http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
오늘 본 자료
조홍준 대한의사협회 2013 대한의사협회지 Vol.56 No.3
Health care has contributed improvement of health, however, it may aggravate health inequity if there is socioeconomic disparities in access to health care service or quality in health care. Health care interventions may cause health inequalities if there is difference in effectiveness among different socioeconomic groups (SEG) because of difference in access, diagnostic accuracy,provider and consumer compliance. In Korea, there are disparities in access to health care between urban and rural population due to geographical maldistribution of medical personnels and facilities. Health care financing was regressive due to reliance on health insurance contribution. Private insurance is more prevalent among higher income group. Health care utilization is more common among lower SEG, however differences nearly disappeared or changed to favor higher SEG when need is considered. This trend is more serious in elderly and for tertiary hospitals. Preventive services including hepatitis B vaccination and cancer screening showed inequality favoring higher SEG, however influenza vaccination among elderly showed opposite and national cancer screening program has reduced the gap. Quality of health care was worse among lower SEG with shorter survival for cancer patients after diagnosis or surgery, patients with myocardial infarction, ischemic and hemorrhagic stroke, hip fracture and burn among lower SEG. Moreover, checkup for diabetes complications and hypertension treatment were less complete among lower SEG. Every health policy should be equity sensitive. Monitoring on health care service equity should be introduced and measures to correct distal and proximal causes of health care inequity should be introduced.
조홍준 대한의사협회 2019 대한의사협회지 Vol.62 No.11
Tobacco use is the most important preventable cause of mortality in South Korea and worldwide. This study aimed to evaluate the tobacco control policies of the Moon Jae-in government, which was established in May 10, 2017. Before the Moon Jae-in government, the tobacco tax was raised by the Park Geun-hye government from 2,500 won to 4,500 won (80% increase), but the price of cigarettes was still much lower in Korea than in other high-income countries. Cigarette smoking has been prohibited in all restaurants and bars since 2015; however, smoking rooms are allowed. Only large buildings are smoke-free. Pictorial warnings on cigarette packages were introduced in December 2016; however, they cover only 30% of the main packaging. Smoking cessation services provided by health care facilities have been subsidized by public health insurance since 2015. However, the advertisement, promotion, and sponsorship of tobacco are not further regulated. Since the beginning of the Moon Jae-in government, there has been no further strengthening of major tobacco control policies except for limited expansion of smoke-free public places and introduction of a lung cancer screening program. The first government-level tobacco control policies by the Moon Jae-in government, announced in May 2019, included increasing the size of the pictorial warnings and introducing standardized packaging by 2025, along with incremental expansion of smoke-free public places with prohibition of smoking rooms. These moves are positive; however, they do not include increasing tobacco taxes and regulating advertisement, promotion, and sponsorship of tobacco, which together are the backbone of tobacco control policies. The Moon Jae-in government should strengthen comprehensive tobacco control policies, ncluding tobacco taxes and banning tobacco advertisement, promotion, and sponsorship, to protect public health.
응급실 방문 환자의 입원의 적절성에 영향을 미치는 요인
조홍준,이상일 한국의료QA학회 1995 한국의료질향상학회지 Vol.2 No.1
Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a terliary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05 Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.