• Health Policy and Management
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• v.2 no.2
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• pp.221-237
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• 1992

The reasons for cost inflation in medical insurance expenditure are classified into demand pull inflation and cost push inflation. The former includes increase in the number of beneficiaries and utilization rate, while the latter includes increase in medical insurance fee and the charges per case. This study was conducted to analyze sources of increases of expenditure in medical insurance demonstration area by the period of 1982-1987 which was earlier than national health insurance and the period of national health insurance(1988-1990). The major findings were as follows: Medical expenditure in these areas increased by 9.4%(15.1%) annually between 1982 and 1990 on the basis of costant price(current price) and for this period, the yearly average increasing rate of expenses for outpatient care[10.5%(15.8%)] was higher than that of inpatient care [7.3%(12.6%)]. Medical expenditure increased by 6.3%(8.9%) annually between 1982 and 1987, the period of medical insurance demonstration, while it increased by 10.7%(18.9%) after implementing national health insurance(1988-1990). Medical expenditure increased by 35.9%(45.9%) between 1982 and 1987. Of this increase, 115.2%(92.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 61.0%(68.1%) was due to the increase in the charges per case, but the expenditure decreased by 76.2%(60.2%) due to the reduction in the number of beneficiaries. Beteen 1988 and 1990, the period of national health insurance, medical expenditure increased by 21.2%(41.4%). Of this increase, 87.5%(46.4%) was attributable to the increase in the frequencies of utilization per beneficiary and 52.4%(73.4%) was due to the increase in the charges per case, and of the increase in the charges per case, 69.6%(40.8%) was attributable to the increase in the days of visit per case. Medical expenses per person in these areas increased by 78.2%(89.0%) between 1982 and 1987. Of this increase, 76.6%(69.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 23.4%(30.9%) was due to the increase in the charges per case. For this period, demand-pull factor was the major cause of the increase in medical expenses and the expenses per treatment day was the major attributable factor in cost-push inflation. Betwee 1988 and 1990, medical expenditure per person increased by 31.2%(53.1%). Of this increase, 60.8%(37.2%) was attributable to the demand-pull factor and 39.2%(62.8%) was due to the increase in the charges per case which was one of cost-push factors. In current price, the attributalbe rate of the charges per case which was one of cost-push factors was higher than that of utilization rate in the period of national health insurance as compared to the period of medical insurance demonstration. In consideration of above findings, demand-pull factor led the increase in medical expenditure between 1982 and 1987, the period of medical insurance medel trial, but after implementing national health insurance, the attributable rate of cost-push factor was increasing gradually. Thus we may conclude that for medical cost containment, it is requested to examine the new reimbursement method to control cost-push factor and service-intensity factor.

• Health Policy and Management
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• v.11 no.2
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• pp.141-168
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• 2001

