• Journal of Society of Preventive Korean Medicine
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• v.11 no.2
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• pp.101-112
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• 2007

Oriental public health programs have been introduced for the purpose of providing comprehensive oriental health care services to community people including vulnerable classes, increasing the accessibility of oriental medicine and the public benefit, and further more elevating the health promotion and the quality of life of community people. Promoting these programs since 2002 in earnest, it is evaluated that it has made a lot of performances. In the other side, it showed many problems and policy issues also. This study is accomplished to analyze the problems made since the system was introduced and until now, 2007, and with this analysis, to examine policy issues and the reasonable recommendations for its development Major problems are as follows. First, fundamental notions and identity of oriental public health programs are not positioned accurately. Second, the infra-structure construction for effective propulsion of business is insufficient. Third, it is short of the capacity for program implementation of oriental public health doctors, related manpower, and health centers. Fourth, oriental health promotion programs that can fulfill the various health needs of community people are deficient. Fifth, active aid of the government and the oriental medical world as well as legal and systematical support for oriental public health programs is insufficient. As a result, to solve the problems and induce the successful settlement of the program, the policy recommendations such as (i) the fundamental notions of the program and establishment of approach strategies, (ii) reinforcement of the foundation of the program implementation, (iii) capacity enhancement of the manpower of the program implementation, and (iv) effective building of supportive system of the program are presented.

• Safety and Health at Work
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• v.14 no.4
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• pp.438-444
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• 2023

Background: To examine the influences of psychosocial work conditions on mental health risk and intention to leave the public sector among workers of public health agencies in Taiwan. Methods: We surveyed 492 public health workers in March 2022 during the COVID-19 pandemic. Information on job demands, job control, workplace justice, experiences of workplace violence and its type and origin, and mental health status (assessed by the 5-item Brief Symptom Rating Scale, BSRS-5) was obtained. Of them, 192 participated in a follow-up survey conducted in May 2023 that assessed mental health status, employment changes, and intention to leave. Results: In the initial survey, 32.93% of participants reported poor mental health status, defined by having a score of BSRS-5 ≧ 10, and 48.17% experienced some form of workplace violence over the past year. Notably, high psychosocial job demands (OR = 3.64, 95% CI = 1.93-6.87), low workplace justice (OR = 2.58, 95% CI = 1.45-4.58), and workplace violence (OR = 2.38, 95% CI = 1.51-3.77) were significantly associated with increased risk of mental disorders. Among those who participated in the followup survey, 22.40% had persistent poor mental health, and 30.73% considered leaving or have left the public sector. Longitudinal analyses indicated that job demands predicted persistent mental disorders and intention to leave the public sector, and the experience of workplace violence added additional mental health risks. Conclusion: The public health workforce is crucial for effective and resilient public health systems. Our findings that public health workers were at high mental health risk and had a high intention to leave the job warrant attention and policy interventions.

• Health Policy and Management
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• v.6 no.1
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• pp.1-28
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• 1996

The paper analyzes OECD health systems from the perspective of historical institutionalism. Criticizing the dependence of Korea's national health program on Pacific countries such as Japan and the U.S., it suggests that European experiences of national health programs can be a model of the Korean health system in the future. Based on an inquiry into Italian and British cases of national health systems, the author emphasizes (1) the role of local governemts in national health programs, and (2) the integration of a national health program with public health programs.

• Health Policy and Management
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• v.26 no.4
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• pp.315-324
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• 2016

Underserved area is a region that has a lack of healthcare resources. In the context of Korea, however, there are not enough detailed criteria for underserved areas. In this study, we aimed to develop indicators for underserved area through Delphi technique. We systematically reviewed the existing measure of underserved area. Sixty indicators were extracted as candidates across four domains in secondary medical care. Four domains are demand, medical resource, quality of care, and health outcome. To develop indicator, two round Delphi survey was conducted among 15 professional experts such as professionals and public administrators. In conclusion, 2 final indicators (accessibility, medical utilization) was determined as an appropriate measure in order to designate underserved area for secondary medical services. Using our criteria from Delphi technique, 36 areas were found as underserved areas for the secondary medical care.

