• Title/Summary/Keyword: care policy

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Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Is Fertility Rate Proportional to the Quality of Life? An Exploratory Analysis of the Relationship between Better Life Index (BLI) and Fertility Rate in OECD Countries (출산율은 삶의 질과 비례하는가? OECD 국가의 삶의 질 요인과 출산율의 관계에 관한 추이분석)

  • Kim, KyungHee;Ryu, SeoungHo;Chung, HeeTae;Gim, HyeYeong;Park, HeongJoon
    • International Area Studies Review
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    • v.22 no.1
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    • pp.215-235
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    • 2018
  • Policy concerns related to raising fertility rates are not only common interests among the OECD countries, but they are also issues of great concern to South Korea whose fertility rate is the lowest in the world. The fertility rate in South Korea continues to decline, even though most of the national budget has been spent on measures to address this and many studies have been conducted on the increase in the fertility rates. In this regard, this study aims to verify the effectiveness of the detailed factors affecting the fertility rate that have been discussed in the previous studies on fertility rates, and to investigate the overall trend toward enhancing the quality of life and increasing the fertility rate through macroscopic and structural studies under the recognition of problems related to the policy approaches through the case studies of the European countries. Toward this end, this study investigated if a high quality of life in advanced countries contributes to the increase in the fertility rate, which country serves as a state model that has a high quality of life and a high fertility rate, and what kind of social and policy environment does the country have with regard to childbirth. The analysis of the OECD Better Life Index (BLI) and CIA fertility rate data showed that the countries whose people enjoy a high quality of life do not necessarily have high fertility rates. In addition, under the recognition that a country with a high quality of life and a high birth rate serves as a state model that South Korea should aim for, the social characteristics of Iceland, Ireland, and New Zealand, which turned out to have both a high quality of life and a high fertility rate, were compared with those of Germany, which showed a high quality of life but a low fertility rate. According to the comparison results, the three countries that were mentioned showed higher awareness of gender equality; therefore, the gender wage gap was small. It was also confirmed that the governments of these countries support various policies that promote both parents sharing the care of their children. In Germany, on the other hand, the gender wage gap was large and the fertility rate was low. In a related move, however, the German government has made active efforts to a paradigm shift toward gender equality. The fertility rate increases when the synergy lies in the relationship between parents and children; therefore, awareness about gender equality should be firmly established both at home and in the labor market. For this reason, the government is required to provide support for the childbirth and rearing environment through appropriate family policies, and exert greater efforts to enhance the effectiveness of the relevant systems rather than simply promoting a system construction. Furthermore, it is necessary to help people in making their own childbearing decisions during the process of creating a better society by changing the national goal from 'raising the fertility rate' to 'creating a healthy society made of happy families'

The Effects of the Revised Elderly Fixed Outpatient Copayment on the Health Utilization of the Elderly (노인외래정액제 개선이 고령층의 의료이용에 미친 영향)

  • Li-hyun Kim;Gyeong-Min Lee;Woo-Ri Lee;Ki-Bong Yoo
    • Health Policy and Management
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    • v.34 no.2
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    • pp.196-210
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    • 2024
  • Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

Legal Issues on the Collection and Utilization of Infectious Disease Data in the Infectious Disease Crisis (감염병 위기 상황에서 감염병 데이터의 수집 및 활용에 관한 법적 쟁점 -미국 감염병 데이터 수집 및 활용 절차를 참조 사례로 하여-)

