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Volume 45(3); May 2012
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Special Articles
Designing an Effective Pay-for-performance System in the Korean National Health Insurance
Hyoung-Sun Jeong
J Prev Med Public Health. 2012;45(3):127-136.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.127
  • 16,195 View
  • 97 Download
  • 7 Crossref
AbstractAbstract PDF

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

Summary

Citations

Citations to this article as recorded by  
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    Kyunghee Yi, Sujin Kim
    Journal of Patient Experience.2023;[Epub]     CrossRef
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    Hongsoo Kim, Shou-Hsia Cheng
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    BMJ Open.2016; 6(4): e009538.     CrossRef
  • Pay for performance in the inpatient sector: A review of 34 P4P programs in 14 OECD countries
    Ricarda Milstein, Jonas Schreyoegg
    Health Policy.2016; 120(10): 1125.     CrossRef
  • Incidence of Adult In-Hospital Cardiac Arrest Using National Representative Patient Sample in Korea
    Yuri Choi, In Ho Kwon, Jinwoo Jeong, Junyoung Chung, Younghoon Roh
    Healthcare Informatics Research.2016; 22(4): 277.     CrossRef
  • The Possibility of Expanding Pay-for-Performance Program as a Provider Payment System
    Byongho Tchoe, Suehyung Lee
    Health Policy and Management.2013; 23(1): 3.     CrossRef
Lessons From Healthcare Providers' Attitudes Toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program?
Jin Yong Lee, Sang-Il Lee, Min-Woo Jo
J Prev Med Public Health. 2012;45(3):137-147.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.137
  • 16,462 View
  • 121 Download
  • 23 Crossref
AbstractAbstract PDF

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.

Summary

Citations

Citations to this article as recorded by  
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    T. Herbst, J. Foerster, M. Emmert
    Health Policy.2018; 122(6): 667.     CrossRef
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    Rebecca A. Vokes, Gonzalo Bearman, Gloria J. Bazzoli
    Current Infectious Disease Reports.2018;[Epub]     CrossRef
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    Fabiana da Cunha Saddi, Matthew J. Harris, Germano Araújo Coelho, Raquel Abrantes Pêgo, Fernanda Parreira, Wellida Pereira, Ana Karoline C. Santos, Heloany R. Almeida, Douglas S. Costa
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    Seung Ju Kim, Kyu-Tae Han, Sun Jung Kim, Eun-Cheol Park
    International Journal for Quality in Health Care.2017; 29(2): 222.     CrossRef
  • Characterization and effectiveness of pay-for-performance in ophthalmology: a systematic review
    Tim Herbst, Martin Emmert
    BMC Health Services Research.2017;[Epub]     CrossRef
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    Christian Krauth, Sebastian Liersch, Sören Jensen, Volker Eric Amelung
    Health Policy.2016; 120(2): 148.     CrossRef
  • Does Pay-For-Performance Program Increase Providers Adherence to Guidelines for Managing Hepatitis B and Hepatitis C Virus Infection in Taiwan?
    Huei-Ju Chen, Nicole Huang, Long-Sheng Chen, Yiing-Jenq Chou, Chung-Pin Li, Chen-Yi Wu, Yu-Chia Chang, Jason Grebely
    PLOS ONE.2016; 11(8): e0161002.     CrossRef
  • Pay-for-performance in resource-constrained settings: Lessons learned from Thailand’s Quality and Outcomes Framework
    Roongnapa Khampang, Sripen Tantivess, Yot Teerawattananon, Sarocha Chootipongchaivat, Juntana Pattanapesaj, Rukmanee Butchon, Natthida Malathong, Francoise Cluzeau, Rachel Foskett-Tharby, Paramjit Gill
    F1000Research.2016; 5: 2700.     CrossRef
  • Pay-for-performance and efficiency in primary oral health care practices in Chile
    Marco Cornejo-Ovalle, Romina Brignardello-Petersen, Glòria Pérez
    Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral.2015; 8(1): 60.     CrossRef
  • Pagamento por desempenho em sistemas e serviços de saúde: uma revisão das melhores evidências disponíveis
    Jorge Otávio Maia Barreto
    Ciência & Saúde Coletiva.2015; 20(5): 1497.     CrossRef
  • When incentives work too well: locally implemented pay for performance (P4P) and adverse sanctions towards home birth in Tanzania - a qualitative study
    Victor Chimhutu, Ida Lindkvist, Siri Lange
    BMC Health Services Research.2014;[Epub]     CrossRef
  • A Qualitative Evaluation of the Performance-based Supplementary Payment System in Turkey
    Ganime Esra Yuzden, Julide Yildirim
    Journal of Health Management.2014; 16(2): 259.     CrossRef
  • Challenges and a response strategy for the development of nursing in China: a descriptive and quantitative analysis
    Yingqiang Wang, Shiyou Wei, Youping Li, Shaolin Deng, Qianqian Luo, Yan Li
    Journal of Evidence-Based Medicine.2013; 6(1): 21.     CrossRef
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    Byongho Tchoe, Suehyung Lee
    Health Policy and Management.2013; 23(1): 3.     CrossRef
Korean National Health Insurance Value Incentive Program: Achievements and Future Directions
Sun Min Kim, Won Mo Jang, Hyun Ah Ahn, Hyang Jeong Park, Hye Sook Ahn
J Prev Med Public Health. 2012;45(3):148-155.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.148
  • 10,053 View
  • 101 Download
  • 26 Crossref
AbstractAbstract PDF