Healthcare service organizations can apply the cost of quality(COQ) model as a method to evaluate a service quality improvement project such as Total Quality Management (TQM). COQ model has been used to quantify and evaluate the efficiency and effectiveness of TQM project through estimation between cost and benefit in intervention for a quality Improvement to provide satisfied services for a customer, and to identify a non value added process. For estimating cost of quality, We used activities and activity costs based on Activity Based Costing(ABC) system. These procedures let the researchers know whether the process is value-added by each activity, and identify a process to require improvement in TQM project. Through the series of procedures, health care organizations are service organizations can identify a problem in their quality improvement programs, solve the problem, and improve their quality of care for their costumers with optimized cost. The study subject was a quality improvement program of the department of radiology department in a hospital with n bed sizes in Metropolitan Statistical Area (MSA). The principal source of data for developing the COQ model was total cases of retaking shots for diagnoses during five months period from December of the 1998 to April of the 1999 in the department. First of the procedures, for estimating activity based cost of the department of diagnostic radiology, the researchers analyzed total department health insurance claims to identify activities and activity costs using one year period health insurance claims from September of the 1998 to August of the 1999. COQ model in this study applied Simpson & Multher's COQ(SM's COQ) model, and SM's COQ model divided cost of quality into failure cost with external and internal failure cost, and evaluation/prevention cost. The researchers identified contents for cost of quality, defined activities and activity costs for each content with the SM's COQ model, and finally made the formula for estimating activity costs relating to implementing service quality improvement program. The results from the formula for estimating cost of quality were following: 1. The reasons for retaking shots were largely classified into technique, appliances, patients, quality management, non-appliances, doctors, and unclassified. These classifications by reasons were allocated into each office doing re-taking shots. Therefore, total retaking shots categorized by reasons and offices, the researchers identified internal and external failure costs based on these categories. 2. The researchers have developed cost of quality (COQ) model, identified activities by content for cost of quality, assessed activity driving factors and activity contribution rate, and calculated total cost by each content for cost for quality, except for activity cost. 3. According to estimation of cost of quality for retaking shots in department of diagnostic radiology, the failure cost was ￦35,880, evaluation/preventive cost was ￦72,521, two times as much as failure cost. The proportion between internal failure cost and external failure cost in failure cost is similar. The study cannot identify trends on input cost and quality improving in cost of qualify over the time, because the study employs cross-sectional design. Even with this limitation, results of this study are much meaningful. This study shows possibility to evaluate value on the process of TQM subjects using activities and activity costs by ABC system, and this study can objectively evaluate quality improvement program through quantitative comparing input costs with marginal benefits in quality improvement.

• Journal of agricultural medicine and community health
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• v.43 no.4
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• pp.258-269
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• 2018

Objectives: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June $5^{th}$ but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification. Methods: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June $2^{nd}$ to June $12^{th}$. Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus. Results: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef) Conclusions: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.

• Health Policy and Management
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• v.34 no.2
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• pp.120-128
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• 2024

From February to now 2024, there continues to be controversy over the expansion of admission number to medical school. Some of the controversy arises from a mix of present and future time points. In the present time point, the controversy over whether physicians are some shortages or not has various aspects. Some aspects are presented as evidence of the physician shortage and others as non-shortage. Also, the presenting evidence of shortage is being disputed, and so is the evidence of the contrary. This controversy over whether there is a shortage or not in the present time point makes it difficult to reach a consensus. In 10 years, the shortage of doctors will increase due to the rapid increase in the elderly population, so the admission number of medical schools will need to be increased. However, the increase must be such that there is minimal deterioration in the quality of medical education. More admission numbers should be allocated to medical schools with a high quality of medical education. This study suggests that large-scale medical schools increase the admission number by 20%-30%, and small-scale medical schools increase the admission number by 40%-50%, if so, the total increasing number is 760 to 1,066. If the 2,000-person increase is enforced, the quality of medical education must be carefully evaluated and the results should be reflected in adjusting the admission number of medical schools. In 20 years later, the admission number of medical schools will have to be reduced. This is because the physician supply is changing to a linear function and the physician demand (medical care demand) is changing to a quadratic function. Even if the current number is maintained, there will be an excess of doctors from 2048, so the medical school admission number must be reduced and its size will be reduced to about 2,000, a 30% reduction from the current number. Because the same reduction rate for all medical schools will result in many small-scale medical schools, the M&A (mergers and acquisitions) strategy should be considered with 40 medical schools and 12 Korean medical schools. In Korea, the main contributor to estimating physician demand is the change in population structure. Due to the rapid decrease in the total fertility rate, future population projections are uncertain. The recent rapid increase in healthcare utilization should be reexamined in the forecasting of physician demand. Since the various factors that affect the estimate of doctor supply and demand are unclear, the estimate of physician supply and demand must be continuously conducted every five years, and the Health Care Workforce Committee must be established and operated. The effects of increasing the admission number of medical schools should be evaluated and adjusted annually.