  • Kim, Jae Sun
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.29-74
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    • 2022
  • As social disasters occur under the Disaster Management Act, which can damage the people's "life, body, and property" due to the rapid spread and spread of unexpected COVID-19 infectious diseases in 2020, information collected through inspection and reporting of infectious disease pathogens (Article 11), epidemiological investigation (Article 18), epidemiological investigation for vaccination (Article 29), artificial technology, and prevention policy Decision), (3) It was used as an important basis for decision-making in the context of an infectious disease crisis, such as promoting vaccination and understanding the current status of damage. In addition, medical policy decisions using infectious disease data contribute to quarantine policy decisions, information provision, drug development, and research technology development, and interest in the legal scope and limitations of using infectious disease data has increased worldwide. The use of infectious disease data can be classified for the purpose of spreading and blocking infectious diseases, prevention, management, and treatment of infectious diseases, and the use of information will be more widely made in the context of an infectious disease crisis. In particular, as the serious stage of the Disaster Management Act continues, the processing of personal identification information and sensitive information becomes an important issue. Information on "medical records, vaccination drugs, vaccination, underlying diseases, health rankings, long-term care recognition grades, pregnancy, etc." needs to be interpreted. In the case of "prevention, management, and treatment of infectious diseases", it is difficult to clearly define the concept of medical practicesThe types of actions are judged based on "legislative purposes, academic principles, expertise, and social norms," but the balance of legal interests should be based on the need for data use in quarantine policies and urgent judgment in public health crises. Specifically, the speed and degree of transmission of infectious diseases in a crisis, whether the purpose can be achieved without processing sensitive information, whether it unfairly violates the interests of third parties or information subjects, and the effectiveness of introducing quarantine policies through processing sensitive information can be used as major evaluation factors. On the other hand, the collection, provision, and use of infectious disease data for research purposes will be used through pseudonym processing under the Personal Information Protection Act, consent under the Bioethics Act and deliberation by the Institutional Bioethics Committee, and data provision deliberation committee. Therefore, the use of research purposes is recognized as long as procedural validity is secured as it is reviewed by the pseudonym processing and data review committee, the consent of the information subject, and the institutional bioethics review committee. However, the burden on research managers should be reduced by clarifying the pseudonymization or anonymization procedures, the introduction or consent procedures of the comprehensive consent system and the opt-out system should be clearly prepared, and the procedure for re-identifying or securing security that may arise from technological development should be clearly defined.

A Study on the existence aspect of the elderly in the Joseon Dynasty (조선시대 노인(老人)의 존재양상 - 연령과 신분을 중심으로 -)

  • Kim, Hyo-Gyong
    • Journal of Korean Historical Folklife
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    • no.52
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    • pp.7-46
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    • 2017
  • The elderly in the Joseon Dynasty consistently attracted attention from the national herb as objects of social respect. Based on the Confucian ideology, the old man was considered to be a receiving body, since he was a person with complete character as a man. The elderly, who have the character of being a slave, transcended their status, and both the souls and the people were transcended beyond their identities and attributes and became objects of respect. The perception of the elderly is divided by age. The persons who are 50 years old and start to be in physical decline were regarded as senior citizens. However, this was just mentioned as an inflection point between the prime of manhood and senior citizens and was not defined as the elderly. As a public duty called a national work ends when they are 60 years old, the age is truly the lowest limit of senior citizens who are applicable to all the social beings. However, because their public duties end when they are 60 years old and they were regarded as general members of society, special benefits were not granted to them. In the caste system and bureaucratic society, senior citizens' treatment were differently done by age. For the senior citizens who are 70 years old, various benefits were just granted to high government officials. Bokho(復戶) and Seojeong were first given to them. And the retirement age of government officials was not specially set. It was done in the way to treat Jonno with exceptional respect by Chisa(致仕: regular retirement). It is the most respectful treatment given to high government officials and ministers. For the senior citizens who are 80 years old, Yangnoyeon(養老宴) was held for both of Yangmin and Cheonmin as an measure to treat them considerately. In addition, official ranks(官品) with social value were allowed by giving them Noinjik (老人職). Official ranks given to Seoin and Cheonin were the best Jonno(尊老) policy. However, the Jonno policy related to senior citizens was different according to position and official ranks as follows: Kings were subjected to social treatment when they were 60 years old. High government officials and royal relatives of the senior grade of the second court rank were subjected to social treatment when they were 70 years old. And general Seoin and slaves were subjected to social treatment when they were respectively 80 and 90 years old. Senior citizens were individually supported. However, social value was granted because the nation supervised it. As Bokho and Sijeong were assigned according to position and official ranks and kinds of things were different, the social limit was clearly shown. Social order was put above the ideology called Jonno thought. However, Jonno acts by age and position did not stay at the individual level and the nation took care of the senior citizens who are the members of society in various ways based on Jonno thought. Society tried to take care of the senior citizens who had difficulties in their activities because of being in physical decline. The nation increased the existence value of the senior citizens by giving things(賜物) including chairs, rice, meat, and ice economically, exoneration(免罪), the reduction system, and wergild legally, and Noinjik called Gaja(加資) socially to them and changing them to the members of society. Yangnoyeon and Gaja held targeting people of every class by transcending position and official ranks make the point that the senior citizens who are more than 80 years old are subject to social jonno clear. That is, the senior citizens were subject to respect for the elderly as the persons who were socially respected transcending their position when they got to be 80 years old.

