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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
Editor in Chief :
Volume & Issues
Volume 11, Issue 4 - Dec 2001
Volume 11, Issue 3 - Sep 2001
Volume 11, Issue 2 - Jun 2001
Volume 11, Issue 1 - Mar 2001
Selecting the target year
Validation of the International Classification of Diseases l0th Edition Based Injury Severity Score(ICISS) - Agreement of ICISS Survival Probability with Professional Judgment on Preventable Death -
Health Policy and Management, volume 11, issue 1, 2001, Pages 1~18
The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.
College Students' Attitude toward Male and Female Doctors
Health Policy and Management, volume 11, issue 1, 2001, Pages 19~36
Numerous foreign studies document perceived difference of the public toward male and female doctors, but little is known about the way Korean college students view the gender of the doctors. This study investigates whether or not college students evaluate the technical and socio-psychological skills differently depending on the gender of the doctors. This study also tests the association between the gender of respondents and the gender of doctors of their choice for several types of diseases. The 440 college students at one campus were selected using systematic stratified random sampling technique and were interviewed by questionnaire survey. Findings indicate that while the scores of technical skills are in favor of male doctors, the scores of socio-psychological skills are favorable to female doctors. We also find that there Is a statistically significant relationship between the gender of respondents and the gender of doctors of their choice.
Development of a Food Replica Information System and Its Applications to Community
Health Policy and Management, volume 11, issue 1, 2001, Pages 37~61
In the course of this research, we developed FRIS(Food Replica Information System), which calculates calories and nutrient values of foods in a very simple and interesting manner, and experienced of application to some communities. We expect that individuals will have opportunities to raise their consciousness of food, nutrients, and healthy living by participating in FRIS. 154 kinds of commonly consumed Korean foods were selected and one serving sized food replicas, having the same shapes, size, and color as the real foods, were constructed with attached bar code labels. An application program with food replicas and bar code was also developed in order to provide information on calories and nutrient values for people's meals or selected foods based on survey results of housewives' requirements related to foods and nutrients. FRIS should be a basic tool in nutrition education and consultation. Its applicability would vary according to the nutritionist's flexibility and contents of developed application programs. Technical stability should be strengthened and more useful contents of application prograln be added to spread the use of the system. Additionally, in future research, more delicate models should be developed and an analytical method should be applied to examine the effects of FRIS to individual behavioral changes in their eating habits.
Job Satisfaction and Organizational Commitment of Medical Insurance Review Nurses
Health Policy and Management, volume 11, issue 1, 2001, Pages 62~86
This study purports to Investigate the determinant of job satisfaction and the organizational commitment of medical insurance review nurses working at Korean hospitals. The independent variables contain three groups of determinants: organizational characteristics variables(job autonomy, work unit control, role variety, role ambiguity, role conflict, workload, resource inadequacy, coworker support, supervisor support, distributive justice, promotional chances, job security, and job hazard), environmental variables(job opportunity, spouse support, and parent support), and psychological variables (met expectation, work involvement, positive affectivity, and negative affectivity). The sample used in this study consisted of 445 medical insurance review nurses from 89 hospitals nationwide. Data were collected with self-administered questionnaires and analyzed using multiple regression analysis. The results of the study are as follows : 1) the following variables, listed in order of size, have significant effects on job satisfaction : role ambiguity(－), distributive justice(＋), work involvement(＋), role variety(＋), met expectation(＋), negative affectivity(－), job autonomy(＋), and positive affectivity(＋). 2) the following variables, listed in order of size, have significant effects on organizational commitment: met expectation(＋), work involvement(.＋), distributive justice(＋), job security(＋), role variety(＋), positive affectivity(＋), negative affectivity(－), resource inadequacy(＋), and tenure(－). 3) the variance of job satisfaction and organizational commitment explained by the variables used in the study are 30.0% and 39.1% respectively. 4) In comparison to the results of other studies on the determinants of job satisfaction and organizational commitment of clinical nursing staff working at hospitals, the results of this study indicate that three variables of distributive justice, work involvement, and role variety are especially important for improving the level of job satisfaction and organizational commitment of medical insurance review nurses.
