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.

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

PURPOSE: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. METHOD: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. RESULTS: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. CONCLUSIONS: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.
Delivery of Health Care ; Information Systems ; Local Government

BACKGROUND: The government staffs studied in this research has been easily exposed to excessive job stress, which can lead to a variety of psychosocial problems and poor quality of life. In this study, we examined the effect of the self reflection meditation program on the psychosocial health and stress responses of government staffs, to suggest the intervention program improving psychosocial health and quality of life in government staffs.METHODS: In this study, we measured the conditions of 36 local government staffs based on self reflection scale, psychosocial health and stress score before and after implementing the short-term intensive meditation program.RESULTS: The results showed that there were significant increase in social role performance and self confidence(p=.003), general health and vitality(p=.019) and significant decrease in stress(p=.010). This change was prominently showed in administrative officer and depression and anxiety(p=.034) also significantly decreased after program.CONCLUSION: Self reflection meditation program was effective in improving the psychosocial health and physical health of government staffs. Therefore, self reflection meditation program could be proposed as program for stress management and promotion of quality of life in government staff.
Depression ; Local Government ; Meditation ; Quality of Life

This article explores the setup and development of the provincial medical system during the early days of Koryo(918-1392) Dynasty. Under the reign of King HyunJong(1009-1031) the dualistic medical system of the UiSa(a medical officer) and the YakJumSa(a provincial medical officer) was established. The former, the officer of central government, were sent to the local government, and the latter, the successor of provincial powerful clan, operated the YakJum. The Uisa supervised the YakJumSa in 13 local governments, and it indicates the will and the limitation of the power of Koryo government. On the other hand, a great number of the YakJumSa were spreaded throughout the country except the capital and the vice capital, and it means the development of medical system during the early days of Koryo. The missions of the Uisa and the YakJumSa were instructing the medical students, collecting the tribute herbs, treatment, and relieve the poor people. And they just took the right of collecting tax of the land as their salaries, and it was different from the another officers. This dualistic medical system of the UiSa and the YakJumSa got under way in the reign of King MoonJong(1046-1083). But after the reign of King YeJong(1105-1122) the YakJumSa became the only provincial medical officer as the UiSa had been perished for reducing the ruling system. So the monistic medical system of the YakJumSa was the final provincial medical system of Koryo. Despite accomplishing the nationwide medical network with the YakJumSa, Koryo government failed to maintain and develop the provincial medical system with the UiSa. And it caused the difference of medical standard between the ruling class of the capital and the people of the province. Therefore, it can be said that the important principal of the medical system of Koryo was hierarchy accordance with the regional difference.
Delivery of Health Care/*history/organization & administration ; Education, Medical/history ; Government/*history ; History, Medieval ; Korea ; Local Government

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 purposes of this study were to investigate the perception of community nutrition programs and the conditions to carry them out, for 32 directors of health centers where public health nutritionists are not employed. The results of this study can be summarized as follows. Nutrition intervention programs were not carried out actively except those for infants but the health center directors strongly felt the necessity of carrying out various nutrition programs. The factors that affect the selecting and priotizing of nutrition programs were the need of community residents, the perception of the local congressmen, and the head of the local government. The most urgent and important problem to be solved in order to intervene nutrition programs was employing public health nutritionists on a tenure basis. Other were securing necessary revenue, precise guidance, political support, hardwares, etc. These results showed the importance of employing public health nutritionists for intervening appropriate nutrition programs and improving the perception of nutrition services for health center directors, local congressmen and personnels in charge of formulating nutrition policies.
Head ; Humans ; Infant ; Local Government ; Nutrition Policy ; Nutritionists* ; Public Health*

A total of 11,395 animals were impounded in shelters in Seoul in 2013. The Animal Protection Division of the Seoul metropolitan government has annual contracts with local veterinary associations as well as Korean animal rescue and management organizations for providing shelter to animals, and collects monthly statistics from these groups. In 2013, the collected intake and outcome data for 25 districts were reviewed to analyze shelter capacity in terms of housing capacity (monthly daily average intake, required holding capacity, and adoption-driven capacity), staff capacity (staff hours required for daily care), and live release rate. Seasonal variations in the monthly daily average intake were observed, indicating that management of these shelters requires various strategies. This study was performed to analyze and interpret meaningful statistics for improving the efficiency of animal shelters in Seoul. However, inconsistent collection of animal statistics limited data compilation. Creation of a basic animal statistics matrix with reference to well-designed matrices from recognized professional animal shelters is essential. These complied statistical data will help plan for future animal shelter needs in Seoul.
Animal Welfare ; Animals ; Housing ; Local Government ; Seasons ; Seoul ; Statistics as Topic*

BACKGROUND: Effective policy implementation is essential for a healthy workplace. The Ryan-Kossek 2008 model for work-life policy adoption suggests that supervisors as gatekeepers between employer and employee need to know how to support and communicate benefit regulations. This article describes a workplace intervention on a national employee benefit, Family and Medical Leave Act (FMLA), and evaluates the effectiveness of the intervention on supervisor knowledge, awareness, and experience with FMLA. METHODS: The intervention consisted of computer-based training (CBT) and a survey measuring awareness and experience with FMLA. The training was administered to 793 county government supervisors in the state of Oregon, USA. RESULTS: More than 35% of supervisors reported no previous training on FMLA and the training pre-test revealed a lack of knowledge regarding benefit coverage and employer responsibilities. The CBT achieved: (1) a significant learning effect and large effect size of d = 2.0, (2) a positive reaction to the training and its design, and (3) evidence of increased knowledge and awareness regarding FMLA. CONCLUSION: CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA.
Humans ; Learning ; Local Government ; Oregon ; Social Control, Formal

PURPOSE: This study analyzed the eco-foodservice perception and satisfaction of 344 elementary school parents in Jeju surveyed from February 1~12, 2010, with the aim of providing basic data for quality improvement of eco-foodservice in Jeju. METHODS: The data were analyzed by descriptive analysis, chi2-test, t-test, ANOVA, and Pearson's correlation coefficients, using the SPSS Win program (version 12.0). RESULTS: Regarding awareness of eco-friendly food materials of subjects, average score was 3.52 points (out of 5 scales) and 'difference between eco-friendly and general agricultural products (3.76)' showed the highest score whereas 'assurance standard and label of eco-friendly agricultural products (3.31)' showed the lowest score. In terms of the recognition of eco-foodservice implementation, 75.0% of parents were aware of it. Regarding the eco-foodservice satisfaction of the subjects, average score was 3.88 points (out of 5 scales) and food safety (3.98 points) showed the highest score whereas food taste (3.70 points) showed the lowest score. The eco-foodservice perception of subjects showed positive correlation with their eco-foodservice satisfaction. CONCLUSION: It is necessary for the government and the local government to provide continuing education for school parents in order to enhance their perception of eco-friendly food materials. In addition, systematic and appropriate government support is needed in order to ensure internal stability of eco-foodservice.
Education, Continuing ; Food Safety ; Humans ; Local Government ; Parents* ; Quality Improvement