• The Korean Journal of Air & Space Law and Policy
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• v.31 no.2
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• pp.145-176
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• 2016

Aviation safety can be secured through regulations and policies of various areas and thorough execution of them on the field. Recently, for aviation safety management Korea is making efforts to prevent aviation accidents by taking various measures: such as selecting and promoting major strategic goals for each sector; establishing National Aviation Safety Program, including the Second Basic Plan for Aviation Policy; and improving aviation related legislations. Obstacle limitation surface is to be established and publicly notified to ensure safe take-off and landing as well as aviation safety during the circling of aircraft around airports. This study intends to review current aviation obstacle management system which was designed to make sure that buildings and structures do not exceed the height of obstacle limitation surface and identify its operating problems based on my field experience. Also, in this study, I would like to propose ways to improve the system in legal and regulatory aspects. Nowadays, due to the request of residents in the vicinity of airports, discussions and studies on aviational review are being actively carried out. Also, related ordinance and specific procedures will be established soon. However, in addition to this, I would like to propose the ways to improve shortcomings of current system caused by the lack of regulations and legislations for obstacle management. In order to execute obstacle limitation surface regulation, there has to be limits on constructing new buildings, causing real restriction for the residents living in the vicinity of airports on exercising their property rights. In this sense, it is regarded as a sensitive issue since a number of related civil complaints are filed and swift but accurate decision making is required. According to Aviation Act, currently airport operators are handling this task under the cooperation with local governments. Thus, administrative activities of local governments that have the authority to give permits for installation of buildings and structures are critically important. The law requires to carry out precise surveying of vast area and to report the outcome to the government every five years. However, there can be many problems, such as changes in the number of obstacles due to the error in the survey, or failure to apply for consultation with local governments on the exercise of construction permission. However, there is neither standards for allowable errors, preventive measures, nor penalty for the violation of appropriate procedures. As such, only follow-up measures can be taken. Nevertheless, once construction of a building is completed violating the obstacle limitation surface, practically it is difficult to take any measures, including the elimination of the building, because the owner of the building would have been following legal process for the construction by getting permit from the government. In order to address this problem, I believe penalty provision for the violation of Aviation Act needs to be added. Also, it is required to apply the same standards of allowable error stipulated in Building Act to precise surveying in the aviation field. Hence, I would like to propose the ways to improve current system in an effective manner.

• The Korean Journal of Air & Space Law and Policy
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• v.32 no.2
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• pp.101-127
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• 2017

Even with the most advanced aviation technology benefits, aircraft accidents are constantly occurring while air passenger transportation volume is expected to double in the next 15 years. Since it is not possible to secure aviation safety only by the post aircraft accident safety action of accident investigations, it has been recognized and consensus has been formed that proactive and predictive prevention measures are necessary. In this sense, the aviation safety management system (SMS) was introduced in 2008 and has been carried out in earnest since 2011. SMS is a proactive and predictive aircraft accident preventive measure, which is a mechanism to eliminate the fundamental risk factors by approaching organizational factors beyond technological factors and human factors related to aviation safety. The methodology is to collect hazards in all the sites required for aircraft operations, to build a database, to analyze the risks, and through managing risks, to keep the risks acceptable or below. Therefore, the improper implementation of SMS indicates that the aircraft accident prevention is insufficient and it is to be directly connected with the aircraft accident. Reports of duty performance related hazards including their own errors are essential and most important in SMS. Under the policy of just culture for voluntary reporting, the guarantee of information providers' anonymity, non-punishment and non-blame should be basically secured, but to this end, under-reporting is stagnant due to lack of trust in their own organizations. It is necessary for the accountable executive(CEO) and senior management to take a leading role to foster the safety culture initiating from just culture with the safety consciousness, balancing between safety and profit for the organization. Though a Ministry of Land, Infrastructure and Transport's order, "Guidance on SMS Implementation" states the training required for the accountable executive(CEO) and senior management, it is not legally binding. Thus it is suggested that the SMS training completion certificates of accountable executive(CEO) and senior management be included in SMS approval application form that is legally required by "Korea Aviation Safety Program" in addition to other required documents such as a copy of SMS manual. Also, SMS related items are missing in the aircraft accident investigation, so that organizational factors in association with safety culture and risk management are not being investigated. This hinders from preventing future accidents, as the root cause cannot be identified. The Aircraft Accident Investigation Manuals issued by ICAO contain the SMS investigation wheres it is not included in the final report form of Annex 13 to the Convention on International Civil Aviation. In addition, the US National Transportation Safety Board(NTSB) that has been a substantial example of the aircraft accident investigation for the other accident investigation agencies worldwide does not appear to expand the scope of investigation activities further to SMS. For these reasons, it is believed that investigation agencies conducting their investigations under Annex 13 do not include SMS in the investigation items, and the aircraft accident investigators are hardly exposed to SMS investigation methods or techniques. In this respect, it is necessary to include the SMS investigation in the organization and management information of the final report format of Annex 13. In Korea as well, in the same manner, SMS item should be added to the final report format of the Operating Regulation of the Aircraft and Railway Accident Investigation Board. If such legal and institutional improvement methods are complemented, SMS will serve the purpose of aircraft accident prevention effectively and contribute to the improvement of aviation safety in the future.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.59-78
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• 2001

