• 대한예방의학회:학술대회논문집
• /
• 대한예방의학회 2005년도 제57차 추계 학술대회 연제집
• /
• pp.348-348
• /
• 2005

• 농촌의학ㆍ지역보건
• /
• 제22권2호
• /
• pp.225-237
• /
• 1997

This study was conducted to the cognition and attitude for internal and external organizational behavior of health centers staff. An analytical model employed in this study was developed by modifying 'organizational behavior model'. Data was collected a mail survey of officers at health center, including 66 directors and 1,768 staffs of the health centers in southern region. The major findings are as follows : Among directors of the health centers 47% of them stated that legislators and chief executive officer(CEO) of local governments are highly concerned about the public health program. However only 15.2% of health center directors reported that legislators and CEO put public health high priority. For leadership type of directors 39.0% of them was classified as controller, 30.3% as participant, 22.7% entertaining and 7.6% comprehending. Regarding sociopsychological characteristics of the health center staffs, about a quarter of them had high degree of group cohesion, while 10.7% had low degree. Those staffs who are older, high educational level, or working in the rural health centers showed higher degree of cohesion than those who are young, low educational level, or working in urban health center. A third of them were less likely to be satisfied by what they are doing at the health centers. The higher educational level, the likely to be satisfied by what they are doing at the health centers. The higher educational level, the more satisfied with their job. Considering these results, policy implication was discussed and suggested. It is suggested that educational efforts be made to improve leadership of the health center directors and concern with public health program by the CEOs and legislators of local governments.

• 보건행정학회지
• /
• 제28권2호
• /
• pp.178-185
• /
• 2018

Background: We investigated association between introduction of the diagnosis-related groups (DRG) system for anal operation and length of stay. Also, we investigated how it is different among hospitals with longer length of stay and among hospitals with shorter length of stay before introduction of the DRG system. Methods: We used data from Health Insurance Review and Assessment which were national health insurance claim data. Total 13,111 cases of anal surgery cases were included which were claimed by hospitals since July 2012 to June 2014. Two-level multivariable regression was conducted to analysis the association between length of stay and characteristics of hospital and patient. Results: Before introducing DRGs, the average length of stay was 5.41 days. After introducing DRGs, average length of stay was decreased to 3.92 days. After introducing DRGs, length of stay has decreased (${\beta}=-1.0450$, p<0.0001) and it was statistically significant. Among hospitals which had short length of stay (shorter than mean of length of stay) before introducing DRGs, effect of introducing DRGs was smaller (${\beta}=-0.4282$, p<0.0001). On contrary, among hospitals which had long length of stay (longer than mean of length of stay) before introducing DRGs, effect of introducing DRGs was bigger (${\beta}=-1.8280$, p<0.0001). Conclusion: Introducing DRGs was more effective to hospitals which had long length of stay before introducing DRGs.

• 보건행정학회지
• /
• 제32권1호
• /
• pp.63-72
• /
• 2022

Background: Depression is a common disease around the world. Many studies are showing that mental health can be improved through physical activity, and daily regular exercise can reduce the negative effects of depression or depressive symptoms. In order to promote individual physical activity, a physical activity-friendly environment must precede. Therefore, this study attempted to confirm whether the number of sports facilities for all affects individual depression. Methods: Among the respondents to the 2018 Community Health Survey, data from 181,086 people excluding missing value were used. Descriptive and chi-square tests were performed to understanding the general characteristics of individual level variables. A multilevel logistic regression was conducted to confirm the effect of individual and regional level variables on depressive symptoms. Results: As a result of confirming the effect of individual characteristics on depressive symptoms, it was confirmed that both socioeconomic and health behavior factors had an effect. Similar results were shown in a model that considered regional level variables, and in the case of the number of sports facilities per population, people who belongs to smaller areas were more likely to have depressive symptoms (odds ratio, 0.98; 95% confidence interval, 0.97-0.99). Conclusion: As a result of the analysis, it was confirmed that both individual level and regional level variables had a significant effect on depressive symptoms. This suggests that not only individual level approaches but also regional level approaches are needed to improve individual depressive symptoms In particular, it may be possible to consider to increase the number of sports facilities in areas where the prevalence of depressive symptoms is high and the number of sports facilities is insufficient.

• 보건행정학회지
• /
• 제25권3호
• /
• pp.197-206
• /
• 2015

Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

• 보건행정학회지
• /
• 제13권3호
• /
• pp.35-51
• /
• 2003

This study purports to develop a quality assessment tool for the process of health promotion programs at public health centers(PHC). The draft of the assessment tool developed by the literature was distributed to 242 staffs who were in charge of the health promotion programs at PHCs for evaluating the feasibility of the tool on September and October 2002. The major results of the study were as follows; The quality assessment tool developed in the study consisted of four domains: strategic planning, program management, monitoring and evaluation, and resources and information. The strategic planning dealt with the function of the planning staff and committees, community data analysis, the feasibility of the program, and the approach methods for attaining the goal of the program. The program management included the items on the qualification and power of the program staff. The monitoring and evaluation included the items on the reporting and communication among program units, and feed back after monitoring. Finally, the resources and information dealt with community networking, clients' response, and consulting activity of the staff. The validity of the tools was tested and partly supported by both formative and criterion-related methods. The assessment tools developed in this study could be used by health promotion workers in the self-evaluation of the program quality. In conclusion, the quality assessment tool developed in the study will be a good safeguard for assuring the quality of the process of health promotion programs.

