• Health Policy and Management
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• v.23 no.2
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• pp.176-187
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• 2013

Background: In 2006 Emergency Medical Services Index (EMSI), which summarizes the performance of regional emergency medical services system, was developed. This study assesses the performance of the EMSI to help determine whether EMSI can be used as evaluation tool. Methods: To build a composite score of the EMSI from predefined 24 indicators, 3 normalized values were calculated for each indicator, the normalized values of each indicator were weighted using 4 weighting methods, and the weighted values were aggregated into the final composite score using 2 aggregation schemes. The performance of EMSI was evaluated using 3 criteria: discrimination, construct validity, and sensitivity. Discrimination was the proportion of regions that did not include the overall median rank in the 5th to 95th percentiles rank interval, which was calculated from Monte Carlo simulation. Construct validity was a correlation among the alternative EMSIs. Sensitivity of EMSIs was evaluated by total shift of quartile membership and changes of 5th to 95th percentile intervals. Results: The total discrimination performance of the EMSI was 50.0%. Correlation coefficients between EMSIs using standardized values and those using rescaled values ranged from 0.621 to 0.997. Variation of the quartile membership of regions ranged from 0.0% to 75.0%. The total change in the 5th to 95th percentile intervals ranged from -19 to +17 places. Conclusion: The results suggested that the EMSI could be used as a tool for evaluating quality of regional EMS system and for identifying the areas for quality improvement.

• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.331-338
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• 2008

Objectives : The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. Methods : The participants of this study were 126 home-helpers of 50 home visit care agencies at the 2nd Long-term Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. Results : Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. Conclusions : The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.

• Health Policy and Management
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• v.30 no.1
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• pp.131-138
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• 2020

The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.774-789
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• 1995

Due to the rapid socioeconomic development and the introduction of the national health insurance system the general population's need for health care and utilization of health care services have increased dramatically. As a result of this change. Korea is experiencing a shortage of health care facilities and health manpower, and this leads long wailing line at doctor's offices. One of the solutions of this problem could be home health care system for those who have minor health related problems. With this background, this study was conducted to look at the feasibility of a home-based prenatal care system using information superhighway and nursing informatics specialists. With the home-based prenatal care system, the pregnant woman checks her blood pressure, tests her urine for sugar and protein, and measures her body weight at home and sends the information to a hospital computer via the information networks such as public telephone line and information superhighway. Nursing informatics specialist at the hospital will go through each patient record and screen those who have abnormal values and notify them to see a doctor as soon as possible. Besides telemonitoring features, the proposed system will include tole-education capabilities for the patients so that patient can learn whatever they need to know ragarding the prenatal care via information networks. If this system develops and operates, patient can save time in terms of travel to and from the hospital and waiting time in the hospital. And the health care institute can utilize its resource more efficiently.

• Journal of Radiation Protection and Research
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• v.46 no.3
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• pp.134-142
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• 2021

Background: From 2018 to 2020, the Expert Study on Public Understanding after the Fukushima Daiichi Nuclear Power Plant Accident (the Expert Study Group) identified and analyzed activities designed to promote public understanding of science and radiation since the Fukushima accident, and held discussions on how to achieve public understanding in the situation where public confidence has been lost, and how experts should prepare for dealing with the public. This panel session was held at the 53^rd meeting of the Japan Health Physics Society on June 30, 2020. Materials and Methods: First, three subgroup (SG) leaders reported their research methods and results. Then, two designated speakers, who participated as observers of the Expert Study Group, commented on the activities. Next, the five speakers held a panel discussion. Finally, the rapporteur summarized. Results and Discussion: SG leaders presented reports from researchers and practitioners in health physics and environmental risks who provided information after the Fukushima accident. During the discussion, experts in sociology and ethics discussed the issues, focusing on the overall goals of the three groups, local (personal) and mass communication, and ethical values. Many of the activities instituted by the experts after the accident were aimed at public understanding of science (that is, to provide knowledge to residents), but by taking into account interactions with residents and their ethical norms, the experts shifted to supporting the residents' decision-making through public engagement. The need to consider both content and channels is well known in the field of health communication, and overlaps with the above discussion. Conclusion: How to implement and promote the public engagement in society was discussed in both the floor and designated discussions. Cooperation between local communities and organizations that have already gained trust is also necessary in order to develop relationships with local residents in normal times, to establish an information transmission system, and to make it work effectively.