Data on reported cancer mortality in the Gyeongsangbuk- do province from 1991 to 1998 were collected and analyzed using the existing mortality reporting system as well as the public health network to furnish accurate data on reported cancer death and to collect data to establish a high quality district health plan. The overall crude death rate in Gyeongsangbuk province in 1991 was 74.56 deaths per 100,000-person but this rate increased to 79.22 in 1998. Among the deaths, the overall death rate of cancer was 16.7% in 1991, which increased to 19.3% in 1998; specifically the death rate of men increased from 19.4% in 1991 to 22.3% in 1998 while that of women increased from 12.4% in 1991 to 15.5% in 1998, showing a more increase among women. The types of cancer and associated death rates in 1991 were gastric cancer(41.5%), followed by liver cancer (28.8%), and lung and bronchogenic carcinoma(8.7%) and in 1998, gastric cancer (24.7%), followed by liver cancer(22.7%), lung and bronchogenic carcinoma(19.3%), showing the same order. For men and women, gastric cancer(40.2% and 44.7%, respectively) was the most common cancer death, followed by liver cancer(33.7% and 16.7%, respectively), and lung and bronchogenic carcinoma(10.2% and 5.0%, respectively) in 1991. However, in 1998, gastric cancer(27.8%) was still the most common type among both men and women, followed by liver cancer (18.5%) and lung and bronchogenic carcinoma(12.7%), showing the most decrease in gastric cancer but most increase in lung and bronchogenic carcinoma. The age- adjusted mortality rates by gastric cancer, hepatoma, laryngeal carcinoma were decreased in both male and female, and also uterine cancer was decreased in female. The age- adjusted mortality rates by lung and bronchogenic carcinoma, pancreatic cancer, rectal cancer were increased in both male and female, and also breast cancer was increased in female. The calculated overall age-adjusted death rate based on the 1995 population was 84.25 in 1991, which decreased to 77.67 in 1998. Male death rate decreased significantly from 119.81 in 1991 to 101.82 in 1998 while the female death rate increased from 48.64 in 1991 to 53.80 in 1998. A census of cancer death rate using accurate death records is important for the establishment of proper and high-quality district health and medical plan and policy. The effort to improve the accuracy of death reports using the health facility network, as had been attempted by this study, can be continued. Furthermore, there must be a way for the Health and Welfare Department to use the death reports to improve the present reporting system. Lastly, additional studies need to be conducted to investigate how much the accuracy was improved by the supplemented death reports in this study.

