Background : Germany is the first country in the world to introduce modern systems of public health insurance, and the country which most widely uses complementary alternative medicine(CAM) in Europe. In early 21st century, a large evaluation studies were conducted to include acupuncture in health insurance payments, which were eventually decided. Objectives : This study is to investigate and analyze the process of public policy determination on insurance coverage for acupuncture in German health insurance system. Methods : We collected the data and information through the literature search and from the websites of German government departments and health insurance organizations. To obtain contextual information, German experts of health insurance and acupuncture clinical study were interviewed. Results : As use of acupuncture had been growing, German public health insurers wanted to evaluate the validity of acupuncture coverage and sponsored three evaluation projects for clinical effectiveness of acupuncture using randomized clinical trials, systematic reviews, and pragmatic trials from 2001 to 2005. For some pain condition, acupuncture was founded not to be effective than sham acupuncture, but more effective than standard care. The federal joint committee of health insurance decided to cover acupuncture for chronic pain of lumbar spine and chronic pain in at least one knee joint due to gonarthrosis. Conclusions : Considering the controversial subject matter in the process of acupuncture's health insurance coverage in Germany, expanding the benefits of Korean medicine in Korea needs to come up with ways to overcome the difficulties of placebo effect, standardization and lack of literature evidence.
Purpose: With the development of media, the ways adolescents can obtain information related to sexual health have diversified. Prior quantitative research on adolescents' sexual health information seeking behaviors (HISB) has limitations in grasping the details, and sexual issues of adolescents have tended to be underreported in quantitative studies. It is necessary to explore sexual HISB through an integrative review of qualitative research. The aim of the study was to analyze the literature on sexual HISB among adolescents, focusing on qualitative research. Methods: An integrative review was undertaken to explore the studies conducted between 2009 and 2018 that addressed sexual HISB such as source preferences, perceived trustworthiness, and tendency according to age and gender among adolescents. Results: Seven studies met the selection criteria and were analyzed according different sexual HISB. It was identified that adolescents preferred trustworthy sources and had a pattern of reviewing and comparing the content among diverse sources to confirm the quality of the information. Female adolescents valued privacy and confidentiality, while male adolescents would like to earn information along with their peers and perceived it as an opportunity to exchange their experiences and thoughts. Late adolescents preferred to seek sexual health information from peers and on the internet such as websites and social platforms compared to early adolescents. Conclusion: This study is significant in that it provides evidence that can be applied when developing programs for promoting sexual health in adolescents. It is suggested that programs should focus on building trustworthiness and consider differences in age and gender to improve the use of sexual health information among adolescents.
Purpose: The study tried to suggest the ways to improve the national disability welfare information projects with evaluating the present condition of the projects. Method: Firstly, the study analyzed the disability information system and disability websites. Secondly, the study found out the problems of the registration of disability and management system through the situation analysis. Finally, the study conducted a survey of the disabled and the information system workers and performance evaluation of the information system. Result: The study offered a proposal of The Disability Unity Management System(DUMS) for the disability registration and management. When the disabled visit the hospital or the public health center, their information is registered automatically in The Disability Unity Management System(DUMS), which helps not to miss out the disability registration. Through this system, they are given the proper service which they need, and the information can be shared with the facilities providing the service for the disabled. Conclusion: The Disability Unity Management System(DUMS) contributes significantly in avoiding the repetition of the support for the disabled and improving the quality of service.
