• Journal of Preventive Medicine and Public Health
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• v.54 no.4
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• pp.265-274
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• 2021

Objectives: Given the importance of social determinants of health in promoting the health of slum residents, this study was conducted with the aim of identifying the main dimensions and components of these determinants. Methods: This scoping review study was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A comprehensive search was performed of PubMed, ProQuest, Scopus, and Web of Science for articles conducted from 2010 to the end of 2019. Studies were selected based on inclusion criteria, with a special focus on studies dealing with the social determinants of physical and mental health or illness. Results: Thirty-three articles were selected to extract information on the social determinants of health. After reviewing the articles, 7 main dimensions (housing, socioeconomic status of the family, nutrition, neighborhood characteristics, social support and social capital, occupational factors, and health behaviors) and 87 components were extracted as social determinants of health among slum dwellers. Conclusions: This framework could be used by planners, managers, and policy-makers when making decisions affecting the health of these settlements' residents due to the common characteristics of slums around the world, especially in developing countries.

• Journal of Preventive Medicine and Public Health
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• v.56 no.4
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• pp.327-337
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• 2023

Objectives: Considering the importance of social determinants of health (SDHs) in promoting the health of residents of informal settlements and their diversity, abundance, and breadth, this study aimed to identify, measure, and rank SDHs for health promotion interventions targeting informal settlement residents in a metropolitan area in Iran. Methods: Using a hybrid method, this study was conducted in 3 phases from 2019 to 2020. SDHs were identified by reviewing studies and using the Delphi method. To examine the SDHs among informal settlement residents, a cross-sectional analysis was conducted using researcher-made questionnaires. Multilayer perceptron analysis using an artificial neural network was used to rank the SDHs by priority. Results: Of the 96 determinants identified in the first phase of the study, 43 were examined, and 15 were identified as high-priority SDHs for use in health-promotion interventions for informal settlement residents in the study area. They included individual health literacy, nutrition, occupational factors, housing-related factors, and access to public resources. Conclusions: Since identifying and addressing SDHs could improve health justice and mitigate the poor health status of settlement residents, ranking these determinants by priority using artificial intelligence will enable policymakers to improve the health of settlement residents through interventions targeting the most important SDHs.

• Journal of Preventive Medicine and Public Health
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• v.53 no.3
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• pp.189-197
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• 2020

Objectives: Our aim was to answer the following questions: (1) Can mental health variance be partitioned to individual and higher levels (e.g., neighborhood and district); (2) How much (as a percentage) do individual-level determinants explain the variability of mental health at the individual-level; and (3) How much do determinants at the neighborhood- or district-level explain the variability of mental health at the neighborhood- or district-level? Methods: We used raw data from the second round of the Urban Health Equity Assessment and Response Tool in Tehran (in 2012-2013, n=34 700 samples nested in 368 neighborhoods nested in 22 districts) and the results of the official report of Tehran's Center of Studies and Planning (in 2012-2013, n=22 districts). Multilevel linear regression models were used to answer the study questions. Results: Approximately 40% of Tehran residents provided responses suggestive of having mental health disorders (30-52%). According to estimates of residual variance, 7% of mental health variance was determined to be at the neighborhood-level and 93% at the individual-level. Approximately 21% of mental health variance at the individual-level and 49% of the remaining mental health variance at the neighborhood-level were determined by determinants at the individual-level and neighborhood-level, respectively. Conclusions: If we want to make the most effective decisions about the determinants of mental health, in addition to considering the therapeutic perspective, we should have a systemic or contextual view of the determinants of mental health.

• Health Policy and Management
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• v.14 no.2
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• pp.99-116
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• 2004

This study estimates the determinants of national health expenditures of OECD countries using panel regression method. The data used are OECD Health Data(2003) covering 33 countries and from 1970 to 2001. This study shows several important different results compared to the previous studies. Further this study estimates the determinants of Korean case using data from 1m to 2000, and compare with the results of OECD panel. The main findings are as follows. The income elasticity of health expenditures is estimated below 1.0, but is shown above 1.0 when the different health systems of each country are controlled. The women's labor participation influences strongly positive effect on the health expenditures. The diffusion of new technologies is positively related with the increasing expense. The increasing government expenditures have a tendency not to contain health expenses, but to increase expenses. The expansion of public health insurance holders is containing the expenses, and the increasing number of doctors is pushing expenditures. This implies the health expenditures are influenced more by the induced demand of providers rather than the moral hazard of patients. However, the above result is opposite in Korean case. The existence of primary care doctors affects slightly up warding rather than containing expenditures. Finally the determinants are seriously depending upon which factors are included in the model and which statistical model is chosen. Therefore it must be cautious to interpret the results of statistical model.

