• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.343-348
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• 2016

Since noncommunicable diseases (NCDs) are generally controllable rather than curable, more emphasis is placed on prevention than on treatment. For the early detection of diseases, primary care physicians (PCPs), as well as general practitioners and family physicians, should interpret screening results accurately and provide screenees with appropriate information about prevention and treatment, including potential harms. The concept of quaternary prevention (QP), which was introduced by Jamoulle and Roland in 1995, has been applied to screening results. This article summarizes situations that PCPs encounter during screening tests according to the concept of QP, and suggests measures to face such situations. It is suggested that screening tests be customized to fit individual characteristics instead of being performed based on general guidelines. Since screening tests should not be carried out in some circumstances, further studies based on the concept of prevention levels proposed by Jamoulle and Roland are required for the development of strategies to prevent NCDs, including cancers. Thus, applying the concept of QP helps PCPs gain better insights into screening tests aimed at preventing NCDs and also helps improve the doctor-patient relationship by helping screenees understand medical uncertainties.

• Health Policy and Management
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• v.28 no.3
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• pp.197-201
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• 2018

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.447-453
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• 2007

Although the New National Health Promotion Plan 2010 target to reduce health inequalities, whether the program will be effective for reducing the health inequalities in Korea remains quite unclear. More and more developed countries have been started to concentrate on comprehensive policies for reducing health inequalities. The health policies of the UK, Netherlands, and Sweden are the most wellknown. I propose that a comprehensive blueprint for tackling health inequalities in Korea should be made and that it must contain five domains: a target, structure and process, life-course approach, area-based approach, and reorganization of health care resources. The target should be based on determinants of health and more attention should be paid to socioeconmic factors. The structure and process require changes from the national health care policy based on medical services to the national health policy that involves the establishment of a Social Deputy?Prime Minister and the strengthening multidisciplinary action. A life-course approach especially focused on the early childhood years. Area-based approach such as the establishment of healthy communities, healthy schools, or healthy work-places which are focused on deprived areas or places is also required. Finally, health care resources should be a greater investment on public resources and strengthening primary care to reduce health inequalities. The policy or intervention studies for tackling health inequalities should be implemented much more in Korea. In addition, it is essential to have political will to encoruage policy action.

• Journal of Preventive Medicine and Public Health
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• v.44 no.2
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• pp.74-83
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• 2011

Objectives: This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. Methods: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP ${\geq}$ 140 mmHg, a diastolic BP ${\geq}$ 90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. Results: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. Conclusions: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.

• Health Policy and Management
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• v.24 no.1
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.3-26
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• 1996

Epidemiology and preventive medicine are changing together with Population and health and with ever expanding medical and non medical technologies. New technologies make epidemiology methodologically more sophisticated, but such advances risk overshadowing epidemiology's most important role: raising questions, providing answers, and helping the medical decision-making at ail levels of prevention. Epidemiology also plays a major role in the evaluation of new and other technologies whose effectiveness is poorly known. Epidemiological approaches, methods, techniques, and interpretations are widely used in new and rapidly expanding fields of medicine: research evaluation and synthesis (meta-analysis), establishment of guidelines for clinical preventive practices, new medical technology assessment, guidelines for national and international health policies, evidence-based medicine, outcomes research and disease management ('population-based' medicine and quality of care improvement). In the nearest future, infectious and noninfectious diseases may cease to be almost the sole subjects of epidemiology and they may share their place with other mass phenomena of the next millennium, such as medical practices and care, or political, social and economic actions and their consequences. Not only will primary, secondary, and tertiary Prevention will remain in the epidemiological mainstream, but health protection and health promotion will require perhaps a redefinition of epidemiology in these domains. Epidemiology and preventive medicine are both subjects of medical ethics and dilemma for right choices.