Purpose: Internet is one of the essential tools in South Korean adolescent life. Recently, researchers suggest that Internet use is positively associated with teens' mental health problems such as depression and suicide. Thus, this study explored a relationship between Internet use and suicide ideation among South Korean adolescents. Methods: Secondary data, the three-wave Korean Youth Panel Survey, were analyzed. First, in terms of the levels of Internet use and suicidal ideation, t-test was used for examining a gender difference, and Analysis of Variance were used for examining differences across three points in time(waves 2 - 4). Second, logistic analysis was performed to examine the significant association between Internet use and suicide ideation after controlling for the other factors' effects. In this analysis, Fixed Effect Regression Method(FERM) was incorporated as well. FERM was useful in adjusting for the effects of time-invariant factors even without measuring them. As a result, it was possible to obtain more accurate findings. Results: Adolescent depression was an important factor influencing the association between Internet use and suicide ideation. After controlling for the effect of depression, the relationship between Internet use and suicide ideation was no longer statistically significant. Conclusion: As a proxy to identify teens who are obsessed with suicide ideation, levels of Internet use do not seem useful. Instead, it is necessary to examine teens' access to websites related to suicide.
Objectives The aim of this study is to evaluate radiation exposure resulting from the comprehensive health examinations of selected university hospital programs and to present basic data for research and management strategies on the health effects of medical radiation exposure. Methods Radiation-based diagnostic studies of the comprehensive health examination programs of ten university hospitals in Seoul, Korea, as introduced in their websites, were analyzed. The medical radiation studies of the programs were reviewed by radiologists. Only the effective doses of the basic studies were included in the analysis. The optional studies of the programs were excluded. Results Among the 190 comprehensive health examination programs, 132 programs (69.5%) included computed tomography studies, with an average of 1.4 scans. The average effective dose of radiation by program was 3.62 mSv for an intensive program for specific diseases; 11.12 mSv for an intensive program for cancer; 18.14 mSv for a premium program; and 24.08 mSv for an overnight program. A higher cost of a programs was linked to a higher effective dose (r=0.812). The effective doses of the examination programs for the same purposes differed by as much as 2.1 times by hospital. Inclusion of positron emission tomography-computed tomography was the most critical factor in determining the level of effective dose. Conclusions It was found that radiation exposure dose from comprehensive health exam programs targeted for an asymptomatic, healthy public reached between 3.6 and 24 times the annual dose limit for the general public. Relevant management policies at the national level should be provided to minimize medical radiation exposure.
Yang, Yu Seon;Cha, Jung Lim;Kong, Jae Hyung;Hwang, Ji Eun;Choi, Jung Mi;Lee, Joung Eun;Oh, Yu Mi
Korean Journal of Health Education and Promotion
/
v.33
no.5
/
pp.71-81
/
2016
Objectives: Tobacco marketing encourages smoking initiation of non-smokers, especially adolescents, and it hinders quit intention of those who smoke or who attempt to quit smoking. Article 13 of the WHO Framework Convention on Tobacco Control(WHO FCTC) requests a comprehensive ban on tobacco advertising, promotion and sponsorship(TAPS). Ratified the Convention in 2005, Korea has partially implemented the provisions. However, online marketing regulations are still insufficient. Methods: Based on relevant national and international regulations, this research designed monitoring mechanism for online tobacco marketing and studied 1,404 websites to identify current situation of online sales and advertisement of tobacco in Korea. Results: This study found that online trade of tobacco products are overtly conducted, while tobacco advertising with flavoring and misleading descriptors are also prevalent. Also, online tobacco marketing facilitate adolescents' access to tobacco product and that advertising and promotion activities lead to tobacco purchase without difficulties. Conclusions: Fundamental solution to prevent online tobacco advertisement and promotion is banning online sales of tobacco and conducting a regular monitoring for compliance. Korean government should consider establishing an official surveillance system for online tobacco advertisement, followed by a comprehensive ban on TAPS to fulfill its obligation as a Party to the FCTC.
