The objectives of this study were to assign reasonability to importance of weight selection issue in key performance indicator for performance evaluation of Centers for Child-care Foodservice Management (CCFSM) developed by using Balanced Scorecard (BSC), to draw key performance indicator (KPI) by perspective and to analyze differences in recognition on importance. From September 25 to October 9, 2012, we conducted a questionnaire-based study via e-mail, targeting chiefs and team leaders of nationwide 21 CCFSMs (43 persons), officials of local governments where CCFSM was established (21 persons), officials of Korea Food and Drug Administration (2 persons) and foodservice management experts (27 persons) in order to estimate the relative importance on 4 perspectives and 14 KPIs and analyzed its results by using 61 collected data. The results showed that relative importance of perspectives was estimated in order of importance as follows: business performance (0.3519), customer (0.3393), resource (0.1557), learning and growth (0.1531). Relative importance of KPIs was in order of importance as follows: Evaluation of sanitary management level in childcare foodservice facilities (0.1327), Level of customer recognition and behavior improvement (0.1153), performances of round visiting inspection on foodservice, sanitary, safety management, and foodservice consulting (0.0913). Our results showed that the recognition differences exist on the relative importance of perspectives and KPIs between officials of CCFSM, KFDA, local government and foodservice management experts. These observations will form the basis for developing evaluation systems, and it is considered that performance indicators developed on this basis will suggest direction of operation which CCFSM will have to perform.
Commerce ; Electronic Mail ; Korea ; Learning ; Local Government ; Safety Management ; United States Food and Drug Administration

OBJECTIVE: To describe the health human resource needs of government hospitals in the Philippines.
METHODS: All 733 licensed government hospitals were included in a survey except 75 of them which the Department of Health have been deploying medical specialists and medical officers to augment the needs of these 75 hospitals.
RESULTS: A total of 96 government hospitals responded to the self-administered survey questionnaire sent to them. Analysis showed 20% to 29% among the level 2, level 3 and level 4 hospital responders have their Chief of Hospitals still without a master's education degree as required by the Department of Health. Fifty-nine percent (59%) of all hospitals do not have nearby medical educational institutions while 28% of them do not have nearby nursing educational institutions.The greatest need, however, is in the adequacy of the number of doctors and nurses. The minimum required number of doctors and nurses has not been met based on the staffing pattern standards set by the Department of Health for the different hospital categories and by the required 40 work hours per week set for civil servants.
CONCLUSION: The decline in the adequate number of health human resources noted to start when local public hospitals were devolved from the national government to the local government units in 1991. With this inadequacy, one cannot expect these public hospitals to provide even fair quality of hospital care; thus, the need for the national government to intervene.

The Supreme Court decision on the Mandanas-Garcia petition regarding the internal revenue allocation given to local government units is a significant ruling in strengthening the concept of decentralized governance and delivery of services. While the ruling grants local government greater resources and financial support, the immediate implication is the full devolution of services defined in the Local Government Code, including health services. The urgent concern is how much the Mandanas Ruling will affect local health systems. This paper presents some existing and foreseeable issues surrounding the implementation of the Mandanas Ruling in relation to the current devolved healthcare system. In particular, challenges in implementing the ruling in relation to health devolution, the local health system process, and the Universal Health Care Act are discussed. Some concrete action points for addressing these issues are also posited for policy-makers and implementors to consider in order to ensure not just the smooth and efficient implementation of the ruling but also the continuity of care for Filipinos.

The purpose of this study was to compare smoking control strategies between Korea and the United States. Korea and other developing countries may learn from the experience of the United States in dealing with the growing epidemic of cigarettes. In particular, smoking control objectives, structures, laws and regulations, funds, programs and activities, research, and surveillance systems were compared. The comparison was conducted at the federal, states/provincial, and county levels of the two countries. The data were collected through various governmental websites, contact with people directly, and a literature review. Based on the comparison, seven recommendations for smoking control strategies were made primarily for Korea.
Cross-Cultural Comparison ; Federal Government ; Financing, Government/organization & administration ; Government Programs/*organization & administration ; Government Regulation ; Health Education/organization & administration ; Health Policy/legislation & jurisprudence ; Health Priorities/organization & administration ; Health Promotion/*organization & administration ; Humans ; Korea/epidemiology ; Local Government ; Population Surveillance ; *Public Health Practice/economics/legislation & jurisprudence ; Research Support as Topic/organization & administration ; Smoking/epidemiology/*legislation & jurisprudence/*prevention & control ; Smoking Cessation/legislation & jurisprudence/methods ; State Government ; United States/epidemiology

