• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.195-206
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• 1988

Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation has gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better.' The shortage itself by no means unnecessitate inventory control. In fact, in spite of shortage, no small amount of blood is outdated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this tudy is to develop formulae forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study informations of $A^+$ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated.48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measures of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of the issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study' were as follows ; 1. The formulae to calculate the standard blood inventory level($S^*$)was $S^*=2.8617X(d)^{0.9342}$ where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performace - outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level - were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First In-First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.3
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• pp.1234-1243
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• 2011

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for community-acquired pneumonia so that we analysed the factors on the variation in length of stay(LOS). The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge In-depth Injury Survey data from 2004 through 2006. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. There are differences according to gender, age, type of insurance, type of admission, but there is no difference of whether patients died in hospital. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for community-acquired pneumonia. There was variation of LOS in regional differences and insurance type, though there was no variation according whether patients receive their care in their residences. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

• Korea journal of population studies
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• v.30 no.3
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• pp.137-156
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• 2007

Total fertility rate (TFR) increased from the lowest 1.08 in 2005 to 1.13 in 2006, and a debate is made whether the increase is temporary or continuous as a result of various pro-natal policies. This study intends to explore policy implications revealed in recent fertility change using vital statistics. For this purpose, tempo-adjusted fertility rate by birth order, fertility rate by age of mother and birth order, age-specific fertility for married, and age-specific divorce rate for married are analyzed. The increase of TFR and births for 2006 is largely due to increase of first births at early thirties with slowdown of delayed first marriage and first child birth. The increase of female population (the third wave effect of baby boom) and first marriages of late twenties in 2006 and 2007 would lead to increase of fertility during 2007-2008. But further increase is uncertain because of the decrease trend of marital fertility and increase trend of never-married for twenties. TFRs for first and second births reduced rapidly, while TFRs for third and above births showed no changes, and second births were largely affected by tempo adjustment of fertility. Thus, constructing social environment for first and second births is more effective and necessary than encouraging third births. In addition, social responsibility of child care, child-women health issues due to delayed births, and the need for multi-cultural family support system are discussed.

• Health Policy and Management
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• v.26 no.2
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• pp.135-147
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• 2016

Background: The voluntary diagnosis-related groups (DRG)-based payment system was introduced in 2002 and the government mandated participation in the DRG for all hospitals from July 2013. The main purpose of this study is to examine the independent effect of mandatory participation in DRG on various outcomes of patients. Methods: This study collected 1,809,948 inpatient DRG data from the Health Insurance Review and Assessment database which contains medical information for all patients for the period 2007 to 2014 and examined patient outcomes such as length of stay (LOS), total medical cost, spillover, and readmission rate according to hospital size. Results: LOS of patients decreased after DRGs (large hospitals: adjusted odds ratio [aOR], 0.87; 95% confidence interval [CI], 0.78-0.97; small hospitals: aOR, 0.91; 95% CI, 0.91-0.92). The total medical cost of patients increased after DRGs (large hospitals: aOR, 1.22; 95% CI, 1.14-1.30; small hospitals: aOR, 1.22; 95% CI, 1.21-1.23). The results reveals that spillover of patients increased after DRGs (large hospitals: aOR, 1.27; 95% CI, 0.70-2.33; small hospitals: aOR, 1.18; 95% CI, 1.16-1.20). Finally, we found that readmission rates of patients decreased significantly after DRGs (large hospitals: aOR, 0.28; 95% CI, 0.26-0.29; small hospitals: aOR, 0.59; 95% CI, 0.56-0.63). Conclusion: The DRG payment system compared to fee-for-service payment in South Korea may be an alternative medical price policy which can reduce the LOS. However, government need to monitor inappropriate changes such as spillover increase. Since this study also is the results based on relatively simple surgery, insurer needs to compare or review bundled payment like new DRG for expansion of various inpatient-related diseases including internal medicine.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.4
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• pp.218-225
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• 2020

This study analyzed the priorities of the cross-compliance items of public-benefit direct payment using an Analytic Hierarchy Process and Fuzzy Decision Making Analysis. The valuation criteria are policy efficiency, farm acceptability, and feasibility, and the valuation targets are the basic and additional cross-compliance items. The survey was performed by targeting 50 experts from each class, and conducted for about a month starting from the beginning of July 2019. The results show that the weight of the valuation criteria is higher in the order of farm acceptability, feasibility, and policy efficiency. Compliance with PLS standards, compliance with disposal standards of waste vinyl and pesticides, soil testing, compliance with toxic substance standards, education, etc. are comparatively evaluated to be higher cross-compliance items in basic cross-compliance. Disposing of an abandoned well, jointly collecting and disposing of agricultural by-products, common area care and cleaning, maintenance of empty houses and poor facilities, growing green manure crops during the fallow period, etc. are comparatively evaluated to be higher cross-compliance items for the additional cross-compliance. The results of this study are expected to contribute to the government's policy related to the cross-compliance of public-benefit direct payment.

