• Health Policy and Management
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• v.32 no.4
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• pp.356-367
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• 2022

Background: The emergence of new infectious diseases threatens public health, increasing socioeconomic damage, and national risks. This study aimed to develop an evidence-based risk assessment tool to quickly respond to new infectious diseases. Methods: The risk elements were extracted by reviewing the risk assessment methods of the World Health Organization, United States, Europe, United Kingdom, and Germany, and the validity and priority of elements were determined through expert meetings and Delphi surveys. Then, the scale and level for each risk element were defined and a final score calculation method according to the risk evaluation result was derived. The developed risk assessment tool was verified using data at the time of domestic transmission of an emerging infectious disease. Results: In case of spread of actual infectious diseases, priority is determined based on the criticality of the elements in each area of transmissibility and severity, from which the weighted score of the risk assessment is derived. Then, the risk score for each element was calculated by multiplying the average value of the risk evaluation by its weight and the evaluation risk assessment score for the two areas was calculated. At last, the final score is plotted in a matrix where the x-axis indicates the transmissibility and the y-axis the severity and plotted on the coordinate plane for time series use. Conclusion: With respect to transmissibility and severity, this risk assessment method to respond to new and re-emerging infectious diseases enables rapid and evidence-based evaluation by quantitatively and qualitatively assessing various risk elements.

• Health Policy and Management
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• v.33 no.1
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• pp.19-28
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• 2023

Background: With the enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act in February 2018, legal guidelines for physician orders for life-sustaining treatment (POLST) were presented. This study was conducted to analyze the association of writing POLST on the use of health care before death. Methods: The study analyzed the electronic medical records and POLSTs of 1,003 adult patients who died at a tertiary hospital located in Seoul from February 4, 2018 to February 4, 2019. Results: Of the deaths, 80% (n=804) completed POLST. Among patients who completed POLST before death, 51% (n=412) were written 1-7 days before death, and only 31% (n=246) were completed by patients themselves. 99% (n=799) decided to withdraw or withhold cardiopulmonary resuscitation. As a result of analyzing the effect of POLST on medical use before death, it was found that POLST and inpatient cost had a significant negative correlation, and POLST completion significantly reduced death in the intensive care unit (ICU). However, both inpatient costs and death at ICU increased when the POLST was completed by surrogate decision-makers rather than patients themselves. Conclusion: The enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act provided a legal basis for withdrawing and withholding meaningless life-sustaining treatment. By specifying the treatment to be received at the end of one's life through the POLST, inpatient treatment costs and death at the ICU were decreased. However, the frequent decision-making by the surrogates and completion of POLST close to death may hinder the original purpose of the law.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.2 no.1
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• pp.17-30
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• 2006

Federal disability law has evolved from several laws geared to protect people with disabilities since the late 1960s and early 1970s. When U.S. Congress passed the Americans with Disabilities Act (ADA) in 1990, no federal statute prohibited the majority of employers, program administrators, owners and managers of places of public accommodation and others from discriminating against people with disabilities. Toward the ends to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with the disabilities, the ADA pursues three major strategies: Title I addresses inequality in employment, Title II, inequality in public services, and Title III, inequality in services and accommodations offered by private entities. The purposes of the study were to analyze the impact of the ADA on health care for persons with disabilities and to review the ongoing health policy reforms at the federal and state governments. Essential remedies that the ADA contemplates are based on two principles, simple discrimination and reasonable accommodation, which significantly improved access to quality care, especially long-term care, by persons with disabilities. However, the ongoing Medicaid policy reforms to control rising health care costs in the U.S. could threaten the access to care by persons with disabilities in optional groups and to optional care services by persons with disabilities in mandatory groups.

• Research in Community and Public Health Nursing
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• v.32 no.1
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• pp.24-39
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• 2021

Purpose: This study was to review the previous studies on the 'Willingness to Pay (WTP)' for healthcare services and suggest future implications for nursing research. Methods: Using the scoping review method, we used RISS, KISS, KMbase, Koreamed, PubMed, EMbase, CINAHL as searching engines. According to the selection and exclusion criteria, 40 appropriate studies were selected and analyzed. Results: 24 studies were categorized into medical service field among medical, public health, and nursing service fields. A total of 16 studies were related to healthcare system (policies), 13 studies were to the healthcare intervention, and 11 studies were categorized into the health management. Most of the methods for eliciting WTP (70%) were about a contingent valuation method (CVM), and the use of double bounded dichotomous choice (DBDC) tended to increase. In the nursing field, five WTP studies were identified: two studies published in the early years of 2000, which were conducted on hospital-based home health visit services. Recent studies were mostly about counseling and education by advanced practice nurses (APNs). Conclusion: WTP studies on healthcare services were largely published from the medical fields and health policy areas with the CVM method. In the field of nursing, studies have been conducted on the subject of limited service areas. More active exploration of research topics is required, particularly under the current policy setting, where discussion of the public health insurance fee for nursing practice is essential.

