As the period since the partition of North and South Korea has been prolonged, the gap between the two Koreas continues to widen in various ways. Indeed, in the health sector, differences that already existed have diverged even more after North Korea's economic crisis. This article will focus on the problematic situation of North Korean health care status and the trends in health aid to North Korea toward future improvement. Since 1990, after the dismantling of the socialist state system and a series of natural disasters, North Korea has accepted partial transformation to free market principles. Along with these changes and due to decreased rations, health workers also began seeking a secondary income to meet their daily needs, and a secondary economy in the pharmaceutical industry became one of their main financial resources. This has led to inequity in health service accessibility and has resulted in changes in North Korean patients' health behaviors. Meanwhile, external aid for health has steadily increased, resulting in dependency on external support. Infectious disease and maternal, neonatal, and child health-related aid support has comprised the largest portion in health aid; however, the changing composition of the disease burden is requiring different allocation and partnerships aligned according to health aid needs. North Korea requires health-related policy reforms that can respond actively to the lack of health resources, the deteriorated health infrastructure, and the instability of the health and social safety net. The South Korean government, as the central coordinator of such aid, should play this role with a specific strategy to support and respond to the changing needs of the North Korean people.
Child ; Communicable Diseases ; Delivery of Health Care ; Democratic People's Republic of Korea ; Dependency (Psychology) ; Disasters ; Drug Industry ; Financial Support ; Health Behavior ; Health Care Sector ; Health Resources ; Health Services ; Humans ; Korea ; Republic of Korea

In this study, we analyzed the healthcare system of North Korea using Kleczkowski's model which categorizes national healthcare infrastructure into five components: health resources, organization, healthcare delivery system, economic support, and management. It was found that the healthcare system in North Korea, which provides clinical medicine, Koryo medicine and preventive medicine, is constituted of a physician system of independent geographic sectors and centralized delivery system while maintaining free universal health coverage. These systems are all managed by the government and the People's Committee Party. However, North Korea has been confronted with severe economic difficulties since the 1990s, such that we question whether the healthcare system has been able to function properly despite of the lack of resources in general throughout the country.
Clinical Medicine ; Collodion ; Delivery of Health Care ; Democratic People's Republic of Korea ; Health Resources ; Preventive Medicine

No abstract available.

The abolishment of the internship training program in Korea has become a hot issue in Korea. The internship has traditionally been a general competency build-up process to becoming a practicing doctor. However, despite its relatively long history, there is still no oversight or guidelines for the educational program itself. It is operated individually department-by-department on a rotation basis with no central supervision or clear goals and objectives. Very often, interns are abused as sources of simple cheap labor, performing not only medical duties but also menial administrative tasks as required by each department, without proper educational activity or training. This significant lack of system and structure is a chronic grievance among those who experience it, yet perhaps due to its short duration, is something that is endured and then forgotten. Medical students, however, have largely opposed the abolition, citing the loss of the opportunity for anthropologic exploration of various clinical departments and the chance to build networks to pursue specialty training in the fields of their choice. The key issue at hand is then whether the current problematic student clerkship training can be improved enough to replace the internship program. To do so would require overcoming the fragmented nature of the clinical education culture, which is still quite clannish in nature and based on family values. Whether these cultural barriers can be broken to develop a clerkship training curriculum sufficient to achieve general competency before specialty training is the determining factor for the fate of the internship program.
Curriculum ; Hand ; Humans ; Internship and Residency ; Korea ; Organization and Administration ; Republic of Korea ; Students, Medical