• Health Policy and Management
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• v.29 no.4
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• pp.382-393
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• 2019

The right to petition is a classical right of the people in constitutional states, and in Korea, it is a statutory right in the Constitution, the National Assembly Law, the Petition Law, and the Local Autonomy Act. The healthcare community first made a successful petition to the National Assembly when it achieved the amendment of the Government Organization Act through a petition to the National Assembly for the independence of the Ministry of Health, and this achievement served as the basis for further petitions. Since then, the healthcare community has successfully achieved the enactment and amendment of related occupational laws through National Assembly petitions, such as the amendment of Article 41, Paragraph 7 of the former Medical Insurance Act (Korean Medical Association, 14th Assembly), enactment of the Dental Health Act (Korean Dental Association, 15th Assembly), and amendment of the Health Functional Foods Act (Korea Pharmaceutical Association, 16th Assembly). Its petition accomplishment rate is higher than the total petition accomplishment rate of the Health and Welfare Committee of the National Assembly. However, along with the overall decrease in the number of National Assembly petitions, the Korean Medical Association and Korea Pharmaceutical Association have not achieved any results through petitioning since the 16th Assembly (June 2000), and the Korean Hospital Association and Korean Nurses Association have not achieved any results through petitioning since the 17th Assembly (April 2004). Furthermore, no National Assembly petitions have been made at all for 5 years (2014-2018). The Korean Medical Association and Korea Pharmaceutical Association previously showed a high petition accomplishment rate through their accumulated experience with National Assembly petitions and vigorous policy assistance from doctors/pharmacists/nurses turned lawmakers. More specifically, healthcare organizations have achieved results by actively conducting organized activities with the National Assembly, as implemented by a national assembly director and employees, and in case of petitions for legislation, each group has established infrastructure for reviewing the relevant laws by appointing a legislative director, as well as a legal advisor and advisory counsel. Although the organization that has submitted the most petitions to the National Assembly is the Korean Hospital Association, the group with the highest petition success rate is the Korean Medical Association, which may be linked to the relatively high proportion of doctors who have become lawmakers. Furthermore, the fact that other healthcare organizations were highly interested in petitioning the National Assembly has had major implications for the petition activities of healthcare organizations.

• Health Policy and Management
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• v.29 no.4
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• pp.469-481
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• 2019

Background: As South Korea is becoming an aged society very rapidly, the increase in osteoarthritis prevalence raises various public health issues in this country. This study aimed to explore the socio-demographic factors associated with osteoarthritis in the current Korean elderlies. Methods: Using the National Survey of Korean Elderly data (2014, 2017), we analyzed 20,326 elderlies (males, 8,248; females, 12,078) and conducted multivariate logistic regression analyses by sex. The dependent variable is whether a participant was diagnosed with osteoarthritis or not. Independent variables of interest is socio-demographic factors such as age, marital status, household type, residential area, household income, religion, the longest job, the number of close relatives, the number of close friends, and survey year. Control variables are various health behavioral factors and disease-related factors. Results: Prevalence of osteoarthritis was 19.2% in male elderlies and 47.0% in female elderlies. According to the results of the multivariate logistic regression adjusted for all studied control variables, the odds ratio (OR) for having osteoarthritis of under-elementary school graduates (their counterpart was college graduate group) was 1.81 (95% confidence interval [CI], 1.29-2.52) in males and 1.67 (95% CI, 1.12-2.47) in females. The OR of those having a job in agriculture & forestry fishery as their longest job (their counterpart was those who had never participated in labor force during their lifetime) was 5.07 (95% CI, 1.46-17.58) in males and 1.49 (95% CI, 1.27-1.74) in females. In males, the second-low quartile group in household yearly income (their counterpart was the highest quartile group) had the OR of 1.22 (95% CI, 0.98-1.53). In females, the OR of those having a religion of Buddhism (their counterpart was those having no religion) was 1.20 (95% CI, 1.07-1.35) and the OR of those who had no relatives (their counterpart was those having more than 3 close relatives) was 1.31 (95% CI, 1.10-1.56). Conclusion: This study found that in Korean elderlies, education, the longest job, household income, religion, and the number of close relatives are associated with their suffering from osteoarthritis. Further study and designing appropriate interventions are needed to alleviate current and future individual and socioeconomic burdens of osteoarthritis in an aged society like South Korea.

