• Journal of Preventive Medicine and Public Health
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• 제51권2호
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• pp.83-91
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• 2018

Objectives: One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households' income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

• Journal of Information Science Theory and Practice
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• 제10권4호
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• pp.38-52
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• 2022

Since older people are traditionally considered disadvantaged when it comes to Internet use, it is useful to examine whether older individuals use the Internet for health information seeking (HIS). This study aims to investigate digital inequalities in terms of Internet use by older population for HIS in the European region. As methods, we applied secondary data analysis (of Eurostat data) to investigate the influence of age, educational level, sex, and countries' wealth. Cluster analysis combined with multidimensional scaling was used to find out those countries exhibiting similarities in older people's online HIS. The main results are: Older individuals do not equally use the Internet in general and for HIS in particular. Older Internet users with higher level of education and of the female sex are more likely to use the Internet for health information.

• International journal of advanced smart convergence
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• 제10권2호
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• pp.37-44
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• 2021

At the time of entering the super-aged society, the health problem of the elderly is becoming more prominent due to the rapid digital era caused by COVID-19, but the gap between welfare budgets and welfare benefits according to regional characteristics is still not narrowed and there is a significant difference in emergency medical access. In response, this study proposes an ICT-based New Normal Smart Care System (NNSCS) to bridge the gap I n health and medical problems. This is an integrated system model that links the elderly themselves to health care, self-diagnosis, disease prediction and prevention, and emergency medical services. The purpose is to apply location-based technology and motion recognition technology under smartphones and smartwatches (wearable) environments to detect health care and risks, predict and diagnose diseases using health and medical big data, and minimize treatment latency. Through the New Normal Smart Care System (NNSCS), which links health care, prevention, and rapid emergency treatment with easy and simple access to health care for the elderly, it aims to minimize health gaps and solve health problems for the elderly.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.201-204
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• 2016

This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.623-627
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• 2014

Background: Esophagus cancer (EC) is among the five most common cancers in both sexes in Iran, with an incidence rate well above world average. Social rank (SR) of individuals and regions are well-known independent predictors of EC incidence. The aim of current study was to assess gender and social disparities in EC incidence across Iran's provinces through 2003-2009. Materials and Methods: Data on distribution of population at province level were obtained from the Statistical Centre of Iran. Age-standardized incidence rates of EC were gathered from the National Cancer Registry. The Human Development Index (HDI) was used to assess the province social rank. Rate ratios and Kunst and Mackenbach relative indices of inequality ($RII_{KM}$) were used to assess gender and social inequalities, respectively. Annual percentage change (APC) was calculated using joinpoint regression. Results: EC incidence rate increased 4.6% and 6.5% per year among females and males, respectively. There were no gender disparities in EC incidence over the study period. There were substantial social disparities in favor of better-off provinces in Iran. These social disparities were generally the same between males and females and were stable over the study period. Conclusions: The results showed an inverse association between the provinces' social rank and EC incidence rate in Iran. In addition, I found that, in contrast with international trends, women are at the same risk of EC as men in Iran. Further investigations are needed to explain these disparities in EC incidence across the provinces.

• Journal of Preventive Medicine and Public Health
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• 제40권6호
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• pp.431-438
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• 2007

Objectives : The aim of this study is to summarize the current conditions and implications of health inequalities in South Korea. Methods : Through a literature review of empirical studies and supplementary analysis of the data presented in the 1998, 2001, and 2005 KNHANEs, we evaluated the extent and trends of socioeconomic inequalities in both health risk factors, such as smoking, physical activity, and obesity, and outcomes, such as total mortality, subjective poor health status by self-reports and metabolic syndrome. Relative risks and odds ratios were used to measure differences across socioeconomic groups, and the relative index of inequality was used to evaluate the changes in inequalities over time. Results : We found clear inequalities to various degrees?in most health indicators. While little change was observed in mortality differences over time, the socioeconomic gaps in risk factors and morbidity have been widening, with much larger differences among the younger population. Conclusions : Socioeconomic inequalities are pervasive across various health indicators, and some of them are increasing. The trends in socioeconomic inequalities in health should be carefully monitored, and comprehensive measures to alleviate health inequalities are needed, especially for young populations.