No abstract available.
Influenza, Human* ; Pandemics*

Obesity results from an imbalance between energy intake and energy expenditure. Drugs can shift this balance in a favorable way by reducing food intake, altering metabolism, and by increasing energy expenditure. All patients with obesity should make efforts to change their lifestyle behaviors to decrease energy intake and increase physical activity. Lifestyle modifications also should be a component of all other levels of therapy. Pharmacotherapy can be a useful adjunctive measure for well-selected patients. Anti-obesity pharmacological treatment is indicated when the patient's body mass index (BMI) is >25 kg/m2 or when the patient's BMI is >23 kg/m2 with co-morbidities such as diabetes, hypertension, hypercholesterolemia, and coronary artery disease. Obesity is a chronic disease that requires long-term therapy for successful long-term weight management. Often, the patients regain their lost weight after therapy is discontinued, so it should be stressed that obesity is not a curable disease, and thus the maintenance of the reduced weight is very important. Obese patients must be examined in detail regarding mood, obesityrelated complications or conditions, current medications, eating habits, and history of drug side-effects. The physicians' choice for anti-obesity medications is based on both the patient's medical conditions and long-term safety and efficacy of antiobesity drugs.
Anti-Obesity Agents ; Body Mass Index ; Chronic Disease ; Coronary Artery Disease ; Drug Therapy ; Eating ; Energy Intake ; Energy Metabolism ; Humans ; Hypercholesterolemia ; Hypertension ; Life Style ; Metabolism ; Motor Activity ; Obesity

Informed consent is an essential issue in medical practice. Recently, new types of informed consent have emerged from doctor-patient relationship. Genetic studies using patients' specimens are regulated by the "Bioethics and Biosafety Act", which mandates every genetic study be performed with given written informed consent. Clinical trials for drug development are regulated by the Korea Good Clinical Practice, which requires a review and approval process by the Institutional Review Board. Organ donation is regulated by the "Organ Donation Act". Informed consent from family members is important for organ donation of the deceased and minors. It is recommended that terminally ill patients have advance directives, but we do not have relevant legislation on this. New types of informed consent stress the justifiable intervention of the Parens Patriae and neutral third party. Along with the legalization, these should be summarized to prevent unnecessary conflicts.
Advance Directives ; Ethics Committees, Research ; Humans ; Informed Consent* ; Korea ; Terminally Ill ; Tissue and Organ Procurement

An informed consent is a document signed by the patient or the patient's legal guardian(s) that signifies the acceptance that the patient will undertake a specific medical treatment suggested and explained by the health care provider(s). Recently, there have been an increasing number of circumstances where obtaining an informed consent is mandatory. However, a standard form and required content of the informed consent, as well as laws, regulations, and analyses regarding the concept of informed consent are not available. This article introduces an observation of the legal force of informed consent forms that are used in practice, and of the legal issues in connection with them.
Consent Forms ; Delivery of Health Care ; Humans ; Informed Consent* ; Jurisprudence ; Medical Records ; Social Control, Formal

Physicians in Korea are nowadays confronted with unprecedented difficulties in practicing medicine-at every point of patient care, they should be prepared against any possibilities of medical disputes, among which ones related to medical certificates are not infrequent. Physicians issue medical certificates based on comprehensive findings from physical examinations and laboratory tests to prove the health status of the patients. Although physicians prepare medical certificates as private documents, they take effect as official documents. Hence medical certificates should be prepared with understanding of relevant health care-related laws to avoid unnecessary and avoidable medical disputes.
Dissent and Disputes ; Humans ; Jurisprudence ; Korea ; Patient Care ; Physical Examination

The health benefits from exercise, particularly in a sedentary society, have gained a compelling body of evidence in the past decade. Younger adults have a considerably bigger physiologic reserve, both in terms of muscular strength and cardiovascular capacity. The elderly, on the other hand, experience a progressive decline in many physiologic functions, including muscular strength and cardiovascular capacity. Habitual exercise, by improving strength and maximum aerobic capacity (VO2max), can increase the physiologic reserve as well as enhance well-being by reducing fatigue associated with activities of daily living. Mostly importantly, it can delay the development of disability and thereby prolong active life expectancy. In addition to habitual exercise for conditioning, there is increasing evidence that resistance exercise to improve muscle strength along with tailored exercise therapies, including those designed to improve balance or to rehabilitate persons with various chronic diseases and acute ailments, may be of special value for the elderly. There is growing evidence that exercise programs offer measurable health benefits, ranging from increased life expectancy to mitigation of adverse sequelae from aging and from many chronic diseases. The greatest challenges in achieving health benefits from exercise are the limited access to effective programs and poor compliance.
Activities of Daily Living ; Adult ; Aged* ; Aging ; Chronic Disease ; Compliance ; Exercise Therapy ; Fatigue ; Hand ; Humans ; Insurance Benefits ; Life Expectancy ; Muscle Strength