Achievements and Challenges of 40th Anniversary Health Insurance / 보건행정학회지

There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

Goals and assignments of healthcare accreditation program in Korea

Healthcare accreditation program was started in November 2010. The program was operated by newly born institute, Korea Institute for Healthcare Accreditation. Major characteristic of healthcare accreditation program in Korea is spontaneous program that hospitals voluntarily request for accreditation survey. Goals of healthcare accreditation program in Korea are to change the culture of healthcare supply side from supplier oriented to consumer oriented culture and to change regulation for quality improvement from government initiated regulation to self regulated quality improvement activities by hospitals. Objectives of accreditation are to assure the patient safety and to improve quality of healthcare services in hospitals. Korean Association of Hospital Management conducted a survey on the impact of accreditation program on hospital management, the survey was supported by Korea Institute for Healthcare Accreditation. Results of the survey showed that accredited hospital had changed to positive direction in patient safety, decision making process, organizational culture and hospital management. Assignments of accreditation program in Korea to be solved are to develop incentive for active participation of small size hospitals, to improve quality of surveyors and to increase the apprehension of accreditation of general population. Korea Institute for Healthcare Accreditation endeavor to improve quality of surveyors under in depth training program and to advertise accreditation program through radio and TV to the general population. However the incentive program must be developed by government policy.

The late Prof. Byung Yik Kim's suggestions on financial stability of the Korea's national health insurance in 2001 and 2002: what is changed in 10 years?

The late Professor Byung Yik Kim published an analysis of the financial crisis of Korea's National Health Insurance (NHI) in 2001, which derived from the introduction of the separation of prescribing and dispensing. Subsequently, Kim published another paper on policy suggestions to achieve financial stability of the national health insurance in 2002. In his paper of 2001, he had analyzed two causes of the crisis. First, the stepwise integration of health insurance funds had brought about financial instability since 1998, when regional health insurance funds were integrated into one fund. Second, the introduction of the separation of prescribing and dispensing without recognition of financial instability led to financial crisis. In his 2002 paper, he proposed several policy recommendations, including postpone of financial integration among insurance funds, increasing government subsidies, introducing new financing sources for health insurance, such as an alcohol tax, and implementing cost-containment policies. This paper reviews what was changed in accordance with his policy suggestions over the past 10 years. Many policymakers agreed with his analysis on the causes of financial crisis, however, they did not accept his policy recommendations. Consequently, the Korea National Health Insurance is still financially unstable.

Introduction Processes of Occidental Medicine in Jeonbuk / 의사학

No abstract available.

The Factors Influencing Korean Health Behavior / 간호학회지

PURPOSE: This study was performed to investigate the factors influencing health behavior. METHOD: Data used in this study was drawn from a 2001 National Health survey done by Korea Institute for Health and Social Affairs. Number of samples were 5,085 people between age 20 years and 69 years in whole country. In this study, we modified Green and Kreuter's Precede-Proceed model to analyse influence of factors in health behavior. Hierarchical regression were used in the analysis. RESULT: 1) Factors that had statistically significant positive relation with overall health behavior were age, educational level, income level, disease in the family, medical examination, subjective weight, and concern about health, 2) Factors that had statistically significant negative relation with overall health behavior were sex, subjective health, stress, and degree of physical activity. CONCLUSION: 1) It would be necessary to set the target group for the health promotion in advance. 2) It was very important to adopt easy and efficient methods to change the health behavior of target group, for example, ability to control stress.

The Imfacts of School Life and Home Surroundings on Adolescent's Smoking

No abstract available.

A study on the pillages of the Korean rural villages under the rule of Japanese Imperialism and the Research Institute for Rural Health / 의사학

The pillages of the Korean rural villages by force under the rule of Japanese imperialism resulted in the extreme impoverishment of the Korean agricultural communities. Especially this was accelerated due to starvation, ignorance and the poor sanitary conditions on the part of the Korean farmers. The research institute of agricultural community hygiene founded by a Korean doctor, Young Choon Lee was the beginning of the rural medical institute that contributed greatly to the disease prevention and health improvements of impoverished farmers.

