Decentralization to local governments and amending of Health Center Law are to promote the efforts of health planning at the level of local agencies. In the health facility planning, it is important to take into account that what to be built, where to be located, how far should be service area and so forth, because health facilities are immovable, and require capital as well as personnel and consumable supplies. The aim of our study, answering to the question of 'where to be located?', is to determine the best location of urban health sub-center. At the local level, planning is the matter of finding the best location of specific facilitiy, in relation to population needs. We confine the accessibility, which is basic to location planning, to geographic one. Location-Allocation Model is used to solve the problem where the location is to maximize geographic accessibility. To minimize the weighted travel distance, objective function, $R_k=\sum{\sum}a_{ij}w_{i}d_{ij}$ is used. Distances are measured indirectly by map measure-meter with 1:25,000 Suwon map, and each potential sites, 10 administrative Dongs in Kwonson Gu, Suwon, are weighted by each number of households, total population, maternal age group, child age group, old age group, Relief for the livelihood, and population/primary health clinics. We find that Kuwoon-Dong, Seodun-Dong, Seryu3-Dong, according the descending orders, are best sites which can minimize the weighted distance, and conclude that it is reasonable to determine the location of urban health sub-center among those sites.
Kim, Ikhan;Bahk, Jinwook;Yoon, Tae-Ho;Yun, Sung-Cheol;Khang, Young-Ho
Journal of Preventive Medicine and Public Health
/
v.50
no.2
/
pp.100-126
/
2017
Objectives: The aim of this study was to measure income differences in smoking prevalence at the district level and to investigate correlations among area deprivation, smoking prevalence, and income differences in smoking prevalence, stratified by urbanity. Methods: Data were pooled from the Community Health Survey data of South Korea between 2008 and 2014. The age-standardized prevalence of smoking and its interquintile income differences were calculated. We conducted correlation analyses to investigate the association of the deprivation index with smoking prevalence and interquintile differences in smoking prevalence. Results: Across 245 districts, the median prevalence of smoking in men was 45.9% (95% confidence interval [CI], 43.4 to 48.5%), with an interquartile range (IQR) of 4.6% points. In women, the median prevalence was 3.0% (95% CI, 2.4 to 3.6%) and IQR was 1.6% points. The median interquintile difference in smoking prevalence was 7.4% points (95% CI, 1.6 to 13.2% points) in men and 2.7% points (95% CI, 0.5 to 4.9% points) in women. The correlation coefficients for the association between the deprivation index and smoking prevalence was 0.58, 0.15, -0.22 in metropolitan, urban, and rural areas, respectively, among men, and 0.54, -0.33, -0.43 among women. No meaningful correlation was found between area deprivation and interquintile difference in smoking prevalence. The correlation between smoking prevalence and interquintile difference in smoking prevalence was more evident in women than in men. Conclusions: This study provides evidence of geographical variations in smoking prevalence and interquintile difference in smoking prevalence. Neither smoking prevalence nor the deprivation index was closely correlated with interquintile income difference in smoking prevalence. Measuring inequalities in smoking prevalence is crucial to developing policies aimed at reducing inequalities in smoking.
In this study, climate change considerations are an important measure to create a resilient city that conforms to the principle of sustainable development that balances the economic, social and environmental harmony of a country or city and can preserve its size, function and characteristics to the maximum extent possible. In this regard, the public transportation system being built and operated in Dublin City, Ireland, illustrates the city's system through green traffic. Therefore, based on the urban-based conditions equipped by Dublin, Ireland, in that Dublin is realizing preemptive mass-traffic-oriented urban development (TOD) considering climate change, the purpose of the study was to classify the methods of research as internal (strong and weak) and external (opportunity and threat) factors through SWOT analysis and to present mass-oriented urban development strategies and policy implications.
Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.
The Journal of Asian Finance, Economics and Business
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v.7
no.9
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pp.719-726
/
2020
Education policy is a dynamic process featuring social development trends. The world countries have focused their education program on empowering the learners for future life and work. This paper aims to assess the higher education curriculum based on a survey of 280 students, employers, alumni, and lecturers in both social sciences and natural sciences in Ho Chi Minh City, Vietnam. The fuzzy decision-making method, namely the Fuzzy Extent Analysis Method (F-EAM), was applied to measure the relative weight of each parameter. Seven factors under the curriculum development have been put in the ranking. Input with emphasis on foreign language was the highest priority in curriculum development, given the expected demand of the labor market. Objective and learning outcome and teaching activities ranked second and third, respectively. The traditional triangle of teaching content, methodology, and evaluation and assessment are still proven their roles, but certain modifications have been defined in the advanced curriculum. Teaching facilities had the least weight among the seven dimensions of curriculum development. The findings are helpful for education managers to efficiently allocate scarce resources to reform the curriculum to bridge the undergraduate quality gap between labor supply and demand, meeting the dynamic trends of social development.
Kim, Yu-Jeong;Kim, Dae-Hyung;Kim, Jinsoo;Kim, Juhan
Resources Recycling
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v.27
no.3
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pp.66-77
/
2018
The import amount of rare metal in Korea is about 6,034 million USD, but the self-sufficiency of rare metals is about only 1%. In order to secure the stable supply of rare metals, it is necessary to operate an efficient stockpile system. In this study, we established a system to assess the adequacy of stockpiles by quantifying the risk factors of tangible and intangible risks in order to establish an efficient stockpile strategy. The model developed in this study aims to select the rare metals that need to be stockpiled first and to suggest the direction of the stockpiling policy in accordance with technological change and market change from the mid and long term viewpoint. The evaluation results derived from the model can quantitatively measure the security level of each rare metal and enable relative comparison between the rare metals using criticality matrix. Therefore, it is expected that more efficient stockpile policy will be possible if the proposed model is utilized in the future policy making.
Kim, Agnus M.;Park, Jong Heon;Kang, Sungchan;Kim, Yoon
Journal of Preventive Medicine and Public Health
/
v.50
no.1
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pp.29-37
/
2017
Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.
Lee, Kunsei;Shin, Eunyoung;Jeong, Hyoseon;Lee, Jung-Hyun;Kim, Hee-Sook;Lim, Young Sil;Kim, Young Taek
Health Policy and Management
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v.23
no.4
/
pp.434-444
/
2013
Background: Regional Cardiocerebrovascular Centers (RCC) were established for the prevention and treatment of cardiocerebrovascular disease and funded by the Ministry of Health and Welfare. The purpose of this study was to develop and validate the measurement tool of public benefits in RCC. Methods: Through the intensive literature review, experts surveys and their repetitive feedback, we selected the 46 items about the public benefits in RCC. Development of measurement tool involved content validity test using Content Validity Index (CVI), construct validity test through factor analysis and reliability test. Results: Thirty-five items were selected by content validity test, which CVI was 0.08 or higher. Through the construct validity test, 32 items in 7 factors were derived. And Cronbach's alpha was 0.951. Finally, public benefits measurement tool is composed of 32 items in 7 factors which are comprehensiveness of health care services, market complement, emergency care, cost, governance, quality improvement, and government control. Conclusion: Though we developed the measurement tool of public benefits in RCC, it would be utilized to measure the public benefits of various health agencies.
With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.
The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.
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