• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.279-281
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• 2002

• Health Policy and Management
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• v.29 no.1
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• pp.86-89
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• 2019

Catastrophic health expenditure refers to spending more than a certain level of household's income on healthcare expenditure. The aim of this study was to investigate the proportion of households that experienced catastrophic health expenditure between 2006 and 2017 with the National Survey of Tax and Benefit (NaSTaB) and between 2011 to 2016 using Households Income and Expenditure Survey (HIES) data. The results of the NaSTaB showed 2.16% of households experienced the catastrophic health expenditure in 2017. In trend analysis, the NaSTaB revealed a statistically significant decreasing trend (annual percentage change [APC] = -2.01, p<0.001) in the proportion of households with the catastrophic health expenditure. On the other hand, the results of the HIES showed 2.92% of households experienced the catastrophic health expenditure in 2016. Also, there was a slightly increasing trend (APC= 1.43, p<0.001). In subgroup analysis, groups with lower income levels were likely to experience catastrophic health expenditure. In conclusion, further public support system is needed to lower experience these healthcare expenditures and monitor the low income group.

• Health Policy and Management
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• v.32 no.1
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• pp.107-112
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• 2022

Catastrophic healthcare expenditure refers to out-of-pocket spending for healthcare exceeding a certain proportion of a household's income and can lead to subsequent impoverishment. The aim of this study was to investigate the proportion of South Korean households that experienced catastrophic healthcare expenditure between 2006 and 2020 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. In the NaSTaB 2020 data, households who experienced catastrophic health expenditure was 1.73%. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -5.55; p<0.0001) in the proportion of households with the catastrophic health expenditure. Also, in the 2018 KHP and the 2016 HIES, households who experienced catastrophic health expenditure was 2.21% and 2.92% respectively. In contrast, the trend was significantly increased in the KHP (APC, 0.55; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, the findings suggest the need to strengthen public health care financial support and monitor catastrophic healthcare expenditures, especially for low-income group.

• Health Policy and Management
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• v.31 no.1
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• pp.74-90
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• 2021

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.

• Journal of Korean Academy of Nursing
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• v.41 no.3
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• pp.393-402
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• 2011

Purpose: This study was done to assess the educational needs that should be considered in developing curriculum for staff in charge of public health services in public hospitals. Methods: The participants in this study were staff in charge of public health services in 130 public hospitals. The Borich's Needs Assessment Model which analyzed the relation of 'required competence level' and 'present competence level', was utilized. Data were collected from October to November 2007 using a structure self-report questionnaire. The return rate was 66.9%. The Cronbach's alpha score was 0.959. Results: The mean scores for 'required competence level', 'present competence level' and Borich's need were 4.02, 3.44, and 2.30 respectively. According to public health service items, 'strategies to recognize the present condition and analyze problems' had the highest score for Borich's need, but 'establishment of annual or monthly objectives' had the lowest score for Borich's need. Conclusion: Education was found to be very important for staff carrying out public health services. Ultimately the results of this study may be utilized to develop education program for staff carrying out public health services in public hospitals.

• Journal of agricultural medicine and community health
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• v.46 no.4
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• pp.266-279
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• 2021

Objectives: The purpose of the study was to classify the health and medical service affairs of local governments, and to analyze the proportions of non-matching fund by local governments and central government subsidies for local government health budget. Methods: First of all, health affairs of local governments were classified to categories based on health-related laws and previous studies by review of the authors. In order to specify the scale of local government-led health affairs, we allocated 1,916 budget units into 6 main and 24 sub categories of the health and medical service affairs of local governments for the 2020 health budget of Jeju Special Self-Governing Province. For each categories, we compared the total amounts and the percentages of the 'central government subsidies', 'local government budget - matching fund', and 'local government budget - non-matching fund'. Results: The total health budget of Jeju Special Self-Governing Province accounts for 1.2% of the total budget. Of the total health budget of Jeju Special Self-Governing Province, the proportion of central government subsidies was 39.6% and the proportions of local government budget-matching fund and non-matching fund were 33.8% and 26.6%, respectively. The proportions of non-matching fund by provincial and basic local governments were 37.3% and 19.9%, respectively. Conclusion: In order for local governments to deal with the health problems of residents, it is necessary to secure and spend more local government budget(i.e., non-matching fund by local government) for health affairs in their administrative jurisdiction.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.379-388
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• 2006

