Analyzing the Effectiveness of Data-Linked Projects for Health Promotion in Public Health Centers of South Korea.

Purpose: The purpose of this study lies in verifying the effectiveness of the health promotion project which the public health center at the local level conducted by systematically linking the health examination results from the Health Insurance Corporation. We intend to emphasize the importance of linking the health-related public data. Methods: A survey was conducted to measure the effect of improving health behavior using EQ-5D-5L and demographic variables. Results: As a result of the analysis, the residents (3.13) who had experienced the use of public health centers recognized more necessity for the service linked systematically with health checkup data than those (2.93) who had not. In addition, the residents who had experienced the use of public health centers responded that their chronic diseases had improved compared to a year ago (2.78→2.93). Next, those (3.04) who had experienced the services linked with health checkup data recognized that their chronic diseases and health conditions had been improved compared to those (2.81) who had not. However, in EQ-5D-5L, after using the service, mobility showed no difference between those who had used the service and those who had not. Furthermore, even in terms of self-management, daily life, etc., the management ability was further improved compared to those who had not used it, before using the service. Conclusion: This study showed the improved health level when the health promotion service of the public health center was provided by systematically linking the health checkup data of the Health Insurance Corporation in Korea. In order to increase the effectiveness of health data-linked projects, it is necessary to prepare guidelines for linking the public health data and to expand the data-linked project. It will be needed to further subdivide the health checkup results to provide customized services, and to secure dedicated personnel to reinforce the system link.

Comparative Analysis of Factors Affecting Quality of Community-Based Care Services in Korea.

Aging societies have an increased need for care services. To solve the problem of care, we suggest community care, through which medical services are provided that meet individual needs. Korea provides care services in advance of the community care project and implements quality control to improve the quality of these social services. Therefore, this study aims to compare and analyze the factors affecting user satisfaction in care services in both 2013 and 2016. We analyzed secondary data from 2013 and 2016 collected by the Social Security Information Service. These data include standardized metrics for the quality of care. Based on the evaluation indexes for care service in 2013 and 2016, we used commonly used indexes for analysis. Specifically, non-profit organizations were influenced by sales, accounting management, lifetime tenure rate, etc., while for-profit organizations were affected by number of users, contract termination, etc. In addition, on-site evaluation had a negative effect on the change rate of user satisfaction. Therefore, in order to increase satisfaction with care services, evaluation indexes by service type should be diversified and differentiated. In addition, field evaluations related to user satisfaction should be performed in order to provide care services appropriate for local characteristics.

Factors influencing the health satisfaction of users of public health and medical institutions in South Korea.

Introduction: In this study, we investigated the health satisfaction levels of users of regional health and medical institutions in South Korea and the influencing factors. Methods: We included randomly selected 300 people with experience in using health and medical institutions from panel data targeting the entire nation. We used questionnaire (EQ-5D-5L) and sociodemographic characteristics to analyze the health satisfaction. EQ-5D-5L was used to measure health-related quality of life in five areas: mobility, self-management, daily activities, pain/discomfort, and anxiety/depression. Hierarchical linear regression analysis was performed in three steps to examine the factors influencing health satisfaction. Results: The analysis showed that the health satisfaction was positively (+) correlated with monthly income, mobility, self-management, daily life, pain/discomfort, and anxiety/depression, and negatively (-) correlated with the number of chronic diseases and type of health insurance. The influencing factors in Step 1 and 2 were chronic diseases (ß = -0.380, -0.385), respectively. The influencing factors in Step 3 were pain/discomfort (ß = 0.202), anxiety/depression (ß = 0.257), and the number of chronic diseases (ß = -0.222). Discussions: The current data suggested that regional health and medical institutions should focus their services on residents with chronic diseases. Moreover, they should expand physical activities to relieve physical pain or discomfort and provide services related to mental health. To accomplish these, we suggested that the government will need to promote post-service health checkup results as a key project, provide user-customized services, provide online services utilizing ICT, expanding the government's financial support, and building infrastructure.