• Korea Journal of Hospital Management
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• v.3 no.1
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• pp.238-260
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• 1998

This article describes the theoretical foundations of government policy for hospitals in terms of correcting market failure and enhancing equity. It then discusses the characteristics that desirable payment systems should have, and the effects of the DRG-based prospective payment system on hospital behavior, its financial performance, hospital industry, and health care expenditure. The rationales and impacts of other public policies for hospitals such as antitrust and fair trade regulation, dissemination of practice guidelines and hospital mortality information, regulation of hospital capital investment, and tax policy are also discussed.

• Health Policy and Management
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• v.26 no.1
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• pp.79-91
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• 2016

'Health in All Policies' is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as 'Health in All Policies' and 'Sustainable Development Goals.' Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing 'Health in All Policies' in local, national, and international circumstances.

• Journal of Environmental Health Sciences
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• v.47 no.1
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• pp.78-86
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• 2021

Objectives: The purposes of this study were to investigate the installation rates and status of indoor smoking rooms in public facilities and to determine the level of compliance level with smoke-free policies in accordance with the National Health Promotion Act. Methods: A visiting survey was conducted on 1,206 public facilities in the Seoul Metropolitan Area and the Daegu and Gyeongsangbuk-do Province area. Researchers selected public facilities such as bars, coffee houses, and internet cafes using convenient sampling. They visited without prior notice, checked the existence of indoor smoking rooms, and recorded their status. Results: Internet cafes (110/116) had the highest installation rate of indoor smoking rooms, followed by bowling clubs (17/19) and billiard rooms (87/100). Depending on the type of business, 50-88% of smoking rooms were not completely enclosed. Coin karaoke rooms showed the least inadequacy in this regard. In addition, out of 512 smoking rooms, in 33% (n = 169) smoking indoors was observed in non-smoking areas. Only 9% of public facilities were in full compliance with the indoor smoke-free regulation. Conclusions: It was found that most of the public facilities with indoor smoking rooms did not comply with the smoke-free policy, and smoking was still observed inside some facilities. Therefore, there is a need for a policy that prohibits indoor smoking rooms completely.

• Journal of Environmental Impact Assessment
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• v.15 no.5
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• pp.309-322
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• 2006

During the last decade, Health Impact Assessment (HIA) has been discussed worldwide as being an important tool for the development of healthy public policy. HIA has been advanced as a means of bringing potential health impacts to the attention of policy makers, particularly in sectors where health impacts may not otherwise be considered. HIA, a systematic assessment of potential health impacts of proposed public polices, programs, and projects, offers a means to advance population health by bringing public health research to bear on questions of public policy. In Korea, health-related items under current EIA (Environmental Impact Assessment) system can only be found in the categories of hygiene and public health. However, environment and public health are not adequately connected and also health is underestimated even though health is an important objective component for the implementation of Environmental Assessments (EA). As a result, health is not well integrated within criteria for investigating the impacts on environment. This study examines linkages for HIA from the related and relatively well-developed field of Prior Environmental Review System (PERS) which is similar to SEA and EIA in Korea.

• Health Policy and Management
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• v.24 no.1
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• pp.24-34
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• 2014

Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

• Health Policy and Management
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• v.18 no.2
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• pp.107-129
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• 2008

The purpose of this paper is to critically examine Korean government's efforts in policy making and implementation regarding the Korea National Health Insurance System in the past and suggest a new paradigm for future policy changes. The structural and political characteristics of the Korea National Health Insurance, where health care services are provided almost exclusively by the private providers and funding for health comes equally from public and private sources, imply persistent difficulties in the operation of the system This may partially explain why the Korean system has continually experienced conflicts among stakeholders whenever there was an attempt to change policy. In this paper, we discuss four cases to illustrate such difficulties and barriers. We propose that in order to address these challenges and reduce policy errors as well as unintended results, it is necessary to restructure policy making process from being oriented toward 'quantitative expansion' to 'qualitative maturity', from a 'linear thinking' to a 'system thinking', from taking a 'top-down' to a 'governance and participatory' decision making process.