• Proceedings of the Korea Technology Innovation Society Conference
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• 2015.05a
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• pp.545-570
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• 2015

Korea is among the ten countries with the largest R&D budget and the highest R&D investment-to-GDP ratio, yet the subject of security and protection of R&D results remains relatively unexplored in the country. Countries have implemented in their legal systems measures to properly protect cutting-edge industrial technologies that would adversely affect national security and economy if leaked to other countries. While Korea has a generally stable legal framework as provided in the Regulation on the National R&D Program Management (the "Regulation") and the Act on Industrial Technology Protection, many difficulties follow in practice when determining details on security management and obligations and setting standards in carrying out national R&D projects. This paper proposes to modify and improve security level classification standards in the Regulation. The Regulation provides a dual security level decision-making system for R&D projects: the security level can be determined either by researcher or by the central agency in charge of the project. Unification of such a dual system can avoid unnecessary confusions. To prevent a leakage, it is crucial that research projects be carried out in compliance with their assigned security levels and standards and results be effectively managed. The paper examines from a practitioner's perspective relevant legal provisions on leakage of confidential R&D projects, infringement, injunction, punishment, attempt and conspiracy, dual liability, duty of report to the National Intelligence Service (the "NIS") of security management process and other security issues arising from national R&D projects, and manual drafting in case of a breach. The paper recommends to train security and technological experts such as industrial security experts to properly amend laws on security level classification standards and relevant technological contents. A quarterly policy development committee must also be set up by the NIS in cooperation with relevant organizations. The committee shall provide a project management manual that provides step-by-step guidance for organizations that carry out national R&D projects as a preventive measure against possible leakage. In the short term, the NIS National Industrial Security Center's duties should be expanded to incorporate national R&D projects' security. In the long term, a security task force must be set up to protect, support and manage the projects whose responsibilities should include research, policy development, PR and training of security-related issues. Through these means, a social consensus must be reached on the need for protecting national R&D projects. The most efficient way to implement these measures is to facilitate security training programs and meetings that provide opportunities for communication among industrial security experts and researchers. Furthermore, the Regulation's security provisions must be examined and improved.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.227-240
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• 2005

Health promotion has more comprehensive approaches in recent years. Nevertheless we accept the concept of health promotion differently, we are agree on that community is the most important field in health promotion which includes population at the aspect of health policy, individual skill and, environment. And there are a number of different approaches to health promotion. In them, 'population approaches' and 'high -risk group approaches' has the most different characteristics. 'Population approaches' is equally important or more important than 'individual approaches' for maintaining and promoting population health. Almost part of this article contents is the summary of the guideline and population strategy of health promotion in Korea, 1999 - 2005. Community based health promotion program should be reinforced, integrated, comprehensive, collaborative through efficiently utilizing community resources. Recent new orientation of community health program is integrated health program, we can find this orientation at Ottawa charter 1986. Comprehensive approaches with the determinant factors for health are essential task. Physical activity is a key health determinant. The population-health approach suggests that educating people about physical activity is not enough. Individual behavior changes are important too, but need to be balanced with strategies for environmental change. Population strategy with physical activity for health promotion should be developed through improving social and physical supportive environment, linking and integrating community resources between public and private sectors in national, regional and local level. Continuous public education and social marketing should be provided through collaborating with community physical activity organization, facilities, work-places and school for increasing concern of all the people of community about physical activity. Governments, agencies and citizens should held and participate to building movement. And the strategy that various 'active for life' program should be developed, delivered, maintained and reinforced continuously. Basically, adequate and sufficient financing, developing human resources, policies and legislation would be provided and supported fully too. At last, research development and knowledge exchange are required domestically and internationally. In Korea, we had classified the category of strategic priority of physical activity programs by environmental support, life-course approach, high-risk group approach and disease group approach for physical activity program based on community health center. Community based core programs for physical activity that includes infrastructure building and establishment of supporting environment, community campaign, health promotion education and public service announcement, physical activity programs for elderly and obesity, exercise prescription program.