Healthy City Project: An application of data envelopment analysis.

PURPOSE: The importance of Korea's Healthy City Project has recently increased due to the growth of the elderly population and chronic diseases. Consequently, local governments are expanding the project to manage health at the local level; however, because local government resources are limited, efficient business operation is required. Thus, the purpose of this study is to present a plan for effective project management by developing a strategy for a Healthy City Project that is suitable for the scale of local governments. METHODS: For efficiency analysis, data were collected from the homepages of 90 local governments that are implementing the Healthy City Project in Korea, and data envelopment analysis (DEA) was conducted using both the CCR model and the BCC model. The input variables for the DEA included budget, manpower, organization, planned projects, and research education. In addition, we selected program, network, and project performance as output variables. RESULTS: Analysis results indicated that the CCR model identified 22 (out of 90) municipalities in which Healthy City Projects are implemented efficiently, while 68 are inefficient. The BCC model identified many more efficient regions than the CCR model; however, the difference was insignificant. Thus, the budget, manpower, planned projects, and network must be increased to improve efficiency. CONCLUSION: First, to improve the efficiency of the Healthy City Project, a sufficient budget must be secured during its implementation. Second, long- and short-term plans are needed to expand the Healthy City Program. Third, networks must be created for local governments to benchmark Healthy City Projects.

How Should the Social Service Quality Evaluation in South Korea Be Verified? Focusing on Community Care Services.

The quality evaluation (QE) of social services tends to have a large variation in results depending on the object and method of service measurement. To overcome these limitations, an analysis of the internal consistency or validity of the social service QE index is necessary, but meta-research on this is insufficient. This study analyzes the internal consistency and validity of evaluation indexes based on the results of social service QE. We utilized the social services QE manual of the Social Security Information Service's Facility Evaluation Department. The social service QE indexes implemented in 2013 and 2016 were coded and analyzed. We found that there was internal consistency between the results of the care services evaluation in 2013 and 2016. In addition, there were differences between the care services QE indexes by service type in 2013 and 2016. It is necessary to construct effective indexes by simplifying, diversifying, and differentiating social service QE indexes. In addition, control devices for external factors (region, composition of the evaluation team, etc.) must be prepared to maintain the consistency of evaluation scores, and in the long term, standardization of social service QE indexes is necessary.

Does Health Promotion Program Affect Local Resident' Emotions?

Healthy cities continuously attempt to improve residents' health. Health is affected by psychological factors, such as happiness and emotions. Therefore, this study investigates the effects of healthy city program performance on individuals' emotions, as well as the correlation between healthy city program performance and emotions using personal happiness index as a parameter. We conducted a questionnaire survey of residents in areas implementing healthy city projects. A total of 596 responses were obtained. We used structural equations to analyze the relationship of structural influences. Results showed that healthy city program performance had significant static effects on emotion. This observation shows that healthy city programs decrease local residents' negative emotions, such as stress and depression. Therefore, healthy city programs stabilize residents' emotions by increasing health friendliness. To improve the performance of healthy city programs, it is necessary to mitigate health risk factors and positively affect individuals' emotions.

Full-face augmentation using Tissuefill mixed with platelet-rich plasma: "Q.O.Fill".

BACKGROUND: Hyaluronic acid fillers have become popular soft tissue filler augmentation agents over the past several years. Q.O.Fill (JW Pharmaceutical Co., Ltd., Seoul, Korea) is a newly developed soft tissue augmentation agent using Tissuefill (hyaluronic acid derivatives) mixed with platelet-rich plasma (PRP). The purposes of this study were to describe the Q.O.Fill method and evaluate the outcome of face augmentation. METHODS: A retrospective chart review was performed over a 2-year period. Seventy-five Asian participants with a mean age of 43.5 years were enrolled in the study. Mean total injection volume (baseline and touch-up) per participant was 8.9 mL. All participants underwent injection of Tissuefill mixed with PRP, Q.O.Fill. The results were evaluated using photographs and according to patients' satisfaction. RESULTS: Six months after the last injection, 100% of participants had improvement. At month 6, 97.3% of participants remained least improved over the baseline, and 90.7% felt much better or a little better until 2 years after the injection. The incidence of complications was low. CONCLUSIONS: The study showed that Q.O.Fill injection resulted in a very good aesthetic outcome and few adverse events. We believe that a facial augmentation with Tissuefill mixed with PRP is a safe and effective treatment method.

