Background: The Universal Health Care (UHC) Act is a landmark legislation that seeks to improve provision of comprehensive health services through the integration of local health systems. The Department of Health (DOH) conducted a series of roundtable discussions to gather stakeholders' inputs and concerns to refine the initial draft of the Implementing Rules and Regulations (IRR) of UHC. Methods: On April 4, 2019, the Department of Health led a roundtable discussion on the Local Health Systems sections of the UHC IRR in collaboration with University of the Philippines Manila. A total of 65 stakeholders from different sectors participated in a semi-structured roundtable event. The proceedings were audio recorded and transcribed. A thematic analysis was done using NVivo 12 software to document gaps and gray areas identified by the participants. Results: Concerns of the participants revolved around the following: role of the private sector in local health systems; the integration of different municipal and other component health systems into a province-wide health system; organizational design of the health systems; pooling and utilization of the Special Health Fund (SHF). Gaps andgray areas were concentrated on the transfer of personnel and other health resources to the province-wide system, the composition of the Provincial Health Board, and the utilization and management of the SHF. Conclusion The roundtable event acquired various perspectives from stakeholders that could help the DOH identify priority action points that could be resolved at the agency level. The identified themes from the study analysis could be of value to decision makers to clarify issues, address policy gaps, and to prioritize future research directions.
Universal Health Care ; Policy Making ; Medical Assistance ; Government Programs ; Health Policy ;

PURPOSE: The objective of this study was to investigate whether financial coverage by the national insurance system for patients with lower economic conditions can improve their 1-year mortality after intensive care unit (ICU) discharge. MATERIALS AND METHODS: This study, conducted in a single tertiary hospital, used a retrospective cohort design to investigate discharged ICU survivors between January 2012 and December 2016. ICU survivors were classified into two groups according to the National Health Insurance (NHI) system in Korea: medical aid program (MAP) group, including people who have difficulty paying their insurance premium or receive medical aid from the government due to a poor economic status; and NHI group consisting of people who receive government subsidy for approximately 2/3 of their medical expenses. RESULTS: After propensity score (PS) matching, a total of 2495 ICU survivors (1859 in NHI group and 636 in MAP group) were included in the analysis. Stratified Cox regression analysis of PS-matched cohorts showed that 1-year mortality was 1.31-fold higher in MAP group than in NHI group (hazard ratio: 1.31, 95% confidence interval, 1.06 to 1.61; p=0.012). According to Kaplan-Meir estimation, MAP group also showed significantly poorer survival probability than NHI group after PS matching (p=0.011). CONCLUSION: This study showed that 1-year mortality was higher in ICU survivors with low economic status, even if financial coverage was provided by the government. Our result suggests the necessity of a more nuanced and multifaceted approach to policy for ICU survivors with low economic status.
Cohort Studies ; Critical Care ; Financing, Government ; Humans ; Insurance ; Intensive Care Units ; Korea ; Mortality ; National Health Programs ; Propensity Score ; Retrospective Studies ; Survivors ; Tertiary Care Centers

OBJECTIVES: Vaccinations for infectious diseases are opposed despite their achievement, and this opposition has recently been revealed in Korea. However, research in Korea has not been vigorous. The authors studied why some Korean parents hesitate to vaccinate their children by applying the health belief model. METHODS: Parents who hesitate to vaccinate and parents who do not were surveyed in alternative education preschools and elementary schools. They were classified into four types of hesitancy and statistically compared. RESULTS: Among the 129 subjects, 43 vaccinated without hesitancy, 20 vaccinated on time with hesitancy, 32 vaccinated with a deliberate delay of one month or longer, and 34 did not vaccinate. Vaccination increased with an increase in the awareness that severe outcomes can occur when unvaccinated. Concerns about adverse reactions from vaccinations or direct/indirect experiences affected refusal. Furthermore, perceptions of the lack of meaningfulness of vaccinations, distrust of policy and safety management, influence of leaders or activists in joined organizations, and experts of Korean traditional or alternative medicine affected refusal. Explanations by doctors, text messages and mails from institutions, and concerns about disadvantages caused by not complying with government policies increased vaccination. CONCLUSIONS: The reasons for vaccine hesitancy and acceptance were similar to the results of international research. Health authorities and professionals should communicate sufficiently and appropriately with hesitant parents and find ways to rationally resolve social conflicts. However, this sample was small and there is little Korean research, so more in-depth and diverse researchs are needed.
Child ; Communicable Diseases ; Complementary Therapies ; Education ; Humans ; Korea ; Parents ; Postal Service ; Safety Management ; Text Messaging ; Vaccination