Model Development of Hospital Process Reengineering by Activity-Based Costing / 대한의료정보학회지

The purpose of this research is to suggest a model for hospital process and verily the model through analyzing the results before and after reengineering grounded on the activity -based costing. The summary of research is as follows: First, two reengineering-applicable processes for a case hospital are chosen based on the issues from the patient requirements analysis and current process analysis as well as the general characteristics of hospital operations: accounting and clinical laboratory e xami nation processes. The integration of payment-related functions principle is applied to an accounting process which includes three sub processes. while the automatic transition of laboratory output principle is applied to a clinical laboratory examination process. Second, the studs shows more than 50% reduction of activities: nine activities from nineteen by the principle of integration of payment-related functions, and nine activities from fourteen by the principle of automatic transition of laboratory output. Finally. activity-based cost analysis before and alter reengineering results in 44% cost reduction: 43.9% in payment-related subprocesses and 41.1% in a clinical laboratory examination process. Therefor this research finds an enormous gap between costs before and after reengineerring. The contributions of this research are two-fold: one is that activity-based costing methodology is practically valid for measuring the cost-performance analysis of hospital process reengineering, and another is that activity -based costing can he utilized not only an initiative of process engineering hut also as a tool for evaluating a variety of activities by a simulation technique.

Fine structures of bone marrow cells in cyclosporine: A treated mouse / 대한혈액학회지

No abstract available.

Morphological studies on differentiation of the goblet cells and the rectal glands in prenatal and postnatal albino rats / 대한해부학회지

No abstract available.

Cost-benefit Analysis of Health Screening Test for the Insured / 예방의학회지

As a result of cost-benefit analysis by making a macroscopic approach to the health screening projects conducted 4 times since 1980 for the insured people of the Korea Medical Insurance Corporation, the following conclusions were reached. 1. The direct costs put into the health screening project, and the time costs which were paid by examines or calculated in terms of social costs have been estimated. The results is that the lowest estimation was 10,337 million won and the highest 15,141 million won when a minimum of 1.5 hours of time spent and a maximum 4 hours were applied. 2. In terms of the psychiatric benefits, the lowest estimation was 5,341 million won while the highest was 5,585 million won. 3. In terms of the benefits for each kind of diseases, the lowest estimation of 37,188 million won and highest estimation of 74,383 million won have been calculated for the liver diseases. And for the cardiovascular diseases, the minimum estimation was 14,475 million won while the maximum was 20,532 million won. In case of pulmonary tuberculosis, with external effect benefits being included, the estimation ranged from the minimum of 1,649 million won to the maximum of 1,832 million won. And the estimation of benefits for diabetes mellitus and renal diseases ranged from 89 million won to 92 million won and from 4,567 million won respectively. 4. In comparing costs and benefits, as a results of comparing each highest and lowest estimation, a range of minimum 46,708 million won and maximum 98,071 million won of benefits has been gained.

The Economic Losses of Smoking / 예방의학회지

The purpose of this study was to identify and measure the economic costs and benefits due to smoking in Korea. Cigarette smoking is a major cause of morbidity and mortality. In addition to the health risks of smoking, there are important economic consequences. A complete assessment of the economics of smoking requires evaluation of various health, economic, and intangible parameters, including benefits as well as costs of both the production and consumption of tobacco. In this article we focus on costs resulting from the health effects of smoking (expenditures for medical care and the value of productive output lost to morbidity, and premature mortality among smokers), since economic benefits from tobacco industry is offset by expenditures for purchasing tobacco. Two distinct methodologies will be applied to measure the economic costs of smoking cigarette, the human capital and willingness-to-pay approaches. This article used the former method. In 1985, total economic losses due to smoking was estimated as 505.7 billion won, which was composed of morbidity losses 64.9 billion won, mortality losses 429.1 billion won and indirect costs 11.7 billion won.

Effect of Radioactive Isotope 131I on Epiphyseal Plate of Tibia in Mice / 대한정형외과학회잡지

The purpose of this investigation was to study the changes in the epiphyseal plate of growing mice by histological, histochemical and electron microscopic observation through the administration of radioactive isotope I which induced hypothyroidism. To confirm hypothyroidism induced, radioimmunoassay for triiodothyronine was carried out and the morphologic changes of thyroid gland were observed by a light microscope. Of the total of eighty ICR strain of mice, fifty received single intraperitoneal injection of 20ue/gm of radioactive isotope I which were dissolved in 0.2ml of saline. Thirty received single intraperitoneal injection of only 0.2ml of saline and these mice were used as control groups. At the end of first, second, third, fourth, sixth and eighth week after injection, both saline injected and I treated mice were sacrifised. The thyroid gland and epiphyseal plate being removed were stained with hematoxylin and eosin, alcian blue and with uranyl acetate lead citrate in each for histological, histochemical and electron microscopic studies, The results obtained are as follows: 1. The thickness of epiphyseal plate was narrowed in the I treated animals. In each zone of epiphyseal plate the cell size was reduced although the cell numbers of each cell column were not changed. This means that the reduction of thickness in the epiphyseal plate was due mainly to decreased cell size and scanty territorial matrix not to decreased cell number. 2. Alcianophility was markedly decreased ln proliferative zone, indicating that acid mucopolysaccharide diminished markedly or was absent in the proliferative zone. 3. In electron microscopic examination, the number of rough surfaced endoplasmic reticulum was decreased and their cisternae were narrowed. Decreasing tendency of dilatation and sacculation of cisternae, .reduced number of attached ribosomes on the endoplasmic reticulum, and atrophy of the Golgi apparatus with diminished number of its vesicles were noted, However glycogen particlea were accumulated. 4. The number and length of each trabeculae in the metaphysis just adjacent to the epiphyseal cartilage plate were reduced markedly, and occasionally chondrocytes which were not consumed by endochondral ossification were observed in the cartilage lattice.