Subjective health status of multimorbidity: verifying the mediating effects of medical and assistive devices.

BACKGROUND: This study aimed to verify the mediating effect of using assistive devices as a factor that alleviates the relationship between multimorbidity and subjective health status. METHODS: This study used three-year data (2011-2013) from the Korea Health Panel (KHP). The data were jointly collected by the consortium of the National Health Insurance Service and Korea Institute for Health and Social Affairs. RESULTS: The mediating effect of using assistive devices was verified, but the direction of the effect was deteriorated subjective health. In other words, in terms of the impact of multimorbidity on subjective health, using assistive devices had a negative impact (-) on subjective health. CONCLUSIONS: The current assessment system for medical devices, narrow scope for choice of assistive devices, and limited scope of health insurance benefits must change to ultimately lead to a positive mediating effect on using medical devices and on subjective health satisfaction of patients with chronic diseases. A system that embraces all ages and generations must be developed. To this end, it is necessary to expand the scope of medical devices and insurance payment in long-term care insurance for elderly users, as well as the active meaning of medical devices in terms of health insurance.

Social Network Analysis in the Legislative Process in the Korean Medical Device Industry.

This study analyzes the legislation process of the Korean government regarding the development of the medical device industry in the perspective of the issue network. It also aims to identify the difference in network structure between conservative and progressive governments and analyze major issues and stakeholders. It examines the network structure in the legislation process of the government to develop and support the medical device industry through social network analysis (SNA). This study conducted a policy network structure analysis of the conservative and progressive governments. SNA was used for the structure analysis, using the contents of newspaper articles as the baseline data related to the medical device industry. We analyze using the 2-mode network analysis that the node centrality is determined by eigenvector centrality. The more nodes with great power (stakeholders, information, resources) it is linked to, the greater power centrality (eigenvector centrality) it will have, which indicates that it has great influence within the network. The conservative government discussed the promotion of the medical device industry led by government departments, focusing on its potential as a future growth engine. On the contrary, the progressive government tended to have fewer stakeholders and issues around the idea, shifting the stakeholders that lead the promotion of the industry from government departments to relevant interest groups, and focusing more on policy issues like transparency than on economic issues. We identify implications to legislate the relevant act by analyzing the relevant stakeholders and issues around legislation, while reinforcing the competitiveness of Korea's medical device industry in the larger global framework. We believe that this study would comprehensively addresses the pros and cons of the government-led promotion of the medical device industry in Korea, as well as the key issues for stakeholders, which can be applicable to many other societies.

Innovative Distribution Priorities for the Medical Devices Industry in the Fourth Industrial Revolution.

PURPOSE: This study aimed to set priorities for improving the medical device distribution structure and to suggest an innovative improvement plan for the distribution structure using the analytic hierarchy process (AHP) method, focusing on stakeholders in the medical device industry. METHODS: This study conducted a survey with 35 specialists using the AHP method, which is a multiple-criteria decisionmaking methodology, in order to set priorities for improvement plans to address the problems faced by the medical device distribution structure. RESULTS: The AHP analysis showed that supply stability was the most important factor, followed by greater transparency, efficiency, smart supply, and cost reduction. CONCLUSIONS: It is necessary to establish a stable supply system and manage crises through supply stability, as well as to provide opportunities for fair trade through greater transparency. As steps towards those goals, we propose establishing a unique device identification system, an information disclosure system, online distribution, and a group purchasing organization system in Korea.