Objectives: To analyze whether there are perceptual differences in internet oral health information use between ordinary people who underwent dental treatments and dental hygienists. Second, the study aimed to analyze related issues, and, third, to find a developmental direction to provide fundamental information for developing patient-customized websites to improve dental services to suit contemporary needs. Methods: From September 1 to September 30, 2018, a questionnaire survey was conducted, with 367 participants (209 dental hygienists and 149 patients) in order to analyze their objective agreement, subjective congruence, and accuracy. As a study tool, the questionnaire consisted of 11 items about the perception of internet oral health information use and 11 on the estimated perceptions of both groups in order to compare their perceptions and estimates of each other. Results: Objective agreement was analyzed and, as a result, dental hygienists and patients were found to demonstrate similar results in terms of their perceptions of internet oral health information use. With regard to subjective agreement, the study subjects either underestimated or overestimated internet oral health information use more than they perceived. In terms of accuracy, dental hygienists and patients had different perceptions regarding internet oral health information use. Therefore, accuracy was somewhat low. Conclusions: In order to improve individuals' self-care ability and increase therapeutic instructional adherence for oral healthcare, it is necessary to apply internet oral health information properly to each patient's individual oral state.
Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.
Background: Fragrance substances in consumer products can cause adverse health effects such as contact allergy. In South Korea, consumer chemical products must list 26 known fragrance allergens on product labels when they contain more than 0.01%. Fragrance substances are mostly used in combination, so co-exposure can occur via use of a consumer chemical product. Co-exposure to fragrance allergens may show a synergistic effect on the human body. Objectives: The aims of the study were to analyze the characteristics of fragrance allergens in consumer chemical products available on public websites and to identify the co-occurrence patterns of fragrance allergens. Methods: The chemicals in 1,443 ingredient disclosures for consumer chemical products were collected through the Ecolife database. The 26 labelled fragrance allergens were identified by category of consumer chemical product. The co-occurrence patterns of the 26 labelled fragrance allergens were analyzed by frequent pattern mining. The unlabelled fragrance allergens presented by European Union Scientific Committee on Consumer Safety were also identified. Results: Consumer chemical products contained an average of 5.3±4.2 substances among the 26 labelled fragrance allergens. More than 85% of air fresheners, deodorizing agents, and fabric softeners contained at least one of the 26 labelled fragrance allergens. The most frequently contained fragrance allergens were limonene (50.5%), linalool (49.9%), hexyl cinnamal (34.0%), and citronellol (28.3%). 16.7% of consumer chemical products showed a co-occurrence of limonene, linalool, hexyl cinnamal, and citronellol. Thirty-eight unlabelled fragrance allergens were found in the consumer chemical products, with hexamethylindanopyran (25.2%) being the most frequently contained substance. Conclusions: The characteristics and co-occurrence patterns of 26 labelled fragrance allergens would be useful information for the management of co-exposure to fragrance allergens in consumer chemical products. It is necessary for attention to be paid to unlabelled fragrance allergens.
This study aimed to analyze health promotion villages from the perspective of therapeutic architecture, and to provide basic information for planning relevant health facilities. On the basis of a review of previous literature, the characteristics of therapeutic architecture were classified into eight categories: safety, comfort, sociality, autonomy, openness, diversity, privacy, and natural environment. Field study and observation were performed in four health promotion villages that conduct programs for lifestyle improvement, physical fitness, and treatment; these villages were also considered to have a healthy residential environment. The researcher and three assistants visited the facilities and checked utilization of space through interviews with the staff and guided tours. Basic information about the subject facilities, such as the purpose of establishment, was gathered from websites before visits. Two of the villages examined in this study had a traditional Korean wooden structure, while the other two were reinforced concrete and masonry block structures. All the facilities emphasized the use of environmentally friendly material and harmony with nature. Each site was divided into the following areas: office, residence, health/treatment, public/rest, and outdoor. The safety standards of the healing architecture were not completely satisfactory at all facilities. In particular, it was found that they lacked adequate universal design equipment. However, the healing characteristics of autonomy and diversity were strong. With regard to autonomy, the facilities allowed visitors to select indoor-outdoor moving lines and the use of front- and backyards constructed on slopes. In addition, they were equipped with many entries, staircases, void, terraces, and crossroads. The architecture was aesthetically designed using feng shui symbolism, and visitors found the scenes depicted in various spaces in the villages to be stimulating. Besides, the facilities were constructed using natural materials, had a natural indoor environment, and provided a sense of spaciousness and flexibility.
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