It has become a common consensus that resource conservation and intensive recycling for improving resource utilization efficiency is an important way to achieve carbon peak and carbon neutrality(dual carbon). Traditonal Chinese medicine(TCM)resources as national strategic resources are the material basis and fundamental guarantee for the development of TCM industry and health services. However, the rapid growth of China's TCM industry and the continuous expansion and extension of the industrial chain have exposed the low efficiency of TCM resources. Resource waste and environmental pollution caused by the treatment and discharge of TCM waste have emerged as major problems faced by the development of the industry, which has aroused wide concern. Considering the dual carbon goals, this paper expounds the role and potential of TCM resource recycling and circular economy industry development. Taking the typical model of TCM resource recycling as the case of circular economy industry in reducing carbon source and increasing carbon sink, this paper puts forward the suggestions for the TCM circular economy industry serving the double carbon goals. The suggestions mainly include strengthening the policy and strategic leading role of the double carbon goals, building an objective evaluation system of low-carbon emission reduction in the whole industrial chain of TCM resources, building an industrial demonstration park for the recycling of TCM resources, and promoting the establishment of a circular economy system of the whole industrial chain of TCM resources. These measures are expected to guide the green transformation of TCM resource industry from linear economic model to circular economy model, provide support for improving the utilization efficiency and sustainable development of TCM resources, and facilitate the low-carbon and efficient development of TCM resource industry and the achievement of the double carbon goals.
Medicine, Chinese Traditional ; Equipment Reuse ; Goals ; Environmental Pollution ; Economic Development ; Carbon ; China

OBJECTIVE: To analyze the inequality of early marriage and adolescent fertility with respect to local economic development among Chinese females aged 15-19 years from 1990 to 2010. METHODS: Aggregated data were extracted from the Chinese National Census from 1990 to 2010. We calculated the ever-married rate and fertility rate of female adolescents aged 15-19 years. Using gross domestic product (GDP) per capita as an indicator for socio-economic status of a province, we calculated the slope index of inequality (SII) and the concentration index (CI) to analyze the subnational inequalities of early marriage and adolescent fertility. Weighted linear regression models were also established to assess the associations between GDP per capita and the ever-married rate/fertility rate. RESULTS: The ever-married rate for Chinese female adolescents aged 15-19 years decreased from 4.7% in 1990 to 1.2% in 2000, and rebounded to 2.1% in 2010. From 1990 to 2000, the fertility rate decreased from 22.0 per 1 000 to 6.0 per 1 000, and further decreased to 5.9 per 1 000 in 2010. In 1990, the socio-economic inequalities of the ever-married rate and fertility rate for female adolescents aged 15-19 years were not statistically significant (P for SII or CI>0.05). The values of SII revealed that, in 2000 and 2010, female adolescents with the lowest GDP per capita had an ever-married rate 2.4% (95%CI: 0.4-4.4) and 2.3% (95%CI: 0.3-4.2) higher than those with the highest GDP per capita, respectively. In the meantime, in 2000 and 2010, female adolescents with the lowest GDP per capita had a fertility rate 12.9 per 1 000 (95%CI: 5.4-20.5) and 9.3 per 1 000 (95%CI: 4.6-14.0) higher than those with the highest, respectively. In 2000 and 2010, the CIs for marriage were -0.32 (P=0.02) and -0.17 (P=0.03), respectively, and the CIs for childbirth were -0.37 (P<0.01) and -0.26 (P<0.01), respectively. In 2000, the ever-married rate and the fertility rate were estimated to increase by 1.4% (95%CI: 0.1-2.7) and 7.9 per 1 000 (95%CI: 2.9-12.8) with 100% increase in GDP per capita, respectively; in 2010, the numbers were 1.5% (95%CI: 0.1-2.9) and 6.7 per 1 000 (95%CI: 3.2-10.1), respectively. CONCLUSION Subnational socio-economic inequality of early marriage and adolescent fertility existed in 2000 and 2010. Female adolescents residing in less-developed areas were more likely to engage in early marriage and childbirth. Reducing income inequality and increasing education investment for poverty-stricken areas seem to be effective measures to reduce this inequality.
Adolescent ; Adult ; Economic Development ; Female ; Fertility ; Humans ; Income ; Marriage ; Socioeconomic Factors ; Young Adult

Air pollution, climate change, and reduced biodiversity are major threats to human health with detrimental effects on a variety of chronic noncommunicable diseases in particular respiratory and cardiovascular diseases. The extent of air pollution both outdoor and indoor air pollution and climate change including global warming is increasing-to alarming proportions particularly in the developing world especially rapidly industrializing countries worldwide. In recent years, Asia has experienced rapid economic growth and a deteriorating environment and increase in allergic diseases to epidemic proportions. Air pollutant levels in many Asian countries especially in China and India are substantially higher than are those in developed countries. Moreover, industrial, traffic-related, and household biomass combustion, indoor pollutants from chemicals and tobacco are major sources of air pollutants, with increasing burden on respiratory allergies. Here we highlight the major components of outdoor and indoor air pollutants and their impacts on respiratory allergies associated with asthma and allergic rhinitis in the Asia-Pacific region. With Asia-Pacific comprising more than half of the world's population there is an urgent need to increase public awareness, highlight targets for interventions, public advocacy and a call to action to policy makers to implement policy changes towards reducing air pollution with interventions at a population-based level.
Administrative Personnel ; Air Pollutants ; Air Pollution ; Air Pollution, Indoor ; Allergy and Immunology ; Asia ; Asian Continental Ancestry Group ; Asthma ; Biodiversity ; Biomass ; Cardiovascular Diseases ; China ; Climate Change ; Climate ; Consumer Advocacy ; Developed Countries ; Economic Development ; Family Characteristics ; Global Warming ; Humans ; Hypersensitivity ; India ; Rhinitis, Allergic ; Tobacco