Effect of sodium selenite on the hepatotoxicity induced with carbon tetrachloride

The authors have demonstrated the effect of sodium selenite on the hepatotoxicity due to carbon tetrachloride, by observing the distribution and disaggregation of the pyroninophilic granules in the hepatic cell of the mature male albino mice. Each experimental mouse of the selenite and the selenite plus carbon tetrachloride groups was given a single dose of 4 ug. of sodium selenite per kilogram of body weight and that of the control and the carbon tetrachloride groups was given 0.1 ml. of distilled water alone. Six hours after the first administration of distilled water or sodium selenite, the experimental mice of the carbon tetrachloride and the selenite plus carbon tetrachloride groups were given a single dose of l.0 ml. of carbon tetrachloride per kilogram of body weight and those of the selenite groups were given 0.l ml. of paraffin oil alone. Following the 1ast administration of carbon tetrachloride or paraffin oil, the mice were sacrificed by bleeding (cutting the common carotid artery) at the intervals of 2,3,4,6,8, and 12 hours respectively. Histochemical preparations were stained by the methyl-green and pyronin method and oil red 0 method. The hepatotoxicity due to the administration of carbon tetrachoride was evident in the hepatic cells; the pyroninophilic granlues were partly reduced in volume in the hepatic cells of the centrilobular and the intermediate zones as early as the 3 hour-period, and markedly reduced or disappeared in the centrilobular and some part of the intermediate zones associated with hydropic degeneration as well as in the 6 hour-period. Thereafter marked reduction or dissolution of the pyroninophilic granules was found and extended as the periportal zone at the 12 hour-period. However, the pyroninophilic granules in the hepatic cells of selenite plus carbon tetrachbride group showed no significant changes in the hepatic cells of these zones, compared to the histochemical feature of the granules in the hepatic cells of the control and the selenite groups. Consequently it is suggested that the lipid peroxidative decomposition of the microsomal membranes, which is induced with carbon tetrachloride, would be prevented by a previous administration of sodium selenite.

Pyroninophilic Granules in Liver Cells of the Mice Treated with Alpha-Tocopherol and Thioacetamide

In an attempt to clarify the protective action of an antioxidant agent against acute toxicity of thioacetamide (TAA) and in order to throw some light on an satisfying concept of the mechanism of its action, a single dose of alphatocopherol (200 mg per kg) was given orally by stomch tube to male mice prior to the administration of thioacetamide in a dose of 200 mg per kg of body weight. Sections of liver samples, obtained from the mice which were sacrificed at intervals of 3, 6, 9, or 12 hours after TAA administration, were stained using the methyl green-pyronin technique. At 3 hours following TAA administration, the pretreatment with alpha-tocopherol inhibited almost completely such alterations of the hepatocytes in the animals given TAA alone, as revealed by loss and clumping of cytoplasmic pyroninophilic granules in the periportal zone of the lobule. At 6, 9, and l2 hours, the prevention of alpha-tocopherol was incomplete in degree and extent. The changes of the hepatocytes were more intense and extensive in the TAA-treated 6 to 12 hour-groups than in the 3 hour-group of TAA-treated ones. Some discussion is given of the mechanism of TAA toxicity, with respect to the microsoma1 lipid peroxidation.

On the Degranulation of Mesenteric Mast Cells Caused by Morphine and Meperidine Hydrochloride in White Rats

Histological studies were carried out on the degranulation of mesenteric mast cells of white rats caused by injections of morphine hydrochbride and meperidine hydrochbride intravenously, intraperitoneally, and by local injection of the rat's mesentery and the following conclusions were obtained. 1. In the groups of intravenous, intraperitoneal, and local injections of morphine hydrochloride, fairly significant degranulation of the mesenteric mast cell was observed, which was probably associated with the concomitant liberation of tissue histamine derived from its source. 2. In the groups of intravenous and intraperitoneal injections of meperidine hydrochbride, the significant degranulation of the mesenteric mast ,cell was recognized. However, the local injections displayed no cytological change of the cell and no increased permeability of dermal capillaries was observed at the injecting site. 3. The degranulation of the mesenteric mast cell followed by an administration of meperidine hydrochloride was effectively inhibited after an adrenalectomy.