1.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
2.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
3.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
4.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
5.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
6.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
7.Salmonellosis outbreaks linked to eggs at 2 gimbap restaurants in Korea
Jun Suk EUN ; Joohyun HAN ; Ji-Hyun LIM ; Eunkyung SHIN ; Junyoung KIM ; Da-Jung KO ; Jaeil YOO ; Sungil KIM ; Jin Sook KIM ; Jung Sub PARK ; Ji-Hyuk PARK
Epidemiology and Health 2024;46(1):e2024036-
OBJECTIVES:
Salmonellosis outbreaks occurred at 2 restaurants 2 days apart, and an epidemiological investigation was conducted to determine whether the outbreaks were connected.
METHODS:
Case studies were conducted for both outbreaks. Stool samples were collected from individuals, and food samples were collected from the restaurants. Pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing analyses were performed on outbreak-related Salmonella enterica serovar Enteritidis (Salmonella Enteritidis) isolates. Traceback investigations were also conducted for the ingredients from gimbap restaurants A and B.
RESULTS:
In total, 106 people from gimbap restaurant A and 5 from gimbap restaurant B met the case definition. Salmonella Enteritidis was detected in samples from 2 food handlers, 22 patients, and 1 food (iceberg lettuce) at gimbap restaurant A and from 1 patient at gimbap restaurant B. According to PFGE, all isolates were identified as SEGX01.089. The molecular typing of all isolates showed the same pattern, and the genetic distance was close according to phylogenetic analysis. Eggs were the only food ingredient that was supplied to both gimbap restaurants.
CONCLUSIONS
The outbreaks were caused by Salmonella Enteritidis, and the source of infections was suspected to be contaminated eggs. To prevent foodborne outbreaks of Salmonella, restaurants should heat eggs sufficiently, and egg farms need to establish management systems that prevent Salmonella infections.
8.Network Structure of Interpersonal Sensitivity in Patients With Mood Disorders: A Network Analysis
Yuna KIM ; Junwoo JANG ; Hyo Shin KANG ; Jakyung LEE ; Daseul LEE ; Hyeona YU ; Yoonjeong JANG ; Joohyun YOON ; Hyukjun LEE ; Tae Hyon HA ; Jungkyu PARK ; Woojae MYUNG
Psychiatry Investigation 2024;21(9):1016-1024
Objective:
Interpersonal sensitivity, characterized by a heightened awareness of others’ behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders.
Methods:
The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups.
Results:
Network analysis detected five communities. Item 10 (“I worry about being criticized for things that I have said or done”) showed the highest value in strength. Multiple items on “Interpersonal Worry/Dependency” and “Low Self-Esteem” showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups.
Conclusion
Our findings emphasize the importance of addressing “Interpersonal Worry/Dependency” and “Low Self-Esteem” in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.
9.Validation of the Short Form of the Mood Instability Questionnaire-Trait (MIQ-T-SF) in the Korean General Population
Joohyun YOON ; Hyeona YU ; Yoonjeong JANG ; Daseul LEE ; Yun Seong PARK ; Hong Kyu IHM ; Hyun A RYOO ; Nayoung CHO ; Jakyung LEE ; Yeoju KIM ; Jungkyu PARK ; Hyo Shin KANG ; Tae Hyon HA ; Woojae MYUNG
Psychiatry Investigation 2023;20(5):408-417
Objective:
Mood instability (MI) is a clinically significant trait associated with psychiatric disorders. However, there are no concise measurements to evaluate MI. The initial Mood Instability Questionnaire-Trait (MIQ-T) was developed to fill this gap. The current study aimed to create a short form of MIQ-T (MIQ-T-SF) that measures MI with high validity and reliability in the Korean general population.
Methods:
Of the 59 items in the MIQ-T, 17 items were chosen for the MIQ-T-SF following the factor analysis process. In total, 540 participants completed the MIQ-T-SF. Cronbach’s alpha and McDonald’s omega were used to evaluate reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to determine construct validity. Concurrent validity was confirmed via comparisons with Personality Assessment Inventory-Borderline Features Scale. Measurement invariance across gender and age groups was confirmed before analyzing differences in scores using Kruskal-Wallis test.
Results:
The MIQ-T-SF displayed expected correlations and high internal consistency (α=0.71–0.90, Ωt=0.72–0.92). Using EFA and CFA, a five-factor structure was confirmed. Measurement invariance was supported, and gender differences were observed.
Conclusion
The MIQ-T-SF is an accurate and reliable method to detect MI in the Korean general population. The study’s results offer new perspectives for future studies on MI.
10.The current status and implications of the medical insurance fee schedule in Japan
Yohan SHIN ; Kye Hyun KIM ; Sung Je MOON ; Joohyun KANG
Journal of the Korean Medical Association 2023;66(12):741-746
Korea has the most rapidly aging population in the world. Medical costs for the elderly are quickly increasing, which raises concerns about the sustainability of health insurance finances. Accordingly, the need to allocate limited medical resources efficiently has increased, with improving the fee schedule seen as an effective way to achieve this. Japan has experienced a super-aging society for at least 20 years prior to Korea and has been successful in improving its fee schedule. Korea’s fee schedule, however, needs to overcome the challenge of being relatively limited in type and simplicity.Current Concepts: The new patient consultation fee in Japan is the same regardless of the type of medical institution and is approximately 40% higher than found in Korea. In the case of established patient consultations, the fee for medical institutions with fewer than 200 beds are substantially higher than for large medical institutions, thereby suppressing re-examination at large hospitals. Japan’s additional points consist of 71 types of items, which is more diverse than Korea’s 28 types, and the additional points for children under six years of age, holidays, and late nights are set significantly higher than that found in Korea.Discussion and Conclusion: Japan designed its fee schedule to structurally reduce the consumption of medical resources and to effectively compensate for the behavior of medical providers. This policy is a standard which Korea’s fee schedule should aim for. In the future, it will be necessary to prepare measures to respond to the super-aging environment through detailed research concerning Japan’s fee schedule.

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