The poverty families, who take care of the demented elderly, can suffer from the deficiency of social services for dementia and the condition and nature the families have. Therefore, This study examines the burden of the poverty caring for the demented elderly. This study focused on the three points : the level of care burden of the families, who take care of the demented elderly ; the needs of welfare services ; the differences of care burden and service demand on trait of the families and the demented elderly. In order to achieve them, the 250 families, who take care of the demented elderly at home, were sampled and the primary caregivers of family member interviewed. Then, the statistics of the 226 people were analyzed by SPSSWIN. The major findings of the study were as follows : First, the level of the care burden the families of the demented elderly have, participated in this research, is higher than 'a little yes'. In a type of the care burden, the social & personal restriction is higher than the other types, including physical restriction, economical restriction, and reciprocal restriction. Second, some families had used service and had a low satisfaction, because of no various and adequate services. It shows that the services for the demented elderly and their families is not enough to use, that the services is not various for the families having many problem related the demented elderly. Third, there are many services needed by the families caring for the demented elderly : residential care facilities for the demented elderly ; day care service center ; short-term care services ; family counseling service ; services at home ; nursing services at home ; night care services ; family meeting. Fourth, the most difficult thing of caring is the economic burden of the families. The families are willing to take care of the demented elderly at home, if the government supports economically them and serves proper services to them. Finally, the lower income of the families is, the more time of caring the demented elderly in a day is, the lower vital functions of the demented elderly are, and the lower level of academic achievement, the higher level of care burden of the families is. According to the result, the level of the care burden can be affected by the family's economic capacity, the vital function of the demented elderly, and the existence of service for the demented elderly. For the elderly welfare especially, the demented elderly and their poverty families, three opinions may be suggested. First, the service programs based on community should be developed to reduce the burdens-economic, psychological, medical burden, etc. - of the poverty families caring for the demented elderly. These programs may include preventive service, education programs of dementia, diagnosis services, family counseling, and medical service. Second, the national government and the local government must try to make policies to solve the temporary problems of the family having the demented elderly.
Aged* ; Caregivers ; Counseling ; Day Care, Medical ; Dementia ; Diagnosis ; Education ; Federal Government ; Humans ; Local Government ; Night Care ; Nursing Services ; Poverty* ; Social Work

BACKGROUND: This study was conducted to evaluate vinly chloride exposure in vinyl chloride and poly vinyl chloride manufacturing factories. The object of this study was compare two different type of air sampling method that of, NIOSH and OSHA recommended and Investigate quantitative correlation between level of vinyl chloride exposure and urinary thiodiglycolic acid excretion. METHODS: Air sampling was conducted by two method and sampling mediums were located at workers breathing zone in the same location. Sampling mediums were changed in 60 minute interval and sampling pumps were recalibrated at the same time. Urine was collected before and end of shift were stored frozen and determined by GC/FID analysis. RESULTS: In NIOSH method, time weighted average was 3.562 +/- 2.898 ppm and OSHA method time weighted average was 4.051 +/- 3.700 ppm. Concentration of urinary TdGA in before shift was 0.527 +/- 0.828 g/g creatinine and end of shift was 4.190 +/- 7.665 mg/g creatinine. Difference of urinary TdGA between end of shift to before shift was 3.662 +/- 7.865 mg/g creatinine. In NIOSH method, correlation coefficient between 8hour-time weighted average (8hrs-TWA) and urinary concentration of TdGA was r=0.666. and last period vinyl chloride level (6th-TWA) and urinary TdGA concentration was r=0.972. In OSHA method, correlation coefficient between last period vinyl chloride level (6th-TWA) and urinary concentration of TdGA was r=0.976 and this was highest value. CONCLUSION: There was no statistically significant difference in NIOSH method and. OSHA method. A correlation were found between level of vinyl chloride exposure and urinary thiodiglycolic acid excretion. Also, vinyl chloride exposure had significantly effected on the urinary thiodiglycolic acid excretion.
Creatinine ; National Institute for Occupational Safety and Health (U.S.) ; Respiration ; United States Occupational Safety and Health Administration ; Vinyl Chloride*

Today, although hospital infectious diseases are readily diagnosed, are treatable and preventable, many of these continues to be a major health problem in the developing countries, as well as the advanced nations. In the advanced countries efforts for hospital infection control has been presented but in Korea. The importance of being knowledge concerning hospital infection control is not much recognized yet. Presently in Korea good quality of care and services in the hospital is a main issue of discussion, therefore the subject of hospital infection control can't be over emphasized. Hospital infection control measures ranged from almost non existent to none when the pathogene transmission were not fully understood. As the knowledge of the transmission and contraction of the diseases expanded, newer and more effective procedures evolved. To be vital it is required to have good system for hospital infection control and inspection, rules and regulations and many numbers of persons with dedication, The strategy had been applied for hospital infection control standards as outlined by the centers for disease control and prevention(CDC). The hospital infection control committee is the factor to be well managed. Especially nurses are the important part of any hospital infection control program because they are the one who makes function properly. It is also required the responsibility of every employer who had employees who are exposed to blood, blood products or other potentially hospital infectious materials. Laws enacted by agencies of the federal government but the emphasis, and the demands for initiating and maintaining these control measures should be practiced on a routine and daily basis. The forgoing facts and requirements will assist us in assuring our hospital infection control program is successful.
Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Cross Infection* ; Developing Countries ; Federal Government ; Humans ; Jurisprudence ; Korea ; Social Control, Formal