A Study on Strategies to Improve the Hospital House-staff Training Systems - In the Perspective of the Training Directors of the Hospital - (전공의 수련교육제도의 발전 방안에 관한 연구 - 수련부장의 인식도 조사결과를 기초로 -)

  • Kim, Gi-Chul;Ha, Ho-Wook;Hwang, In-Kyoung
    • Korea Journal of Hospital Management
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    • v.6 no.1
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    • pp.120-146
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    • 2001
  • This study was carried out to provide the essential information in improving the graduate medical education in Korea. For the study, a survey targeting the directors of GME of nationwide teaching hospitals was performed with a questionnaire asking the questions such as the director's perception on the quality of GME, trainees' salary level, trainees' specialty selection tendency, training system and its duration. The collected data were analyzed using t-test, ANOVA, and $x^2$-test. The results were as follows: 1. The survey were executed on 240 teaching hospitals in Korea and the response rate was 66.2% (159 hospitals replied). 2. The bigger a hospitals is the better in Quality of education. Larger hospitals tend to have better status in all items including medical specialists' experience, contents of medical curriculum, general environment for medical education and medical trainees's salary level. The result supported the general perception on the positive relationship between hospital size and Quality of GMA. 3. Providing convenience for medical trainees who prepares for the medical specialist Qualifying examination didn't affect the results of the examination. 4. The directions of GME have a perception that the trainees give positive impact on financial performance of their hospitals. This seems to be one of the reasons that hospitals try to retain as many trainees as possible. 5. The directors of GME considered medical trainees as an educate, and most of them responded positively on the need of governmental supports for the education cost and the trainee's salary. Considering above results, it seems that GME would get more social attention and the trainees' impact on hospitals operation would be increased more than before. In response to these trends, hospitals would find out the ways to lower dependency on trainees, and this change of attitude of hospitals on the GME would cause problems in operation of hospitals and GME itself. In order to prevent these problems the policy on GME should be directed in following ways. 1. The contents of Qualifying examination for specialist should be improved. 2. The curriculum of GME should be strictly followed. 3. The status of trainee in a hospital has to be defined as eductee. 4. Government has to support a half of the education cost and salary of trainee. 5. The distribution of the trainee among the hospital group have to be based on total available. 6. The financial support and welfare of trainee should be improved gradually and systematically.

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Comparision of experiences of caring parent-in-law in Korean families among daughters-in-law from Korea, China and Japan (한국, 중국, 일본 며느리의 한국에서의 부양 경험)

  • Kim, Yun-Jeong
    • Journal of Digital Convergence
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    • v.12 no.8
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    • pp.501-513
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    • 2014
  • The purpose of this study was to examine experiences of caring parents-in-law in Korea among daughters-in-law who are currently caring their parents-in-law while living with them, or have experienced such care-giving, and who have been married for at least 5 years. Daughters-in-law this study deals with are from three countries: Korean women, Chinese and Japanese women who immigrated to Korea by getting married with Korean husbands. To find out those women who can express their experiences clearly, this study used an intentional sampling method where this study asked the Multicultural Family Support Center to recommend five Chinese and five Japanese housewives who matched the following qualifications: those who have experiences of caring their parents-in-law at home, who have lived in Korea for at least five years, and who had no difficulty in expressing their opinions in Korean language. Korean married women were recommended by the neighbors. This study conducted in-depth interviews to those 15 housewives from Korea, china, and Japan. Before doing the interview, this study gave explanation of the contents and aims of this study to those interview participants over phone, and got the written consent from each of the women. To analyze the interview data, Colaizzi's phenomenological method was used. The emergent themes identified in the findings were as follows: 'positive perception of traditional nature of filial duty', 'help and encouragement by those who are nearby', 'exhausting marriage life', 'Korean family culture that is hard to adapt to', and 'unreasonable male-focused patriarchal culture.'