• Safety and Health at Work
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• 제7권2호
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• pp.89-96
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• 2016

The incidence of occupational injuries and diseases associated with industrialization has declined markedly following developments in science and technology, such as engineering controls, protective equipment, safer machinery and processes, and greater adherence to regulations and labor inspections. Although the introduction of health and safety management systems has further decreased the incidence of occupational injuries and diseases, these systems are not effective unless accompanied by a positive safety culture in the workplace. The characteristics of work in the $21^{st}$ century have given rise to new issues related to workers' health, such as new types of work-related disorders, noncommunicable diseases, and inequality in the availability of occupational health services. Overcoming these new and emerging issues requires a culture of prevention at the national level. The present paper addresses: (1) how to change safety cultures in both theory and practice at the level of the workplace; and (2) the role of prevention culture at the national level.

• 보건행정학회지
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• 제32권1호
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• pp.14-20
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• 2022

In this study, we distinguished urban and rural areas in Naju-si, Jeollanam-do, grasped the characteristics of those areas, and investigated the depression-related factors in Naju-si based on this. This study used Community Health Survey data from 2017 to 2019. To investigate the factors affecting the depression in Naju-si local residents, the odds ratio was calculated using a complex sample logistic regression model. As a result of confirming the factors affecting the prevalence of depression in Naju-si residents, the risk of depression was significantly higher at 1.59 (95% confidence interval [CI], 1.02-2.50) for women, 2.14 (95% CI, 1.20-3.83) for recipients of basic livelihoods, 2.35 (95% CI, 1.46-3.79) for those who did not practice walking, and 2.00 (95% CI, 1.23-3.26) for those who slept less than 5 hours. It is necessary to select high-risk groups as a regional-specific project to resolve the mental health disparities in Naju-si and to intervene in early depression prevention through support for mental health support services.

• 한국경제지리학회지
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• 제26권3호
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• pp.289-309
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• 2023

우리나라의 국민건강보험은 빠른 시간에 보편적 의료시스템을 정착시키는데 큰 기여를 했다. 하지만 연령대에 따른 의료서비스의 차이는 지속되고 있으며, 내과, 가정의학과, 소아청소년과와 같은 핵심의료 서비스에서 이러한 불평등이 존재하는 것은 큰 우려를 불러일으킬 수 밖에 없다. 진료기관 접근에 대한 불평등은 연령대만이 아니라 지역, 특히 도시와 농촌 사이에도 크게 나타나고 있다. 본 연구는 1995년부터 2021년까지 초기진료기관의 분포를 이용하여 변화하는 경제환경 속에서 의료서비스의 공간적 불평등이 어떻게 변화되어 왔는지를 살핀다. 다양한 불평등 지수와 공간통계분석의 결과를 토대로 볼 때, 1997년 IMF 경제위기, 2008년 금융위기, 그리고 2020년의 COVID-19 공중보건 위기를 겪으며 불평등이 심화 확대된 것을 확인할 수 있었다. 또한 초기의료기관의 불균등 분포에 큰 변화가 온 시기도 밝혀낼 수 있었는데, 이러한 변화에는 유소년이나 전체 인구 분포보다는 고령인구의 분포가 큰 역할을 하고 있었다. 본 연구결과는 인구와 의료서비스의 공간적 분포를 통합적으로 고려하여 핵심적인 의료자원의 불평등을 해소하기 위한 노력이 절실히 필요하다는 것을 강조한다. 특히 이러한 노력은 미래의 경제적 충격에도 적절한 수준의 의료 서비스를 지속할 수 있는 기반이 될 수 있을 것이다.

• 보건행정학회지
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• 제14권2호
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• pp.17-33
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• 2004

The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.