Objectives: This study assessed the influences of various factors that are related to youth smoking such as gender, age and type of school, and we wanted to provide supporting data for tailored and effective policy initiatives to reduce adolescent smoking. Methods: A self-report survey was conducted on 14,910 teen-age students who were selected based on the nationwide distribution of students in large and small cities and counties, the gender ratio of the students and the ratio of students attending various type of school at 38 middle and high schools in six representative areas of each province. The survey was handled and managed by a health education teacher at each school. Binary and multinomial logistic regression was used in the analyses. Results: Smoking by adolescents was associated with gender, age and even height. Male high school students tended to smoke more than female high school students, but this differences was not significant for middle school students. The older the adolescents were, the more likely that they smoked, except for the female high school students. Height was meaningful for all adolescents, except for the boys at the vocational high schools. Monthly allowance was significant for all adolescents. School factors such as type of school and the students' school performance were also crucial factors. Attending a vocational high school was strongly related to smoking, especially for girls. Students' school performance and the perceived level of stress were strongly associated with smoking, especially for boys. Home factors such as the relationship with parents and conversation time with family members were closely related to smoking behavior. Knowledge about the health hazard of smoking was also found to be strongly related to adolescent smoking. Conclusions: In conclusion, demographic factors, school factors, home surroundings and the perception on the harmfulness of smoking are strongly related to adolescent smoking behavior, but these differ from gender and type of school.

• Journal of Preventive Medicine and Public Health
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• v.22 no.4 s.28
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• pp.466-473
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• 1989

• Health Policy and Management
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• v.16 no.4
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• pp.112-127
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• 2006

The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P=0.011), weaken poorly families per manpower(OR:0.42, 95%CI:0.35-0.50, P<0.001), business vehicles per manpower(OR:1.13, 95%CI:1.04-1.24, P=0.007) type of public health center(OR:4.42, 95%CI:3.32-5.90, P<0.001), region of public health center(OR:0.53, 95%CI:0.32-0.89, P=0.017). Secondly, performance indicators for quality of public health center based home healthcare were developed as basic investigation, registration, intervention and discharge level. Preparing for Activation of public health center based home healthcare in Korea, the result application as follows is possible. Firstly, we can conclude that the major factors of registrated weaken poorly residents in the community based home healthcare are jurisdictional families per manpower, weaken poorly families per manpower, type of public health center, region of public health center, business vehicles per manpower. Secondly, the new developed performance indicators which are divided into basic investigation, registration, intervention, discharge for public health center based home healthcare could be applied it for improving quality of home healthcare services.

• Health Policy and Management
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• v.22 no.4
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• pp.597-627
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• 2012

As misalignments among images, identity, and legitimacy of health professionals and institutions have been on the rise, CEOs of health care organizations have been required to enhance organizational accountability. Despite the accumulation of literature on the conceptual discussions of accountability, only a few studies empirically investigated key barriers to accountability and its facilitators. To identify perception on accountability with key barriers and facilitators of organizational accountability, a semi-structured interview with 11 CEOs of Korean hospitals was conducted. A short survey was taken to get quantitative data on CEO's perception on organizational accountability. To CEOs, accountability was very complex and unfamiliar concept, but understood as physician's code of ethics by nature and basic principle of hospital management. CEOs thought accountability could be improved through ethical leadership, financial stability and learning climate of hospitals. Distrust of the government, which failed to provide economic incentives for hospitals to increase accountability activities, was emphasized as a serious barrier to hospital accountability. There was consensus among hospital CEOs as to the importance of accountability in management. However, there were concerns that, without policy instruments to motivate hospitals toward increasing community benefits as well as collective efforts among health professionals to rebuild moral climate for being accountable, greater accountability would not be achieved in hospitals.