This study aims to examine the performance of public municipal hospitals through the analysis of data envelopment analysis, efficiency, profitability, and publicness by using panel data during period from 2006 to 2010. The main findings of the study are as follows. First, as a result of efficiency analysis during the period from 2006 to 2010, it was revealed that the number of staff by each job category, labor cost ratio, the number of operating beds need to be decreased. Second, the performance data represented by the indicators of efficiency, profitability and publicness were complementary and showed a tendency of being increased or decreased in same direction. Third, from the result of panel analysis, the efficiency was mainly influenced by the structural factors, while the profitability was influenced by managerial factors, and the publicness by medical environment. In conclusion, in order to enhance the performance of public municipal hospitals in Korea, it is important to harmonize the effort for efficiency, financial and policy support by central and local government, and the continuous participation of community residents.
Hospitals, Municipal* ; Korea ; Local Government

Along with the steady growth of health functional food (HFF) markets, research evaluating the human effects of HFF has been expanding. In this study, we investigated the regulatory and management system of human study on HFF in the USA, Japan and UK, and the Korean domestic regulations on HHF, medicines, medical devices, cosmetics and biotechnology in order to improve the domestic management system. In these four countries, institutional review board (IRB) or research ethics committee (REC) approvals are required for on human study of HHF, but regulatory and management systems differ from country to country. In the USA, human studies on HFF for structure/function claims do not require the FDA's prior approval but clinical trials of the disease treatment effects of HHF require prior approval from the FDA. In the USA, IRBs are managed by the Department of Health and Human Services (DHHS) rather than the FDA, and IRBs in those institutions which would execute the clinical trials requiring prior approval from the FDA or human studies funded by the USA federal government are required to be registered on the DHHS. In the UK, although the government does not require prior approval of human study, authorized RECs managed by the National Research Ethics Service (NRES) and other independent RECs review the human study. In Japan, human study for HFF must conform with "Ethical guidelines for epidemiological research" and IRB registration has not been required. In Korean domestic regulations, the responsibilities, compositions, functions and operations of IRBs on medicines, medical devices and biotechnology are legally specified, but not those of IRB on HHF. These foreign statuses for the management of human study on HFF and comparisons with Korean regulations are expected to be used as basic data to improve the domestic legal system.
Biotechnology ; Cosmetics ; Ethics Committees, Research ; Ethics, Research ; Federal Government ; Financial Management ; Functional Food ; Humans ; Japan ; Social Control, Formal ; United States Dept. of Health and Human Services

In 1991, the Ministry of Health & Social affairs adopted a nationwide service program for neonatal screening of phenylketonuria, galactosemia, maple syrup urine disease, homocystinuria, histidinemia & congenital hypothyroidism for newborns delivered from low class pregnant women registered in health centers. Government decreased the test items from six to two, PKU & congenital hypothyroidism to increase test numbers with same budget from 1995. Government decided to test PKU & hypothyroidism for all newborns from 1997. 78 laboratories wanted to participate for neonatal screening test in 1999. Government didn't decide laboratory center for a certain district and placed responsibility on free competition. Government are planning to test 573,000 newborns from 1998, Government decided to screen 6 items PKU, congenital hypothyroidism, maple syrup urine disese, homocystinuria, galactosemia and congenital adrenal hyperplasia from 2006. 17 laboratores are participating now. The cost of screening test is supported by both the federal government and local government on a 40-60 basis. In case a patient with an inherited metabolic disease is diagnosed by screening of government program, special milk is provided at government's expense. Interlaboratory quality control was started 6 times a year from 1994. According to the government project, 3,707,773 newborns were screened. 86 PKU, 718 congenital hypothyroidism were detected. So incidence of PKU is 1/43,114 and congenital hypothyroidism is 1/4,612. Maeil dairy company produced new special formula for PKU, MMA and PA, MSUD, urea cycle disorder, homocystinuria, isovaleric acidemia from Oct. 1999. The cost benefit of performing screening procedures coupled with treatment has been estimated to be as high as 1.77 times in PKU, 11.11 times in congenital hypothyroidism than cost without screening. We are trying to increase the budget to test all newborns for Tandem mass sereening & Wilson disease from 2008. Now it is a very important problem to decrease laboratory numbers of neonatal screening in Korea. So we are considering 4-5 central laboratories which cover all newborns and are equipped with tandem mass spectrometer & enzyme immunoassay for TSH, 17OHP & enzyme colorimetric assay for galactose.
Acer ; Adrenal Hyperplasia, Congenital ; Budgets ; Congenital Hypothyroidism ; Cost-Benefit Analysis ; Federal Government ; Female ; Galactose ; Galactosemias ; Government Programs ; Hepatolenticular Degeneration ; Homocystinuria ; Humans ; Hypothyroidism ; Immunoenzyme Techniques ; Incidence ; Infant, Newborn* ; Korea* ; Local Government ; Maple Syrup Urine Disease ; Mass Screening* ; Metabolic Diseases* ; Milk ; Neonatal Screening ; Phenylketonurias ; Pregnant Women ; Quality Control ; Urea Cycle Disorders, Inborn