• Journal of Preventive Medicine and Public Health
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• v.15 no.1
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• pp.5-16
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• 1982

The Saemaul Undong has brought great improvements tothe life-style environment of rural communities, but it has not been able to focuson a health program. In order to improve rural health, develop human resources, and utilise the nation's manpower, the Saemaul Undong should focus on a community health project. Mobilizing the manpower for such a project can be done by providing opportunities for youth and young adults, especially village women, to betrained as primary health caretakers. This project can be achieved through the joint support of the Ministry of Horne Affairs, the Ministry of health and Social Affairs, and other Ministries. It will take decision and courage by government officials to implement such a grand plan, but it is a very crucial task to promote primary health care throughout the whole nation. This calls for top leader's concern & will to adovocate and support a 'Saemaul Movement for health', giving health asfirst priority to the Saemaul Undong as afresh political drive of the fifth Republic of Korea Government.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.83-91
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• 2002

Bioinformatics is a rapidly emerging field of biomedical research. A flood of large-scale genomic and postgenomic data means that many of the challenges in biomedical research are now challenges in computational sciences. Clinical informatics has long developed methodologies to improve biomedical research and clinical care by integrating experimental and clinical information systems. The informatics revolutions both in bioinformatics and clinical informatics will eventually change the current practice of medicine, including diagnostics, therapeutics, and prognostics. Postgenome informatics, powered by high throughput technologies and genomic-scale databases, is likely to transform our biomedical understanding forever much the same way that biochemistry did a generation ago. The paper describes how these technologies will impact biomedical research and clinical care, emphasizing recent advances in biochip-based functional genomics and proteomics. Basic data preprocessing with normalization, primary pattern analysis, and machine learning algorithms will be presented. Use of integrated biochip informatics technologies, text mining of factual and literature databases, and integrated management of biomolecular databases will be discussed. Each step will be given with real examples in the context of clinical relevance. Issues of linking molecular genotype and clinical phenotype information will be discussed.

• Journal of agricultural medicine and community health
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• v.47 no.1
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• pp.1-13
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• 2022

Objectives: This study aimed to establish a linkage model involving regional responsible medical institutions after analyzing the existing conditions and deriving problems through qualitative analysis within the community care system. Methods: A total of 14 participants of this study were selected through the snowball sampling method, including 7 community care service providers and 7 service users. As for the research data, primary data were collected through interviews, and as a result of analyzing according to Aday&Anderson' model, a total of 5 catergories, 8 topics, and 22 sub theme were derived. Results: The problem derived from the interview is that division services are provided for each institution due to the absence of a key central institution of community care system, and users' commercial institutions is unclear. The second is the inconsistency between the needs and supply for community care, resulting in a possibility of delay in returning to the community after discharge. Based on these problems, it is necessary to unify it as an community care window of the Dong-community center. In addition, there is a need for public health centers to play an active role, and to establish a public-private joint system with the Health and Living Support Center to establish a model that can play a certain role. Conclusions: Therefore, based on the results of this study, it can be used as basic data when constructing community care model and applying it as an expanded model in the future.

• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.51-60
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• 1995

This study was to examine the awareness of health and the utilization of primary health care in rural areas. The data were obtained from self-administered questionnaire conducted 450 parents of Mi Gum md Su Dong middle school students in Nam yang Ju city, Kyung Gi-Do, Korea, from December 15 to 20 in 1993. The results were as follows : 1) Among the causes of disease, 'insufficient health care' was the highest(39.1%), and 'bad environment'(28.9%), 'complexity of life style'(17.8%) in next order. 2) In the priority between 'daily farm work' and 'primary health care', only 45.6% of respondents answered that primary health care is more important than the daily farm work. The 29.8% of respondents answered 'daily farm work', and the 23.1% answered 'the equal of the both'. 3) The 63.6% of the respondents recognized correctly, the meaning of primary health care. And the rate of information source in primary health care were 'TV and Radio'(42.2%), 'medical facilities'(23.3%), and 'newspaper and magazine'(11.3%) in order. 4) In the choice rate of medical facilities for primary health care, 'drug store' was the highest(34.9%), and 'local private clinic'(34.7%), 'health (sub)center'(15.8%), 'hospital'(10.2%) in next order. 5) The 53.5% of the respondents had experienced to visit the health (sub)center more than once. And the disfavorite reasons of health (sub)center were 'insufficient equipment'(36.7%), 'inavailable time to visit'(26.9%), and 'poor treatment'(9.1%). 6) Among the preference of the physicians for primary health care, 'specialist' was the highest rate of the respondents(54.2%), and 'general practitioner'(32.4%), and 'family doctor'(9.8%) in next order. The major obstacles in utilizing the medical facilities for primary health care were 'daily farm work'(41.6%), 'distance'(21.1%) and 'medical cost'(10.4%) in order. 7) The weakened reasons in health (sub)center function were 'insufficient medical equipment'(44.4%), 'the lack of resident's understanding for health (sub)center'(21.8%), and 'short thought of duty in health (sub)center personnel'(16.9%) in order.