• 보건행정학회지
• /
• 제29권3호
• /
• pp.368-373
• /
• 2019

Korea is undergoing a rapid environmental change in health and welfare. Therefore, the law mandates the establishment and implementation of plans in accordance with the changes. A total of 49 long-term plans related to health and welfare were specified by the National Law Information Center, the Korean representative legal information website managed by the Korea Ministry of Government Legislation. Of the 49 long-term plans, 10 plans (20.4%) were not yet fully constructed. Eight out of 10 non-constructive plans have been put into force for more than a year, but these plans still require further systematic planning and development. The complete construction of long-term plans is substantial to account for the changes in South Korean health and welfare. In addition, a systematic plan with solidarity and continuity between the mutual plans should be established in planning.

• 보건행정학회지
• /
• 제26권2호
• /
• pp.115-124
• /
• 2016

Background: This study aims at making a survey on health care service providers' cultural competence and making an appraisal of Chinese medical tourists on service quality, health care service providers' cultural competence, perceived value, and satisfaction. Methods: The data was collected from August until November, 2014 and 150 health care service providers and 65 Chinese medical tourists from 12 medical institutions in Daegu were enrolled in analysis. Results: The results showed that health care service provider's knowledge on Chinese culture was very low with 33.5% of correct answer. Health care service providers were found to get 3.82 point on a 5 point-scale in cultural perception, 3.53 points in cultural sensitivity, and 2.85 points in cultural skills. Chinese medical tourists were analyzed to give 4.08 points on a 5-point scale to satisfaction on health care service, followed by 4.01 points to health care service quality, 4.00 points to perceived value of health care service, and last 3.85 points to a health care service providers' cultural skills. However, there was a difference in points in cultural skills between health care service providers and Chinese medical tourists. Chinese medical tourists' satisfaction with health care service in Daegu was found to be comparatively high, but in relation to satisfaction with communication, it was found to be relatively low. Conclusion: Through this research, health care service providers' knowledge level of Chinese culture and cultural skills were low while they seemed to take a half-hearted attitude towards educational experience for building up cultural competence and foreign patient service response.

• Journal of Preventive Medicine and Public Health
• /
• 제54권3호
• /
• pp.173-181
• /
• 2021

The National Health Plan 2030 (HP2030) started to be prepared in 2017 and was completed and announced in December 2020. This study presents an overview of how it was established, the major changes in policies, its purpose, and future directions. This study analyzed the steps taken in the past 4 years to establish HP2030 and reviewed major issues at the international and governmental levels based on an evaluation of HP2020 and its content. HP2030 establishes 6 divisions and 28 topic areas, and it will continue to expand investments in health with a total budget of 2.5 trillion Korean won. It also established goals to enhance health equity for the first time, with the goal of calculating healthy life expectancy in a way that reflects the circumstances of Korea and reducing the gap in income and healthy life expectancy between regions. The establishment of HP2030 is significant in that it constitutes a sustainable long-term plan with sufficient preparation, contains policy measures that everyone participates in and makes together, and works towards improvements in universal health standards and health equity. With the announcement of HP2030, which includes goals and directions of the national health policy for the next 10 years, it will be necessary to further strengthen collaboration with relevant ministries, local governments, and agencies in various fields to concretize support for prevention-centered health management as a national task and to develop a health-friendly environment that considers health in all policy areas.

• 보건행정학회지
• /
• 제22권1호
• /
• pp.1-28
• /
• 2012

Since its establishment in 1948, World Health Organization (WHO) has tried and facilitated international cooperation of public health under the goal of "the highest attainable health," and gained outcomes like the eradication of smallpox and polio, turning itself into the representative of international public health. However, there was discord between member nations during the cold war era, and the status of WHO experienced rise and fall after its establishment. WHO, the representative international health organization, also has not been freed from influences from international regime changes, which means that the discussion on the internal causes of WHO functionings should be expanded more. In this study, functionalism was tested as one of international relations theory that tries to explain the establishment and role of WHO. Especially, this study analyzed the problems and problem-solving process that WHO had to face by using Imber's five steps theory that arranged chronologically the theory of Mitrany. We mainly investigated the secondary source that described historic facts on the rise and fall of WHO in terms of roles and functionings during establishment of WHO, the cold war era, and international cooperation of public health. The roles of WHO were analyzed by selecting the gains of WHO in the post cold war era. The functionalism arrangement of Imber was appropriate to some extent in explaining the establishment and role of WHO. The first step was International Sanitary Conference in 1851 that made nations to recognize international cooperation of public health, and the second step was the establishment of WHO that handles public health as an international organization. Recent cases of the Framework Convention on Tobacco Control and International Health Regulations showed that each nation agreed with an international norm that they had to cooperate each other to tackle infectious diseases and smoking, and this implies that these were emergence of global governance. This process was the third step of Imber's theory (nations had a gain from international cooperation would agree with the expansion of authority of international organization). However, the last two steps of the theory are still not realized. The partial success of WHO was based on the functional elements that WHO deals with non-political elements, human resources centering on professionals, and democratic decision making process. This essential and non-political characteristics mean that necessity of international cooperation catalyzed by WHO would continue despite of the global governance era when global health governance get faced more challenges.