• Health Policy and Management
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• v.25 no.2
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• pp.67-70
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• 2015

To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.14 no.2
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• pp.65-75
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• 2007

Purpose: This study was conducted to provide fundamental information for policy integration of the home health care system. Methods: Focused review was performed from 8 studies out of 48 literature related to home care needs. Results: Females utilized home care based on hospital and public health centers at a higher rate than males. While there had been more rate of the elderly above 60 year-old at hospital and community based home care, on the other hand below 45 year-old at public health center. The most common disease amongst users in all three types was cerebrovascular disease, the second was cancer based at hospitals, hypertension and arthritis at public health centers. There were more needs for those using artificial respiratory equipment, cancer patients, and puerpera. However, the needs for hospital and community based home care were very similar. Conclusions: Due to similar disease characteristics but varied severity at the three home care based settings, they should be managed with flexibility. Home care curriculum should be developed according to common disease type, and home care services should be strengthened for its expertise.

• Korean Journal of Health Education and Promotion
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• v.34 no.1
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• pp.47-65
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• 2017

Objectives: This paper aims to identify depressive or stress related symptoms and its associated risk and protective factors among marriage immigrant women in Korea. Methods: The study participants were 490 immigrant wives from '2012 Survey of Foreign Residents in Korea'. The participants completed self-administered questionnaires on socio-demographics, health status, family members' related factors, and other environmental factors. Results: Difficulties on child nursing, finance, family conflict, and experience of physical or verbal violence were significant risk variables to the depressive stress related symptoms. Family life satisfaction, discussion about troubles with Koreans, healthy status, social trust, and discussion about troubles with people from home country were the significant protective variables to mental health. However economic activities were not protective factors but risk factors. Conclusions: Mental Health promotion programs for marriage immigrant women and their family members need to consider the family and community related protective mental health factors and develop supportive system with pre-existing programs and policy modification.

• Health Policy and Management
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• v.17 no.4
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• pp.54-81
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• 2007

The paradigm of health promotion requests community participation and its active problem-solving. Community is conceptualized as a resource pool to be organized. Such resource is called community capacity. Community participation is a process of capacity building. Community voluntary associations are considered as valuable resource to be used for health promotion. This paper tried to identify the network structure among community voluntary associations and to infer the possibility to make such network of organizations participate in health promotion programs. Two survey data were used for this research: 1) Measurements and Evaluations of Community Capacity on Dobong-gu (N=94) 2) A development plan of health medicine service to be Healthy Gangdong-gu (N=69). The questionnaire included such variables measuring community capacity as leadership, membership, organizational resources, and inter-organizational network, etc. Both regions had the following common characteristics: 1) There were positive correlations between the organization's budget and membership. 2) Organizational types were associated with their founded years. Two regions showed the following differences: Dobong displayed the high density of community organizations, but Gangdong showed the low density. Dobong community organizations were able to be classified into three network clusters such as women & environments, youth & adolescent, and sports organizations. Each cluster of organizations favored the different type of health promotion programs. Gangdong community organizations were less developed, and not possible to be clustered. Depending upon the level of community capacity or community organizations' differentiation, the strategy of community participation could be settle down in different ways. Particularly the health agency had to pay more attention to support the growth of civil organizations.

• Health Policy and Management
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• v.33 no.1
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• pp.29-39
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• 2023

Background: Breaking the chain of disease transmission from overseas is necessary to control new infectious diseases such as coronavirus disease 2019 effectively. In this study, we developed a mobile app called Self-Symptom Checker (SSC) to monitor the health of inbound travelers. Methods: SSC was developed for general users and administrators. The functions of SSC include non-repudiation using QR (quick response) codes, monitoring fever and respiratory symptoms, and requiring persons showing symptoms to undergo polymerase chain reaction tests at nearby screening stations following a review of reported symptoms by the Korea Disease Control and Prevention Agency, as well as making phone calls, via artificial intelligence or public health personnel, to individuals who have not entered symptoms to provide the necessary information. Results: From February 12 to March 27, 2020, 165,000 people who were subjected to the special entry procedure installed SSC. The expected number of public health officers and related resources needed per day would be 800 if only the phone was used to perform symptom monitoring during the above period. Conclusion: By applying SSC, more effective symptom monitoring was possible. The daily average number of health officers decreased to 100, or 13% of the initial estimate. SSC reduces the work burden on public healthcare personnel. SSC is an electronic solution conceived in response to health questionnaires completed by inbound travelers specified in the World Health Organization International Health Regulations as a requirement in the event of a pandemic.

• Journal of Digital Convergence
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• v.19 no.12
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• pp.29-42
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• 2021

As the low fertility intensifies in Korea, this study investigated fundamental differences between the government's low fertility policy and public perception of it. To this end, we selected four times 'Aging Society and Population Policy' documents and news comments for two weeks immediately after announcement of the third and fourth Policy as analysis targets. Then we conducted word frequency analysis, co-occurrence analysis and CONCOR analysis. As a result of analyses, first, direct childcare support during the first and second periods, and a social structural approach during third and fourth periods were noticeable. Second, it was revealed that both policies and comments aim for the work-family compatibility in 'parenting'. Lastly it was showed public interest in environment of raising children and the critical mind to effectiveness of the policy. This study is meaningful in that it confirmed the public perception using big data analysis, and it will help improve the direction for the future low fertility policy.