• 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 Preventive Medicine and Public Health
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• v.57 no.1
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• pp.65-72
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• 2024

Objectives: Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019. Methods: Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE. Results: The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05). Conclusions: Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.87-101
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• 2017

[Purpose] This study aims to classify of healthcare decline and analyze the corresponding health outcomes among cities in Korea. In pursuing the above, this paper gives the particular attention to draw policy implications. [Methodology/Approach] Public healthcare data of 81 cities between 2014 and 2015 was obtained from the National Medical Center of Korea. A matrix analysis, t-test, ANOVA and multivariate regression were applied. [Findings] The study results indicated that declining cities tend to have the most healthcare resources, compared to growing or maintaining cities. However, accessibility to healthcare appeared to be lower in declining cities. Based on the classification of cities on healthcare decline, 42 out of 81 cities were categorized as a maintain/improvement group, while 39 cities were characterized as decline/depression. The group with a decline/depression type has significantly more healthcare facilities than maintain/improvement type. In contrast, maintain/improvement cities indicated lower incidence of morbidity and mortality than decline/depression cities. Lastly, according to the multivariate regression analysis for the healthcare outcomes by the type of healthcare decline, incidence of morbidity and mortality tended to decrease as the number of healthcare workers, the proportion of people who have healthcare accessibility, and the Timely Relevance Index increased regardless of the number of medical facilities including hospital beds and special beds. [Practical Implications] In conclusion, focusing on the improvement of healthcare accessibility as well as staffing, rather than expanding facilities is essential to set the healthcare policies.

• Korean Medical Education Review
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• v.22 no.1
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• pp.32-45
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• 2020

This narrative review introduces global trends in pharmacovigilance (PV) education for healthcare professionals and the status of PV education in Korea. Proactive participation of healthcare professionals, including physicians, pharmacists, and nurses in reporting suspected adverse events is the main driving force for effective operation of the spontaneous adverse event reporting system database, which in turn facilitates early safety signal detection of otherwise unknown suspected adverse events. The World Health Organization recognizes PV education curriculum as a key aspect in promoting awareness of PV and adverse event reporting among healthcare professionals, and multiple studies have demonstrated that PV educational interventions for healthcare professionals have increased overall adverse event reporting. Considering the global trends in PV education, the curriculum in Korean universities still has room for improvement in promoting PV obligation among future healthcare professionals. Further research is needed to develop PV education curriculum. We suggest a three-step project for innovating PV education in Korea to meet the global PV educational standards: a survey to gauge current PV competencies among healthcare professionals, reform of current PV academic curriculum, and evaluation and fine-tuning of the reformed curriculum.

• Journal of Pharmacopuncture
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• v.19 no.4
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• pp.293-302
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• 2016

The use of folk medicine has been widely embraced in many developed countries under the name of traditional, complementary and alternative medicine (TCAM) and is now becoming the mainstream in the UK and the rest of Europe, as well as in North America and Australia. Diversity, easy accessibility, broad continuity, relatively low cost, base levels of technological inputs, fewer side effects, and growing economic importance are some of the positive features of folk medicine. In this framework, a critical need exists to introduce the practice of folk medicine into public healthcare if the goal of reformed access to healthcare facilities is to be achieved. The amount of information available to public health practitioners about traditional medicine concepts and the utilization of that information are inadequate and pose many problems for the delivery of primary healthcare globally. Different societies have evolved various forms of indigenous perceptions that are captured under the broad concept of folk medicine, e.g., Persian, Chinese, Grecian, and African folk medicines, which explain the lack of universally accepted definitions of terms. Thus, the exchange of information on the diverse forms of folk medicine needs to be facilitated. Various concepts of Wind are found in books on traditional medicine, and many of those go beyond the boundaries established in old manuscripts and are not easily understood. This study intends to provide information, context, and guidance for the collection of all important information on the different concepts of Wind and for their simplification. This new vision for understanding earlier Chinese medicine will benefit public health specialists, traditional and complementary medicine practitioners, and those who are interested in historical medicine by providing a theoretical basis for the traditional medicines and the acupuncture that is used to eliminate Wind in order to treat various diseases.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.214-223
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• 2019