A Reflection on the Struggles 2000 around the Separation of Prescribing and Dispensing
Health Policy and Management, volume 11, issue 1, 2001, Pages 87~106
There has been a series of struggles around the governmental enforcing separation of prescribing and dispensing since the consensus for the policy at May 10, 1995, and the strike among the physicians nationwide at June 19, 2000. This thesis is to review the process of the affair as a whole and find out some achievements and lessons from it. Most visible achievement is that physicians have obtained governmental apology for the enforcing the unprepared policy, and promise to revise the Law on the Pharmaceutical Affairs, to enlarge governmental support for the medical insurance program, to construct a presidential committee for the reformation of medical affairs, and so on. Besides these achievements, physicians have learned much on the relations among them and with society in general. However this is only the first scene on the road to an extensive transformation in the medical area following more critical Issues on the medical reformation.
Review of Debate over the Expansion of Public Medical Facilities to Enhance the Public Role in the Medical Care Sector
Health Policy and Management, volume 11, issue 1, 2001, Pages 107~130
During the last year, we had a very severe situation with the strike of physicians working in medical facilities. From that time, many politicians and scholars insisted on the expansion of public hospitals to enhance the public role in the medical care sector. They think that private medical facilities work for profit motivation and that the high proportion of private to whole facilities is an obstacle to the public function of medical care under social insurance system. They found that one of the reasons for failing to prevent the physicians' strike was the high proportion of private facilities. Others insisted that the strike was not a good reason for the expansion of public hospitals. The physicians' strike was a very rare case, and it is not a good basis for generalization of the discussion of public hospitals. Last year almost all apprentice physicians in public facilities took part in the strike, and consequently the public hospitals also lost the role of public function. They view this increasing involvement of government in the medical sector as improper and the cause of inefficiencies. In this paper we review the debate over the expansion of public facilities. To clarify the debate, we review traditional criteria for the role of government in a market system and to apply these criteria to medical care. There are two traditional areas where government Is acknowledged to have a role in a market system: market imperfections and market failure. Where market imperfections and market failure exist, there may be a role for government. The justifications for government intervention are consumer protection and the existence of externalities. One of externalities is to provide medical care for the poor. The appropriate measures to provide medical owe to the poor can be sought in both demand and supply side subsidies. National health insurance is a method of demand subsidies and establishment of public hospitals is a method of supply side subsidies. Under the National Health Insurance System, the expansion of public hospitals is not an appropriate subsidy policy.
The Function of Health Center in the New Public Health Age
Health Policy and Management, volume 11, issue 1, 2001, Pages 131~152
Public health system and public health practice have changed over the past decades as the result of social and epidemiologic changes. New public health concept emphasizes leadership, strategical thinking, systematic planning and effective performance to identify and solve complex health problem In Korea, the role of Health Center has been expanded rapidly. However there is strong suspicion that Health Center can achieve their mission. This paper aims at understanding what is the needed functions of Health Center and which of its aspects needs improvement. The main results of this study are summarizes as follows. District Health Law does not address the core functions of Health Center. The staffs of Health Center have difficulties in prioritizing their services. The recent attempt to restructure Health Center and change delivery pattern of public health services ended with only limited success. To effectively confront threats to the public's health, the three major function of Health Center must be
modifying individual behavior and lifestyle,
improving social and economic conditions, and
reforming health policies. Better results do not come from setting new functions only; they come from understanding and improving the processes that will then leads to better outcome. We recommend that policy-makers focus economic evaluation of public health programs, building and spreading of the scientific evidence of programs, linkage of public health research and public health program. The criteria of delegation of public health service to private sector is urgently needed. Making community health information data available on a routine basis to providers, managers and researchers of public health services helps promote the efficiency of the overall operation of public health system.