• Journal of Preventive Medicine and Public Health
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• v.53 no.2
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• pp.89-97
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• 2020

Objectives: The quality of life (QoL) of the elderly and elder abuse are growing public health concerns. This study aimed to evaluate the prevalence of abuse and the association between QoL and abuse in older adults. Methods: Multistage random cluster sampling, along with valid QoL (LEIPAD: LEIden, the Netherlands; PADua, Italy; Helsinki, Finland) and abuse questionnaires, were used to assess QoL and elder abuse. Path analysis was performed using Mplus. SPSS and AMOS were used for the other analyses. Results: A total of 386 elderly individuals with a mean age of 68.00±6.10 years were interviewed, of whom 200 (51.8%), 289 (74.9%), and 376 (97.4%) were women, educated, and married, respectively. Moreover, 167 (43.2%) had low-to-moderate QoL, and 108 (27.9%) had experienced a moderate level of abuse. QoL and abuse were inversely associated (r=-0.253), with men (β=-0.24) more affected than women (β=-0.21). Musculoskeletal disorders were also strong determinants of QoL in the elderly. QoL was strongly associated with emotional abuse, while abuse was highly related to the social component of QoL. Furthermore, emotional abuse was the type of abuse most significantly associated with the self-care, depression/anxiety, cognitive, and social components of QoL. Sexual abuse, violation of personal rights, and neglect were the main determinants of the physical functioning, life satisfaction, and sexual domains of QoL, respectively. Conclusions: Nearly half of the elderly individuals lacked a high QoL, and at least one-fourth had experienced some form of abuse. Elder abuse was correlated inversely with QoL. Therefore, preventive interventions are recommended to decrease elder abuse in the family, community, and other settings.

• Korea journal of population studies
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• v.3 no.1
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• pp.5-41
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• 1979

Vast volumes of studies of the medical and public health aspects of fertility and family planning have been published by the various institutes of health related research and university scholars in Korea. None of them, however, have dealed with the population problems associated with biologically and mentally handicapped people. It must be emphasized that the purpose of Korea's population policy should be to improve the quality of the population rather than to decrease its rate of increase. In this spirit, the first report of this study is to identify problems related with mentally and physically less fitted population, and to attempt to offer the possible solutions to the health planners and policy-makers. Several nation-wide surveys of the handicapped people in Korea have been compared. Each survey shows a wide range of difference in the prevalence of the handicaps(see Table 13). In this study, the data on the handicaps are collected by two independent system ; one by the nation-wide survey and the other by the reporting system existing at the Seoul National University Demonstration Health Project. The Chandrasekar-Deming technique was used to estimate the total number of handicaps. The estimates are summarized in the tables 8, 9 and 10. Estimate of total number of handicapped people in Korea is 601, 400 with the prevalence rate of 16.1 per thousand persons. Even if taking a number of conditions which may result in a biased estimate of the total number of the handicaps into consideration, the proportion of handicapped people in Korea has increased in the past two decade as the result of the rapid decline in fertility and childhood mortality, which consequently prolonged life expectancy of persons with congenital or acquired impediment. An increase in the proportion of handicapped people will eventually bring about serious problems of social welfare, medical care, and population qualities from various aspects including eugenics. To tackle the problem, there must be an increased emphasis on the prevention of handicaps from the government and private sector. Based on the amount and quality of data, and from the practical point of view, this study prepared a set of recommendations for the government to strengthen its programs of the preventive activities during the prenatal period and early childhood, early finding from routine examinations, and proper social and medical rehabilitation.

• 한국사회정책
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• v.25 no.2
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• pp.165-189
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• 2018

Under the principle of subsidiarity, the German family policy formed in the 1950s and 1960s minimized the role of the state while maximizing the role of the parents. The German Constitutional Court, however, ruled that the level of compensation for the financial burden of child support costs must follow the basic rights, not the principle of subsidiarity. The Federal Constitutional Court has taken the duty of protecting the human dignity of the state under Article 1 of the Constitution as the starting point of the judgment. The Federal Constitutional Court held that the dignity of a child is guaranteed only if the level of the child's allowance or deduction is equal to or higher than the level of the child standard benefit under the Social Assistance Act established by Congress. The Federal Constitutional Court also regarded the state to compensate parents for child support costs as much as the level of child standard benefit under the Social Assistance Act as a family protection obligation of the state under Article 6, Section 1 of the Constitution. In addition, the Federal Constitutional Court ruled that the right to equality declared by Article 3 of the Constitution can be realized by compensating all parents for child support costs at the level of child standard benefit under the Social Assistance Act.