• The Journal of Korean Medicine
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• v.32 no.1
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• pp.97-108
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• 2011

Objective: This study aimed to analyze the utilization of Oriental medical services and its determinants among the elderly. Method: Data from a Korean longitudinal study of aging was used. Regression analysis was used to find the determinants of the utilization of medical care. Results: People with low education and low income were more likely to use Oriental medical services. Determinants of using Oriental health service were sex, marriage, income, subjective health condition, activity restriction due to pain, and chronic disease. Among them, only subjective health condition and activity restriction due to pain were significant determinants of frequency of and expenditure on Oriental medical services. Especially, activity restriction due to pain was a significant factor in the use of Oriental medical services, but not in the use of Western medical services. Conclusion: Treatment related to pain was closely associated with Oriental medical services. These treatments need to be developed with scientific and clinical evidence.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• Health Policy and Management
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• v.19 no.4
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• pp.33-52
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• 2009

Health promotion policies have needed to assess in detailed and evidence-based work to set a policy goal and clear future directions of health promotion in Korea. To identify the major factors related with health promotion, we assessed the associations between public health outcome (potential years of life loss, PYLL) and national health determinants. For this purpose, we used a pooled cross sectional time-series regression analysis with corrected fixed effect models involving sixteen member countries of the Organisation for Economic Cooperation and Development during the period 1970 to 2001. The PYLL was positively associated with tobacco and alcohol consumption (model 1 and 2) and calories intake (model 2 and 3) while the PYLL was negatively associated with GDP, fruit and vegetable intake (model 2), number of doctors (model 3), coverage rates of health care security, and elderly population rates (model 4). In conclusion, health behaviors related with tobacco, alcohol, and nutrition were significant health determinants for health outcome. Overall analysis results of this study will provide a guidance toward improved macro- and micro-policy development for future health promotion policy in Korea.

• Korean Journal of Health Education and Promotion
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• v.28 no.5
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• pp.145-160
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• 2011

Objectives: This study attempted to apply the Intervention mapping and Transtheoretical models to develop a program to promote moderate alcohol drinking in university students. Methods: Surveyed data from 1,137 university students were analyzed to identify personal and environmental determinants for alcohol drinking. Based on these determinants, program objectives were established. Crossing the objectives with related important determinants resulted in matrices of learning objectives for which educational strategies were developed. Subsequently, an intervention program were designed to achieve those objectives. Results: Identified personal determinants included awareness, attitudes, self-efficacy and behavioral skills. Environmental determinants were binge drinking behaviors of family members and peers, and social pressure for drinking. Program, impact and learning objectives were developed to change the identified determinants. Program activities included provision of information on positive and negative consequences of binge drinking, opportunities for assessing one's drinking pattern, increasing outcome expectancies of and skill building for monitoring drinking, resisting peer pressure and managing stress. To facilitate adoption and maintenance of the program, an intervention diffusion plan was suggested. An evaluation plan was developed by utilizing RE-AIM framework. Conclusions: In order to expand evidence bases for effective theory-based programs, the developed program should be tested in diverse university settings.

• Health Policy and Management
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• v.11 no.2
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• pp.58-84
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• 2001

This study was conducted to explore the relationship between the efficiency and its organizational determinants of tile Community Mental Health Centers(CMHCs). Data are obtained from 81 personnel of 27 CMHCs from Sept. to Oct. in 1999(19 in Kyunggi province, 7 in Seoul City and 1 in Chunchon, Kangwon province). Major findings of this study are as follows. 1. DEA is a mathematical programming technique that optimizes the relative efficiency ratio of inputs over outputs for each decision-making unit(DMU). It produces a summary scalar efficiency ratio for each DMU of CMHCs. It assessed multiple inputs and multiple outputs simultaneously, and compared to specific peer group of CMHCs. 2. Organizational determinants of DEA efficiency of CMHCs we proved as advertisement(＋), location of CMHCs(in public facility)(＋), area of facility(＋), period of operation(＋), job satisfaction(＋), clarity of work-role(vague), cohesion(－), rate of certified personnel(＋), number of referral(＋), and voluntary service time(－).

• The Korean Journal of Health Service Management
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• v.7 no.2
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• pp.113-124
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• 2013

The purpose of this study is to investigate of determinants of hospital organization trust affecting to hospital worker's trust in organization. This study was measured levels of trust in organization of hospital workers and 5 determinants of organization trust, organizational fairness, consideration, morality, competence and responsibility toward a society. Levels of trust in organization of hospital workers and determinants of organization trust were assessed using a sample of 190 employees who work at 2 hospitals in Seoul, Kyunggi. Data were collected by self-administered questionnaires from november 22 to 29 in 2012 and analyzed SPSS 18 by using t-test, ANOVA and regression analysis. The results of this study indicate that organizational fairness, consideration and responsibility toward a society among 5 determinants were positively related to levels of trust in organization of hospital workers. Based on these findings, it can be defined that 5 determinants of hospital organization trust influences levels of trust in organization of hospital workers. The implications of this study are discussed and areas for future research are presented.