• 보건행정학회지
• /
• 제9권4호
• /
• pp.41-64
• /
• 1999

The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.

• Journal of Preventive Medicine and Public Health
• /
• 제40권4호
• /
• pp.259-264
• /
• 2007

Effective communicable disease surveillance systems are the basis of the national disease prevention and control. Following the increase in emerging and re-emerging infectious diseases since late 1990s, the Korean government has strived to enhance surveillance and response system. Since 2000, sentinel surveillance, such as influenza sentinel surveillance, pediatric sentinel surveillance, school-based sentinel surveillance and ophthalmological sentinel surveillance, was introduced to improve the surveillance activities. Electronic reporting system was developed in 2000, enabling the establishment of national database of reported cases. Disweb, a portal for sharing communicable disease information with the public and health care workers, was developed. In general, the survey results on usefulness and attributes of the system, such as simplicity, flexibility, acceptability, sensitivity, timeliness, and representa-tiveness, received relatively high recognition. Compared to the number of paid cases of national health insurance, reported cases by national notifiable disease surveillance system, and various sentinel surveillance system, the result of the correlation analysis was high. According to the research project conducted by KCDC, the reporting rate of physicians in 2004 has also greatly improved, compared with that in 1990s. However, continuous efforts are needed to further improve the communicable disease surveillance system. Awareness of physicians on communicable disease surveillance system must be improved by conducting education and information campaigns on a continuous basis. We should also devise means for efficient use of various administrative data including cause of death statistics and health insurance. In addition, efficiency of the system must be improved by linking data from various surveillance system.

• 대한예방의학회:학술대회논문집
• /
• 대한예방의학회 1996년도 제48차 추계 학술대회 연제집
• /
• pp.293-294
• /
• 1996

• 한국산학기술학회논문지
• /
• 제15권12호
• /
• pp.7179-7186
• /
• 2014

이 연구는 감염병 발생자료와 감염병 관리사업 평가지표와의 관계를 실증적으로 분석함으로써 감염병 관리사업의 평가지표의 타당성을 실증적으로 분석함을 목적으로 하였다. 자료는 2004년과 2005년 2개년간의 시군구(보건소) 감염병 환자 발생 수 합계와 2005년도 감염병관리사업 평가지표 등 이었다. 자료의 분석은 빈도분석, 분산분석, 다중회귀분석 등을 이용하였다. 보건소 유형 및 법정감염병 각 군별로 각기 상이한 지표들이 도출되었으며, 각 군로도 특이한 지표 보다는 다양한 분야의 지표들이 혼재되어 있는 양상으로 도출되었다. 특히, 교육실적 등이 발생건수와 유의한 관계를 보이는 경우가 많아 발생건수는 신고건수 즉, 사업의 성과의 결과로 판단하는 것이 더욱 타당할 것으로 판단된다. 전체적인 지표의 개선이 필요하거나 사업의 투입시간 및 추이를 본 후 재평가가 필요할 것으로 생각되며, 각 사업별로 분리하여 특이한 평가지표를 생산할 필요가 있어 보인다. 감염병관리사업의 평가지표 개발은 기초자치단체별 감염병관리사업 종합평가체계를 구축하는데 핵심적인 역할을 할 것이며, 감염병관련업무 표준화를 촉진하고 관련지침을 개정에 활용될 것이며, 향후 보건사업 및 보건의료조직의 계량적인 성과 평가에 활용될 것이다. 또한 시군구 보건소에서 수행한 성공적인 감염병 관리 사업의 사례를 발굴, 제시함으로써 보다 성공적인 감염병관시업의 접근이 가능케 할 것이다.

• 환경위생공학
• /
• 제9권2호
• /
• pp.41-49
• /
• 1994

Water- borne infectious diseases can be acquired by contact with contaminated water or by ingestion of contaminated water. There are many water- borne infectious agents such as bacteria, virus, and parasite. Among many of water- borne infectious diseases, health authorities of Korean government has particularly intensified to prevent and control typhoid fever(class I ), shigellosis(class I ), cholera(class I ), paratyphoid fever(class I), amebiasis(class II ) and leptospirosis(euivalent to class II ) under the communicable disease control law. Water- borne disease Prevention and control guideline itself has been also well provided by the health authorities. However, in practical public health point of view, there are still many problems remained to be solved out; no prospective investigation project to survey water borne infectious diseases under the national disease prevention and control programmes, incredible statistic data of annual notifiable disease report frequent appearance and varieties of drug resistance water- borne infectious agents, little cooperation and information- exchange system in between the related government authorities( the health authorities, the environment sanitation authorities and the food hygiene authorities) which should be closely collaborated, lack of health consciousness of the people, necessity of evaluation and Hndification on to the outcomes of performed health activities and programmes, neglect activities for water quality investigation, shortage of expertise and human resources in the related field, and poor investment of the government budget to develope and improve public health and sanitation field. In order to prevent and control water- borne infectious diseases effectively, it is emphasized that all the above indicated should be considered and performed to improve under the national health and sanitation development programmes.

• Journal of Preventive Medicine and Public Health
• /
• 제43권5호
• /
• pp.436-444
• /
• 2010

Objectives: Infectious diseases are known to be affected by climate change. We investigated if the infectious diseases were related to meteorological factors in Korea. Methods: Scrub typhus, hemorrhagic fever with renal syndrome (HFRS), leptospirosis, malaria and Vibrio vulnificus sepsis among the National Notifiable Infectious Diseases were selected as the climate change-related infectious diseases. Temperature, relative humidity and precipitation were used as meteorological factors. The study period was from 2001 through 2008. We examined the seasonality of the diseases and those correlations with meteorological factors. We also analyzed the correlations between the incidences of the diseases during the outbreak periods and monthly meteorological factors in the hyper-endemic regions. Results: All of the investigated diseases showed strong seasonality; malaria and V. vulnificus sepsis were prevalent in summer and scrub typhus, HFRS and leptospirosis were prevalent in the autumn. There were significant correlations between the monthly numbers of cases and all the meteorological factors for malaria and V. vulnificus sepsis, but there were no correlation for the other diseases. However, the incidence of scrub typhus in hyper-endemic region during the outbreak period was positively correlated with temperature and humidity during the summer. The incidences of HFRS and leptospirosis had positive correlations with precipitation in November and temperature and humidity in February, respectively. V. vulnificus sepsis showed positive correlations with precipitation in April/May/July. Conclusions: In Korea, the incidences of the infectious diseases were correlated with meteorological factors, and this implies that the incidences could be influenced by climate change.

• Journal of Preventive Medicine and Public Health
• /
• 제31권3호
• /
• pp.471-480
• /
• 1998

This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.