BACKGROUND/AIMS: Food intolerance/malabsorption, particularly histamine intolerance (HIT), may cause nonspecific functional gastrointestinal and extraintestinal symptoms. We evaluated gastrointestinal and extraintestinal symptoms in patients with HIT. METHODS: In an analysis of outpatients' charts we identified 133 patients, who presented with recurring nonspecific functional gastrointestinal, extraintestinal symptoms, and a diamine oxidase value <10 U/mL, indicative of HIT. A standardized anonymous questionnaire with symptoms of HIT based on known symptoms and the 4 histamine receptors including gastrointestinal, cardiovascular, respiratory and skin complaints was developed, and sent by mail to the patients. RESULTS: In the 62 patients that completed the questionnaire, bloating was the most common and most serious symptom. Other commonly reported gastrointestinal symptoms were postprandial fullness, diarrhea, abdominal pain, and constipation. The presence of 2 from a list of 24 symptoms resulted in 276 various symptom combinations. From calculated 2.024 possible combinations of 3 symptoms the patients with HIT presented 1.975 combinations. CONCLUSIONS: The knowledge of this wide variability of symptoms and complex symptom combinations in patients with HIT may help to clinically recognize and diagnose HIT.
Abdominal Pain ; Amine Oxidase (Copper-Containing) ; Anonyms and Pseudonyms ; Constipation ; Diarrhea ; Gastrointestinal Diseases ; Glutens ; Histamine ; Humans ; Irritable Bowel Syndrome ; Postal Service ; Receptors, Histamine ; Skin

PURPOSE: Using a quantitative approach, this study aims to assess Indonesian nurses' perception of their knowledge, skills, and preparedness regarding disaster management. METHODS: This study was a descriptive comparison in design. The research samples are Indonesian nurses working in medical services and educational institutions. The variables of nurses' preparedness to cope with disaster victims were measured using the Disaster Preparedness Evaluation Tool (DPET), which was electronically distributed to all nurses in Indonesia. Data were analyzed using a statistical descriptive one-way Analysis of Variance (ANOVA) and t-test with a significance level of 95%. RESULTS: In total, 1341 Indonesian nurses completed this survey. The average scores of preparedness to cope with disasters, the ability to recover from disaster, and evaluation of disaster victims were 3.13, 2.53, and 2.46, respectively. In general, nurses surveyed in this study are less prepared for disaster management, and do not understand their roles both during the phase of disaster preparedness, and when coping with a post-disaster situation. CONCLUSION Nurses' preparedness and understanding of their roles in coping with disasters are still low in Indonesia. Therefore, their capacity in preparedness, responses, recovery, and evaluation of disasters needs improvement through continuing education. The efforts needed are significant due to potential disasters in Indonesia and adequate nurses resources.
Adaptation, Psychological ; Adult ; Civil Defense ; Cross-Sectional Studies ; Disaster Planning ; Disaster Victims ; Education, Nursing, Continuing ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Indonesia ; Male ; Middle Aged ; Nurses ; psychology ; Perception ; Professional Role ; Surveys and Questionnaires ; Young Adult

