Estimating the Disability Weight of Major Cancers in Korea Using Delphi Method / 예방의학회지

OBJECTIVES: To estimate the weighting for the disability caused by major cancers in Korea using the Delphi method. METHODS: We selected 19 panelists to estimate the disability weighting of major cancers in Korea by using the Delphi method. To select the relevant kinds of cancers, we used National Death Certificate Data produced by the National Statistical Office in 1996. Then the stability of each delphi round was calculated by using the coefficient of variance. RESULTS: The disability weight of major cancers for males was pancreas cancer(0.36), liver cancer(0.35), esophageal cancer(0.30), stomach cancer(0.27), lung cancer(0.26), and colorectal cancer(0.30). The disability weight of major cancers for females was pancreas cancer(0.36), liver cancer(0.34), esophageal cancer(0.29), stomach cancer(0.28), lung cancer(0.26), and colorectal cancer(0.28). CONCLUSION: The results of this study will provide baseline data useful for the measurement of the burden of disease caused by cancers in Korea.

Factors Affecting Users' Satisfaction with Order Communicating System / 예방의학회지

OBJECTIVES: To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. METHODS: A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was performed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience , OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. RESULTS: There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. CONCLUSIONS: There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.

Change in Medical Care Utilization over Time in Early Years of Insurance Coverage / 예방의학회지

The purpose of this study is to observe the pattern of change in medical care utilization over time in early years of insurance coverage. The source of data is the benefit records file of a voluntary medical insurance society for covering the four-year period, from 1982 to 1985. The measure of medical care utilization used in this study is the age-sex standardized percentage of the enrollee who have visited a physician over total analytical population during a three-month period. For six cohorts by the year of enrollment (1979-1984), the relationship between the utilization and duration of insurance coverage was examined controlling for the calender year and season. In the analysis, logistic multiple regression and residual analysis were employed. It was observed that medical care utilization rapidly increased during the early stage of insurance coverage, and after then increased at a slower rate over time to become almost stable in about twenty months.

Development of the Standard Blood Inventory Level Decision Rule in Hospitals / 예방의학회지

Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation gas gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better'. The shortage itself by no means unnecessitated inventory control. In fact, in spite of shortage, no small amount of blood is out dated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this study is to develop formulate forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study information of A+ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated. 48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measure of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study were as follows ; 1. the formulate to calculate the standard blood inventory level(S*)was. S*=2.8617 x (d)0.9342. where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performance-outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level-were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

An Analysis on Contents of Health- Concerned Editorials in Korean Newspapers / 예방의학회지

The editorials the leading newspapers may reflect as well as help formulate the public opinions to a significant degree. Bearing this in mind, this study was carried out to provide information useful in formulating such public health policies that could practically meet the social interests and demands in health appearing in the editorials of the newspapers. This analysis covered the editorials of 5 leading newspapers such as Donga Iibo, Chungang Ilbo, Kankook Iibo, Chosen Ilbo and Seoul Shinmoon for about 10 years from Jan. 1st, 1970 through Oct. 31th, 1979. The major findings are as follows : 1. The total number of health-concerned editorials in the five daily papers for the period was 1,768 or occupied 6.4% of the total editorials of the same sources. The increasing trend of frequency of the health-concerned editorials since 1976 indicates the increment of social interests and demands in health. Analysing the contents, environmental pollution received the greatest attention in those editorials, which was followed by medical affairs, environmental, and disease control in order in terms of frequency of appearance. However, there was a tendency that the interests in the environmental pollution, medical affairs and social welfare tended to increase year by year, whereas those in environmental hygiene and disease control comparatively decreased. 2. Motives of dealing with the health-concerned editorials were provided by announcement of the governmental policies and implementation for 25.6% and by out-breaks of the relevant event for 23.9%. This tendency coincides with the general characteristics of the editorials that reflect the timely issues. Closely analysing, however, the fact that the motive engendered by the out- breaks of the relevant events or by the season concerned comparatively tended to decrease as years pass by, indicates that the editorials tend more to seek the future-oriented demands in health rather than the current issue-oriented. 3. The editorials appeared to be more concerned with the governmental policies. 95.7% of all the editorials analysed were addressed to the government. This signifies the role of government in the field of public health and medical affairs. Their attitudes toward health-related policies of the government were much more negative than the other editorials that were addressed to the government in other fields. This suggests that the governmental interests in health were neither sufficient nor fair. 4. What the editorials most stressed were ; (1) increment of governmental interests in health, (2) improvement of the governmental health administration, (3) enriching the basic statistics, and (4) development of various technologies pertinent to health affairs and disease control, and so forth. However, must of their suggestions were not concrete but rather abstract and conceptual. 5. The editorials also expressed strong interests in research are. The areas of the needed research most suggested by items are ; (1) development of effective health care delivery system, (2) establishment of more practical system if calculating medical cost, (3) implementation of effective policies to control degenerative diseases, (4) division of medical care services and pharmaceutical services systems, (5) effective ways to prevent Co poisoning accidents, (6) changing status of environmental pollution and its effects upon health, and (70 status of occupational disease, and so forth. 6. There were some editorials-not small in quantity-that have risk to mislead the public opinions as well as the health policies due to lack of professional knowledge of the writes. It is desirable to establish some kind of mechanism that screens the erroneous contents of the editorials to help prevent misleading opinions.