Objectives: Equity in financial protection against healthcare expenditures is one the primary functions of health systems worldwide. This study aimed to quantify socioeconomic inequality in facing catastrophic healthcare expenditures (CHE) and to identify the main factors contributing to socioeconomic inequality in CHE in Iran. Methods: A total of 37 860 households were drawn from the Households Income and Expenditure Survey, conducted by the Statistical Center of Iran in 2017. The prevalence of CHE was measured using a cut-off of spending at least 40% of the capacity to pay on healthcare services. The concentration curve and concentration index (C) were used to illustrate and measure the extent of socioeconomic inequality in CHE among Iranian households. The C was decomposed to identify the main factors explaining the observed socioeconomic inequality in CHE in Iran. Results: The prevalence of CHE among Iranian households in 2017 was 5.26% (95% confidence interval [CI], 5.04 to 5.49). The value of C was -0.17 (95% CI, -0.19 to -0.13), suggesting that CHE was mainly concentrated among socioeconomically disadvantaged households in Iran. The decomposition analysis highlighted the household wealth index as explaining 71.7% of the concentration of CHE among the poor in Iran. Conclusions: This study revealed that CHE is disproportionately concentrated among poor households in Iran. Health policies to reduce socioeconomic inequality in facing CHE in Iran should focus on socioeconomically disadvantaged households.

• Korea Journal of Hospital Management
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• v.21 no.1
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• pp.43-50
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• 2016

The public medical centers are required to make efficient and profitable operation. The efficiency is usually measured by DEA(data envelopment analysis), and profitability is measured by medical income rate. But DEA is measured by relative, not absolute value. So, profitability rate is used alternatively for DEA. This study want to analyze the interchangeability between DEA ranking and medical income rate ranking among public medical centers. The return on total assets is same ranking with DEA on bed number, employee number and total asset, but 60-70% relationship with DEA on bed number and employee number, as input resources. The operating margin is similar ranking with DEA on bed number and employee number, but 50-60% relationship with DEA on bed number, employee number and total asset, as input resources.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.44 no.3
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• pp.146-164
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• 2021

This study examines the effects of the public's perception of emergency medical service (EMS) on the public health system's brand equity and the moderating effect of governance on this relationship using Keller's customer-based brand equity model. It uses four EMS functions: rescue/first-aid and transfer activities; disaster prevention, preparation, and response activities; educational activities in urgent situations; and medical treatment in emergency rooms to examine the effects of them on brand meaning of the public health system. Our findings are important for understanding the public as customers of the public health system and devising and/ or adapting healthcare policies and marketing strategies to develop brand equity and increase customers' loyalty to the public health system.

• Asian Journal for Public Opinion Research
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• v.11 no.1
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• pp.54-74
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• 2023

This study examined the subcomponents of the local environment that have an important influence on the life satisfaction of people living in single-person households and analyzed how the causal relationship between these variables differs between generations. Specifically, the local environment was classified into the following subcomponents: convenience, comfort, safety, healthcare, and neighborhood relationships. This study analyzed the data of 3,260 respondents from single-person households in the 2020 Residents' Quality of Life Survey in Gyeonggi Province. As a result, it was found that the perception of all subcomponents of the local environment had a positive effect on the life satisfaction of people in single-person households. The effect of neighborhood relationships was relatively large compared to other subcomponents. Next, the influencing factors on life satisfaction of people in single-person households showed differences between generations, which were defined by this study as youth (under age 35), middle-aged (35-64), and elderly (65 and older). Convenience and safety for the youth group and neighborhood relationship for the middle-aged group were most important. The elderly group was most affected by healthcare. The proportion of single-person households worldwide, including in Korea, is gradually increasing, and considering this, this study provides important policy implications.

• Journal of The Korea Institute of Healthcare Architecture
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• v.19 no.4
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• pp.29-36
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• 2013

Purpose: Currently meaning and the needs of the times for the mental health are extensively changing. Contemporary needs for mental health has led to a change in the mental health policy and mental health facilities. But Change on Most of the mental health facilities have been focused on quantitative increase. So, changes in mental health facilities due to changes in mental health policy are needed for the study. This study investigate to the mental health facility system through this changes. Methods: In order to determine the flow of Mental health policy in Korea the mental health laws and reports were investigated Results: the result of this study can be summarized into two points. Korea's mental health policy has changed from the rehabilitation of the mentally ill to the prophylaxis of all the people. So, mental health facilities are changing form rehabilitation facilities in the private sector to public mental health center. Especially, mental medical institutions and mental health center are changing to requirement for the needs of the times. Mental medical institutions are changing from inpatient to outpatient and mental health center are changing from the rehabilitation of the mentally ill to the prophylaxis of all the people. Implications: Understand the flow of mental health policy, mental health facilities and the corresponding need.