The Journal of Targeted at the general public for the Modeling of Well-dying Program Development (일반인 대상 웰 다잉 교육프로그램 개발을 위한 모델링에 관한 연구)

  • Kim, Kwang-Hwan;Kim, Yong-Ha;Ahn, Sang-Yoon;Lee, Chong Hyung;Lee, Moo-Sik;Kim, Moon-Joon;Park, Arma;Hwang, Hye-Jeong;Shim, Moon-Sook;Song, Hyeon-Dong
    • Journal of Digital Convergence
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    • v.12 no.8
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    • pp.369-376
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    • 2014
  • Death education the subject of interest is the subject of the medical staff for the death of stress degree and acceptable approach to analyze the death centered on the hospital space education in order to take advantage of From April 2014 until April 30, 281 people who lived Daejeon were surveyed. Analysis of the results, if they are taken the death education, it was considered more important than none education. If Patient in an unrecoverable state, to the question of who to notify, guardian had the highest score. Suitable for end-of-life include home, healthcare, social welfare facilities in order. When you take advantage of the results, In order to understand and take care of the phenomenon of death, we accommodate health and medical treatment perspective, humanity perspective, social perspective. It is Study for Death education program that can be applied to public. It is significant as a basis material to popularize and generalize death education program.

A Research on Rationality and Equity of the Military Service System Against Athletes in Korea (우리나라 남자 운동선수 대상 병역 제도에 대한 합리성과 형평성에 대한 연구)

  • Hwang, Ho-Young
    • Journal of Digital Convergence
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    • v.14 no.5
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    • pp.507-517
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    • 2016
  • Social obligation of a nation must be assigned to the people, legally belong to the nation. The Republic of Korea assigns a social obligation to the Koreans, the Military Service which is regulated by the Constitution of the Republic of Korea and the Military Service Law of Korea. However, behind the law, a serious discussion, the rationality and equity, is possibly discovered from the reality of the military service system against athletes of Korea. The purpose of this study was to analyze the military service system against athletes of Korea based on the Constitution of Republic of Korea and the Military Service Law of Korea. Three proposals, prohibit duplicated benefits of athletes, military service evasion after care system and keeping the military and police sport organization as nonprofessional, to recover the institutional problems regarding the equity and rationality were suggested in the end of this research. With the results, this research hopefully contribute to the development of sport law, fundamental obligation with sports and the military service system on athletes in Korea.

Research on the Ecological System Variables Predicting Korean 4-year-olds' Cognitive Development (만4세 유아의 인지발달에 영향을 미치는 생태체계변인 연구)

  • Kim, Jihyun;Kim, Jung Min
    • Korean Journal of Childcare and Education
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    • v.11 no.2
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    • pp.87-108
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    • 2015
  • The purpose of this study was to investigate the difference in Korean 4-year-olds' cognitive development depending on variables concerning ecological system variables, predictive influences among these variables, and different predictive patterns between working mothers and non-working mothers. The subjects consisted of 998 4-year-olds, derived from the Korean Child Panel data of 2012. The results were as follows: First, 4-year-olds' cognitive development was different depending on their sex, education level of mother and father, mothers' working status, quality of home environment, and mothers' involvement in children's life in their institution. Second, mothers' involvement in children's life in their institution, children's sex, quality of home environment, and mothers' working status predicted 4-year-olds' cognitive development. Third, there was a different pattern of predictive influence among variables according to the mothers' working status. The mothers' involvement in their children's lives in their institution and children's sex was proved to be important in both, but that was more significant in working mothers, and the quality of home environment predicted cognitive development only in working mothers. These results were discussed in terms of necessity of the Korean national policy to support young children's cognitive development efficiently, especially for working mothers.