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: 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

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

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: To evaluate changes in clinical practice in the field of refractive surgery in Korea over the past 10 years. METHODS: A survey consisting of 59 multiple-choice questions regarding the preferred types of refractive surgery, excimer laser machine, and presbyopia surgery was mailed to 742 members of the Korean Society of Cataract and Refractive Surgery in January 2016, and 50 members responded to the survey. These data were compared with the 2005 or 2007 survey results.
Cataract ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Korea ; Lasers, Excimer ; Myopia ; Phakic Intraocular Lenses ; Postal Service ; Presbyopia ; Refractive Surgical Procedures ; Surveys and Questionnaires

Historically, Plasmodium vivax malaria has been one of the most highly endemic parasitic diseases in the Korean Peninsula. Until the 1970s, vivax malaria was rarely directly lethal and was controlled through the Korean Government Program administered by the National Malaria Eradication Service in association with the World Health Organization's Global Malaria Eradication Program. Vivax malaria has re-emerged in 1993 near the Demilitarized Zone between South and North Korea and has since become an endemic infectious disease that now poses a serious public health threat through local transmission in the Republic of Korea. This review presents major lessons learned from past and current malaria research, including epidemiological and biological characteristics of the re-emergent disease, and considers some interesting patterns of diversity. Among other features, this review highlights temporal changes in the genetic makeup of the parasitic population, patient demographic features, and spatial distribution of cases, which all provide insight into the factors contributing to local transmission. The data indicate that vivax malaria in Korea is not expanding exponentially. However, continued surveillance is needed to prevent future resurgence.
Communicable Diseases ; Culicidae ; Democratic People's Republic of Korea ; Global Health ; Government Programs ; Humans ; Korea ; Malaria ; Malaria, Vivax ; Parasitic Diseases ; Plasmodium vivax ; Population Characteristics ; Public Health ; Republic of Korea