OBJECTIVES: Vaccinations for infectious diseases are opposed despite their achievement, and this opposition has recently been revealed in Korea. However, research in Korea has not been vigorous. The authors studied why some Korean parents hesitate to vaccinate their children by applying the health belief model.METHODS: Parents who hesitate to vaccinate and parents who do not were surveyed in alternative education preschools and elementary schools. They were classified into four types of hesitancy and statistically compared.RESULTS: Among the 129 subjects, 43 vaccinated without hesitancy, 20 vaccinated on time with hesitancy, 32 vaccinated with a deliberate delay of one month or longer, and 34 did not vaccinate. Vaccination increased with an increase in the awareness that severe outcomes can occur when unvaccinated. Concerns about adverse reactions from vaccinations or direct/indirect experiences affected refusal. Furthermore, perceptions of the lack of meaningfulness of vaccinations, distrust of policy and safety management, influence of leaders or activists in joined organizations, and experts of Korean traditional or alternative medicine affected refusal. Explanations by doctors, text messages and mails from institutions, and concerns about disadvantages caused by not complying with government policies increased vaccination.CONCLUSIONS: The reasons for vaccine hesitancy and acceptance were similar to the results of international research. Health authorities and professionals should communicate sufficiently and appropriately with hesitant parents and find ways to rationally resolve social conflicts. However, this sample was small and there is little Korean research, so more in-depth and diverse researchs are needed.
Child ; Communicable Diseases ; Complementary Therapies ; Education ; Humans ; Korea ; Parents ; Postal Service ; Safety Management ; Text Messaging ; Vaccination

OBJECTIVES: This study examined the relationship between the personality traits and job performance of Centers for Children's Foodservice Management (CCFSM) staff on emotional exhaustion and job satisfaction. In addition, the characteristics of the center organization were examined to provide practical guidelines for the operation of the center. The aim was to determine management implications with an important meaning in human resource management to enhance the efficiency of the operation of Centers for Children's Foodservice Management (CCFSM). METHODS: Out of 207 centers, there were 1,057 employees at 173 centers who agreed to participate in the study, the questionnaire was mailed on February 17, 2017 and collected by mail on March 31, 2017. Finally, 81 centers (46.82%) participated in the survey and 493 questionnaires were used. RESULTS: Neuroticism among the five personality factors had a positive (+) influence on ‘cynicism’ and ‘exhaustion’ among the three subordinate factors of emotional exhaustion, negative (−) effects on the ‘job’ among the six subscales of job satisfaction. In addition, openness showed a negative (−) effect on ‘loss of professional confidence’ of emotional exhaustion and positive (+) relationship with the ‘job’ of job satisfaction. Agreeableness appeared to have a negative (−) effect on all factors of emotional exhaustion and a positive (+) influence on all factors of job satisfaction. As a result of analyzing the effects of job performance on emotional exhaustion and job satisfaction, the planning and operations management team showed a positive (+) influence on all factors of emotional exhaustion and negative (−) influence on all factors of job satisfaction. On the other hand, the nutrition management team showed a negative (−) influence on all emotional exhaustion factors and a positive (+) influence on the factors of job satisfaction. The hygiene management team showed a positive (+) relationship with ‘Emotional exhaustion’ among the subordinate factors of emotional exhaustion and a negative (−) influence on the ‘Educational opportunity’ of job satisfaction. CONCLUSIONS: The personality type and job performance of Centers for Children's foodservice management (ccfsm) staff significantly affected the emotional exhaustion and job satisfaction.
Hand ; Humans ; Hygiene ; Job Satisfaction ; Postal Service ; Work Performance

OBJECTIVES: This study examined the relationship between the personality traits and job performance of Centers for Children's Foodservice Management (CCFSM) staff on emotional exhaustion and job satisfaction. In addition, the characteristics of the center organization were examined to provide practical guidelines for the operation of the center. The aim was to determine management implications with an important meaning in human resource management to enhance the efficiency of the operation of Centers for Children's Foodservice Management (CCFSM). METHODS: Out of 207 centers, there were 1,057 employees at 173 centers who agreed to participate in the study, the questionnaire was mailed on February 17, 2017 and collected by mail on March 31, 2017. Finally, 81 centers (46.82%) participated in the survey and 493 questionnaires were used. RESULTS: Neuroticism among the five personality factors had a positive (+) influence on ‘cynicism’ and ‘exhaustion’ among the three subordinate factors of emotional exhaustion, negative (−) effects on the ‘job’ among the six subscales of job satisfaction. In addition, openness showed a negative (−) effect on ‘loss of professional confidence’ of emotional exhaustion and positive (+) relationship with the ‘job’ of job satisfaction. Agreeableness appeared to have a negative (−) effect on all factors of emotional exhaustion and a positive (+) influence on all factors of job satisfaction. As a result of analyzing the effects of job performance on emotional exhaustion and job satisfaction, the planning and operations management team showed a positive (+) influence on all factors of emotional exhaustion and negative (−) influence on all factors of job satisfaction. On the other hand, the nutrition management team showed a negative (−) influence on all emotional exhaustion factors and a positive (+) influence on the factors of job satisfaction. The hygiene management team showed a positive (+) relationship with ‘Emotional exhaustion’ among the subordinate factors of emotional exhaustion and a negative (−) influence on the ‘Educational opportunity’ of job satisfaction. CONCLUSIONS: The personality type and job performance of Centers for Children's foodservice management (ccfsm) staff significantly affected the emotional exhaustion and job satisfaction.
Hand ; Humans ; Hygiene ; Job Satisfaction ; Postal Service ; Work Performance