• Health Policy and Management
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• v.28 no.1
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• pp.98-103
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• 2018

This study aims to evaluate the status of Korean healthcare among Organization for Economic Cooperation and Development countries and to monitor the trend of health care status since 2000. The position value for relative comparison (PARC) index was selected to gauge the level of healthcare status in demand, supply, accessibility, quality, and cost as per healthcare policy aspects. The Mann-Kendall test was conducted to allocate healthcare status of Korea since 2000. The PARC values indicate strength and weakness of Korean healthcare system by the mathematical comparisons. Korea positioned higher in demand, supply, accessibility, and quality. Yet, there are shortages in human resources and primary care. In conclusion, we suggest utilizing this study provides evidence to prioritize health care problems that can lead to establishing healthcare policy.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.852-869
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• 1997

This study was conducted to develop and evaluate the reliability and the validity of a questionnaire in order to determine the applicability as a screening tool for estimating environmental exposure and health effects related to air pollution. The questionnaire was developed with adopting some items of others such as ISAAC or ATS-DLD. And then we performed test-retest to 89 middle school students and their mothers at interval of three months. Cohen's Kappa values, weighted Kappa values, Spearman's correlation coefficients, and Pearson's correlation coefficients for each item were computed as reliability coefficients. The validity coefficients and validity coefficient bounds were also obtained by simply using these reliability coefficients. As results, Kappa ranged broadly from 0.10 to 0.61 of the items 'diet', $0.52\sim0.79$ of the environmental tobacco smoke, $0.39\sim0.44$ of the functional categories of surrounding environment, and $0.39\sim0.44$ of the using transportation systems; these items were regarded as confounding factors. For items related to health outcomes, Kappa ranged from -0.02 to 0.37 in the respiratory system of past medical history, and from 0.11 to 0.55 in the current health status. But Kappa of the others were over 0.60. In conclusion, if some items can be corrected or modified, the questionnaire developed in this study can be used as a tool for evaluating environmental exposure and health effects associated with air pollution.

• Journal of Korean Society for Atmospheric Environment
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• v.28 no.4
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• pp.374-383
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• 2012

In this study, we have observed the airborne radon levels in the subway cabins before and after platform screen doors (PSD) installation. The measurements have been conducted at Seoul metropolitan subway lines in 2008, 2009 and 2010. The mean concentration of the radon inside subway cabins were increased by approximately 53% from $20.1Bq/m^3$ to $30.8Bq/m^3$ by installing PSD. After PSD installation, measured values for the different lines were rather different, and varied between 8.2 and $76.5Bq/m^3$. And mean radon concentrations were in the decreasing order for subway lines 5, 6, 7, 8, 3, 4, 2, 9 and 1. It was also found that the indoor radon concentrations in the subway cabins were highly dependent on the management approach of a ventilation system at the subway stations. By assuming an average of $720\;h\;year^{-1}$ and $2,880\;h\;year^{-1}$ spent in subway cabin, effective doses to passengers and employee were estimated. The expected annual effective dose, in case of an equilibrium factor of 0.4, were $0.07mSv\;y^{-1}$ and $0.26mSv\;y^{-1}$, respectively.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.13 no.21
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• pp.29-41
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• 1990

An assessment of risk in industrial and urban environments is essential in the prevention of accident and in the analysis of situations which are hazardous to public health and safety. The risk imposed by a particular hazard increases with the likelihood of occurence of the event, the exposure and the possible consequence of that event. In a traditional approach, the calculation of a quantitative value of risk is usually based on an assignment of numerical values of each of the risk factors. Then the product of the values of likelihood, exposure and consequences called risk score is derived. However vagueness and imprecision in mathematical quantification of risk are equated with fuzziness rather than randomness. In this paper, a fuzzy set theoretic approach to risk analysis is proposed as an alternative to the techniques currently used in the area of systems safety. Then the concept of risk evaluation using linguistic representation of the likelihood, exposure and consequences is introduced. A risk assessment model using approximate reasoning technique based on fuzzy logic is presented to drive fuzzy values of risk and numerical example for risk analysis is also presented to illustrate the results.