randomly selected and were requested to complete a survey using the Korean version of Child Oral Health Impact Profile (COHIP) questionnaire before and after participating in DPHSC. Overall, 107 participants completed the pre- and post-survey. COHIP scores and clinical results such as numbers of decayed and missing teeth, malocclusion, and oral hygiene status from dental examination were statistically analyzed and the reliability and the validity of the responses were verified. There was a significant clinical increase in mean overall COHIP scores following DPHSC (p < 0.001, effect size 1.05). Children with decayed and missing teeth demonstrated poor OHRQoL. In conclusion, DPHSC can improve the OHRQoL of 10-year-old children.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3639-3644
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• 2015

Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.8
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• pp.5169-5175
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• 2014

The aim of this study was to find the factors related to smoking-cessation among citizens receiving smoking-cessation clinics' services in a public health center in Daejeon metropolitan city. The study subjects were 2,125 participants registered in "smoking-cessation clinic", public health centers in 2007. Frequency analysis, chi-squared test and multiple logistic regression analysis were used to determine the relationships between the success rate of smoking-cessation and the characteristics. The success rate of smoking-cessation during 6 months was 39.8%. Males had a higher rate than females, and people over 65 years of age had a higher rate than those less than 40 years of age. High blood pressure, drinking of more 2 times per week, regular exercise, CO under 10ppm had significantly relationships with the smoking-cessation rate. The other independent variables had no statistically significance with the smoking-cessation success rate. Logistic regression analysis showed that age, number of nicotine patches used and total consultation times had significantly relationships with the smoking-cessation success rate. The total consultation times showed the highest odds ratio than the other significant factors. This study suggests that regular consultations will be the most effective intervention towards maintaining smoking cessation programs of smoking-cessation clinics in public health centers.

• Health Policy and Management
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• v.21 no.3
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• pp.349-364
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• 2011

Objectives : The purpose of this study was to evaluate the relationship between new-building of rural public health centers and the outpatient medical utilization. Methods : The study subjects were 141 public health centers in rural area. The data were collected from 1995 to 2001, medical utilization and local population, healthcare resources, and economic characteristics were included. In order to evaluate new-building effects, we performed paired t-tests and multivariate regression analyses. Results : The following variables are significant affecting the medical utilization of rural public health centers: urban side location of public health centers(p<0.05), pre- and post-IMF economic crisis(p<0.001), number of medical aid recipients(p<0.01), number of private clinics(p<0.05), workers of public health centers(p<0.001), financial independent level of local governments(p<0.001). In contrast, the existence of new-building and number of the aged 65 and over were not significant variables. Conclusions : We could not find out the positive relationship between the existence of new-building and the volume of medical utilization in rural public health centers. In particular the medical utilization of rural public health centers is significantly affected by IMF economic recession and number of the poor strata, the economically depressed area.

• Journal of Preventive Medicine and Public Health
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• v.53 no.6
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• pp.447-454
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• 2020

Objectives: The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses. Methods: In the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance. Results: A total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p<0.05). Occupational safety climate and patient safety climate also showed significant correlations with safety performance. Conclusions: Close correlations were found among occupational safety climate, patient safety climate, and nurses' safety performance. Therefore, improving both the occupational and patient safety climate can improve nurses' safety performance, consequently decreasing occupational and patient-related adverse outcomes in healthcare units.

• Journal of Preventive Medicine and Public Health
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• v.53 no.6
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• pp.487-491
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• 2020

Objectives: Reproductive health education is essential for adolescents with hearing impairment. Since they communicate using specialized language (i.e., sign language), specialized reproductive health services in sign language is a necessity. This study aimed to describe the needs, availability, and expectations of reproductive health services among adolescents with hearing impairment. Methods: This study used a qualitative approach. It was carried out at a school for children with special needs in the city of Denpasar, Bali, Indonesia. Data were collected by in-depth interviews. The informants were 6 adolescents with hearing impairment aged 16-17 years and 4 other key informants, including school staff and health officers. The data were then analyzed using the thematic method. Results: We found that the informants had insufficient knowledge regarding reproductive health. There was no specific subject in the curriculum regarding this issue. Teachers did not specifically provide reproductive health information. The health service unit in the school had not been utilized well for this purpose. Furthermore, no reproductive health services were provided due to the limited number of healthcare workers who could use sign language. Conclusions: The awareness and intentions of adolescents with hearing impairment regarding access to reproductive health services remain low. Health service units at schools should be optimized to enable schools to provide reproductive health information and services for these adolescents.

• Journal of Preventive Medicine and Public Health
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• v.53 no.4
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• pp.289-292
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• 2020

Yemen has been faced with the worst cholera epidemic of modern times, with more than 1 million suspected cases and 3000 deaths at the time of writing. This problem is largely due to the longstanding civil war between pro-government forces and the Houthi armed movement, which has severely damaged already vulnerable sanitation and healthcare facilities and systems in the country. It is further compounded by a dire lack of basic amenities, chronic malnutrition, and unfavourable weather conditions. Another contributory component may be aerial transfer by cholera-infected chironomid insects. To contain the spread of cholera in Yemen, a nation-wide armistice should be negotiated, and national and local committees must be convened to coordinate efforts on the ground. Community isolation facilities with proper sanitation, reliable disposal systems, and a clean water supply should be set up to isolate and treat sick patients. The continuity of vaccination programmes should be ensured. Public health campaigns to educate local communities about good hygiene practices and nutrition are also necessary. The One Health paradigm emphasizes a multi-sectoral and transdisciplinary understanding and approach to prevent and mitigate the threat of communicable diseases. This paradigm is highly applicable to the ongoing cholera crisis in Yemen, as it demands a holistic and whole-of-society approach at the local, regional, and national levels. The key stakeholders and warring parties in Yemen must work towards a lasting ceasefire during these trying times, especially given the extra burden from the mounting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak worldwide.

• Journal of Preventive Medicine and Public Health
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• v.53 no.4
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• pp.266-274
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• 2020

Objectives: Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017. Methods: We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was ≥0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index. Results: The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05). Conclusions: Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.