This study investigated the healthcare status of South Korea and member states of the Organization for Economic Cooperation and Development (OECD). By employing the position value for relative comparison index, healthcare status was measured through the following components: demand, supply, accessibility, quality, and cost. Statistical analysis was conducted through the Mann-Kendall test from analyzing trends from 2000 onwards. Results showed that while Korea, on average, scores higher than the OECD average in most of the investigated components, it is below average in certain indexes including primary care and mental health care. Considering the various health issues that have been raised about these indexes, it is important these components be improved upon by policy-makers.
Delivery of Health Care ; Health Policy ; Korea ; Mental Health ; Organisation for Economic Co-Operation and Development ; Primary Health Care

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. ‘Transfers from government domestic revenue’ share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to ‘compulsory contributory health financing schemes,’ ‘transfers from government domestic revenue’ share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.
Belgium ; Censuses ; Classification ; Gross Domestic Product ; Guanosine Diphosphate ; Health Expenditures ; Healthcare Financing ; Japan ; Korea ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Social Security ; World Health Organization

Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.
Delivery of Health Care ; Germany ; Insurance, Health ; Japan ; Korea ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Sick Leave ; Sweden

On May 1, 2019, the Minister of Health and Welfare announced publicly the first Comprehensive Plan of National Health Insurance (NHI). The Comprehensive Plan which is the 5-year plan including expenditure and revenue aspect of NHI, is desirable in 42 years of introduction of NHI and 30 years of universal coverage of NHI, though the Plan was late and had some conflict process. The Comprehensive Plan was established without evaluation of Moon's Care Plan, did not included to relationship with NHI and other health security systems, and did not have the blue print of NHI. The Plan was not sufficient in content of adequate health care utilization and relationship with service benefit and cash benefit. The Comprehensive Plan should be modified in considering the blue print of NHI and national healthcare system with participating stakeholder in turbulent environment-low fertility, rapid ageing, low economic growth rate, era of non-communicable diseases, unification of the Korean Peninsula, and 4th industrial revolution. Therefore, I suggest to establish the President's Committee of Improving Healthcare System for the blue print of health care and NHI.
Clergy ; Delivery of Health Care ; Economic Development ; Fertility ; Health Expenditures ; Humans ; National Health Programs ; Patient Acceptance of Health Care ; Universal Coverage

After the announcement of Moon Jae-in Government's plan (Moon's Care) for Benefit Expansion in National Health Insurance in August 2017, it is necessary to monitor the effects of the policy, especially household out-of-pocket payments (OOP). This paper aims to observe the current status and trend of OOP in Korea. Current health expenditure (CHE) was 144.4 trillion won in 2018, which accounts for 8.1% of gross domestic product (GDP) increased 9.7% from the previous year. Although GDP's share of CHE has been close to the average of the Organization for Economic Cooperation and Development (OECD) countries, the public fund's share was 59.8% of the total in 2018, which was lower than the OECD average of 73.5%. OOP's share was 32.9% in 2018, which decreased from 37.4% in 2008. The share of OOP of non-covered services was 20.0% in 2018, which decreased from 22.9% in 2008. The share of cost-sharing with third-party payers was 12.9% in 2018, which decreased from 14.5% in 2008. The OOP of non-covered services was significantly decreased in hospital and inpatient curative care, but the OOP of non-covered services was significantly increased in the medical clinic. The effect of Moon's Care was not showed in OOP through the results of 2017 and 2018, but further monitoring is needed because the Moon's Care is progressing and the observational period is short.
Family Characteristics ; Gross Domestic Product ; Health Expenditures ; Humans ; Inpatients ; Insurance, Health, Reimbursement ; Korea ; Moon ; National Health Programs ; Organisation for Economic Co-Operation and Development

BACKGROUND: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2–3 times more likely to commit suicide than women, which called the ‘gender paradox of suicide.’ The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. METHODS: The data was collected through the Korean Statistical Information Service. The study areas were 227 si · gun · gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. RESULTS: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. CONCLUSION: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.
Budgets ; Cause of Death ; Chungcheongnam-do ; Depression ; Divorce ; Female ; Gangwon-do ; Geographic Information Systems ; Gyeongsangbuk-do ; Health Behavior ; Humans ; Information Services ; Korea ; Male ; Marriage ; Mortality ; Organisation for Economic Co-Operation and Development ; Residence Characteristics ; Social Security ; Suicide ; Urbanization

BACKGROUND: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups. METHODS: This study utilized the National Health Insurance Service's National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of ‘middle-aged’(45–64 years) and ‘old-aged’(≥65 years) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development “Health Care Quality Indicators” project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized. RESULTS: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups. CONCLUSION: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.
Ambulatory Care ; Cohort Studies ; Continuity of Patient Care ; Health Policy ; Hospitalization ; Humans ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Primary Health Care