PURPOSE: Recently, according to the development of digital technology, computer aided design/computer aided manufacture (CAD/CAM) system is widely used for fabrication of various dental prostheses in the field of dentistry. This study aims to survey the present state and awareness of CAD/CAM system on domestic dental field, and to supply the advice for the application of the new system. MATERIALS AND METHODS: In this questionnaire survey was conducted for a total of 298 dentists, dental hygienist and dental technicians of the whole country including the dental hospital of Seoul National University for two months from November to December, 2016 through mail. RESULTS: The most important purpose to consider when purchasing a dental CAD/CAM milling machine were the performance of the milling machine (64.43%) and the use of milling machine was the highest with 49.33% of manufacturing for dental prosthesis and customized implant abutment. In addition, more than 60% of respondents answered positively about the purchase of new milling machine if the CAD/CAM milling machine was improved to satisfactory performance. CONCLUSION: This survey results show that the improved CAD/CAM milling machine would be play an important role in the dental industry in preparation for digitization and the 4th industrial revolution.
Dental Hygienists ; Dental Prosthesis ; Dental Technicians ; Dentistry ; Dentists ; Humans ; Postal Service ; Seoul ; Surveys and Questionnaires

BACKGROUND: This study aimed to identify the difference of perception about the role of appointing health officers by comparing and analyzing the response of entrustment workplace (EW) and specialized health management institution (SI). This is considered an important aspect of an institutional assessment to improve the quality of health management services. METHODS: A survey questionnaire was mailed to 122 SIs and 319 EWs nationwide. The questionnaire survey was about the general characteristics of SIs and EWs and main occupations for each evaluation item. In total, 81 SIs (66.4%) and 30 EWs responded to the questionnaire. A logistic regression analysis was performed to compare the opinions of SI and EW. RESULTS: Based on the analysis, the items showing statistically significant differences were as follows. Doctors’ main tasks survey: “Guidance on their wearing personal protective equipment (PPE)” (OR: 4.58), “Guidance of improvement of work environment (WE)” (OR: 3.33), etc.; Nurses’ main tasks survey: “Guidance on their wearing PPE” (OR: 3.86), “Guidance for programs on health process in confined space (CS)” (OR: 0.36), “Guidance on the hearing conservation program (HCP)” (OR: 0.28), etc.; Industrial hygienist (IH)‘s main tasks survey: “Guidance of work through inspection (WTI)” (OR: 0.15), “Guidance on the improvement of WE” (OR: 0.32), “Management confirmation of substances used by process and Material Safety Data Sheet (MSDS)” (OR: 0.08), “Guidance on posting or keeping of MSDS and warning signs” (OR: 0.03), “Prevention of dust-induced medical problems” (OR: 0.28), “Guidance for programs of health process in CS” (OR: 0.39), etc. CONCLUSIONS: It is necessary to educate the EWs to recognize the need for physicians to perform tasks, such as wearing a PPE, and instruction to improve WE. As for nurses’ tasks, such as education about the CS and the noise work, educating the nurses of the SI is regarded necessary as the demand of the EWs is considered. With respect to the unique tasks of IH, such as WE management and instructions for wearing PPE, among several other tasks of IH, training should be provided for improved IH recognition.
Confined Spaces ; Delivery of Health Care ; Education ; Hearing ; Korea ; Logistic Models ; Material Safety Data Sheets ; Noise ; Occupations ; Personal Protective Equipment ; Postal Service