Private health insurance and catastrophic health expenditures of households with cancer patients in South Korea.

This study examines the effects of private health insurance (PHI) on the incidence of catastrophic health expenditures (CHE) for households with a patient with cancer. This study uses 1-year data from 2013 and households with cancer patients as the unit of research rather than individual household members. The sample thus includes 468 households with members with cancer who also used emergency, outpatient and hospitalisation services. Households with PHI had a lower incidence of CHE for all thresholds than those without did. At the 10% threshold, the incidence became significantly lower, by 0.59 and 0.60 times, respectively, if householders had higher education and income levels. Moreover, the incidence of CHE was higher by 8.71 times if the householders are female, and lower by 0.84 times if the householders did not have a spouse at the 20% threshold. From the analysis of households with cancer patients that hold PHI as the key variable, these households showed a lower incidence of CHE than the others did. PHI provides healthcare payments not secured through national health insurance (NHI) and protects households from health expenditures, thereby complementing NHI to a certain degree.

Outcome of facial rejuvenation with polydioxanone thread for Asians.

BACKGROUND: Techniques in rejuvenating the aging face have evolved, involving various types of threads. Facial rejuvenation with absorbable polydioxanone is popular in aesthetic clinics in Korea. AIM: The purpose of this study was to describe our polydioxanone thread method and to evaluate the outcomes of facial rejuvenation. PATIENTS/METHODS: A retrospective chart review was performed over a 12-month period. Thirty-five Asian patients were included. All participants underwent thread-lifting using polydioxanone. On each side, five 360° spiral cog threads were used in the procedure. The results were evaluated using photography and patient satisfaction. RESULTS: Thirty-three patients (94.3%) were satisfied with the outcomes. Objective outcomes using photography were categorized as very much improved (68.6%), much improved (25.7%), and improved (5.7%). Subjective outcomes using patients' satisfaction were categorized as excellent, very good, good, fair, and poor. The incidence of complications was low, and the complications resolved spontaneously without any surgical interventions. Asymmetry, however, was noted. CONCLUSIONS: Using our technique, we could achieve the desired facial rejuvenation. Our method demonstrated an excellent success rate in patients with moderate degree laxity. We believe that facial rejuvenation with polydioxanone thread for Asians is a safe and effective treatment method.

Perception of Community on Attachment and Resilience According to Closing of Hospitals.

This study includes a comparison analysis of how community resilience and its influence factor of community attachment were changed before and after the closing of the hospital in the rural community. In order to analyze the influence factors of healthcare and medical vulnerability on community resilience, as well as the mean difference from before and after the closing of the hospital, this study conducted matching sample t test, hierarchical regression analysis, difference in differences (DID) analysis. The results indicate that community attachment consists of such factors as closeness, preference, affective bond, and identity, and they showed significance in confidence. It showed that resilience and community attachment are lower after closing than before closing. Moreover, as a result of DID analysis where the variation of community attachment affects community resilience, closeness together with closeness had an influence on the community resilience. It needs to expand public projects to improve the settlement environment of the basic local government, and in particular, it should consider various support measures to overcome vulnerabilities in the healthcare and medical sector.

Effect of carrier injection stress in thin film solar cells by impedance spectroscopy.

In amorphous silicon solar cells, degradation is directly related to V(oc), FF and cell performance. The dependence of the stability of thin film amorphous silicon solar cells is studied in terms of the volume fraction of B2H6 in the p-layer. When the volume fraction of B2H6 is increased by an order of magnitude, the doping-induced defects tend to increase quite rapidly. Low-doped p-type a-SiO(x) layers had better initial properties but rapidly degraded. Heavily doped p-type a-SiO(x) layers had lower initial properties but displayed better stability. The improvement in stability is explained in conjunction with the capacitance and resistance values of impedance spectroscopy. When the B2H6 gas flow rate is increased, the cell is degraded showing a capacitance decay decrease from 51.75% to less than 18.18%. In addition, the increase in the resistance decreased from 90.90% to 11.73%.