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

Summary

Citations

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  • Relationship between patient outcomes and patterns of fragmented cancer care in older adults with gastric cancer: A nationwide cohort study in South Korea
    Dong-Woo Choi, Seungju Kim, Sun Jung Kim, Dong Wook Kim, Kwang Sun Ryu, Jae Ho Kim, Yoon-Jung Chang, Kyu-Tae Han
    Journal of Geriatric Oncology.2024; 15(2): 101685.     CrossRef
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    Journal of Microbiology, Immunology and Infection.2022; 55(5): 812.     CrossRef
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Original Articles
Comparison of Sexual Risky Factors of Men Who Have Sex With Men and Sex-buying Men as Groups Vulnerable to Sexually Transmitted Diseases
Minsoo Jung, Joongyub Lee, Dong Seok Kwon, Byung-Joo Park
J Prev Med Public Health. 2012;45(3):156-163.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.156
  • 8,932 View
  • 92 Download
  • 9 Crossref
AbstractAbstract PDF
Objectives

It is necessary to examine groups carrying out sexually risky behavior because the prevalence of sexually transmitted diseases (STDs) is high among them. In this study, the prevalence of STDs among homosexuals and sex-buying men in South Korea was investigated, along with their sexual risk factors.

Methods

Men who have sex with men (MSMs, n=108) were recruited in Seoul and Busan by applying the time location sampling method, while sex-buying men (n=118) were recruited from a john school in Gyeonggi province, the suburbs of Seoul. Dependent variables included past or present infection with syphilis, Chlamydia, gonorrhea, and human immunodeficiency virus. Independent variables included health behavior, social support, sexual behavior, and safe sex.

Results

It was found that when the MSMs were non-drunk while having sexual intercourse (odds ratio [OR], 0.132), they showed a higher STD infection rate when they had a higher number of anal sex partners (OR, 5.872), rarely used condoms (OR, 1.980), had lower self-efficacy (OR, 0.229), and were more anxious about becoming infected with an STD (OR, 3.723). However, the men who paid for sex showed high STD infections when they had more sex partners (OR, 2.286) and lower education levels (OR, 3.028).

Conclusions

STD infections among the two groups were high when they were engaged with many sex partners and not having protected sex. In other words, there was a gap in risky sex behavior within such groups, which was significantly related to the possibility of developing an STD. Therefore, the preventive intervention against STDs for these groups needs to be expanded to include management of sex behaviors.

Summary

Citations

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Pattern of Hepatitis A Incidence According to Area Characteristics Using National Health Insurance Data
Joo Youn Seo, Jae Hee Seo, Myoung Hee Kim, Moran Ki, Hee Suk Park, Bo Youl Choi
J Prev Med Public Health. 2012;45(3):164-173.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.164
  • 10,769 View
  • 62 Download
  • 13 Crossref
AbstractAbstract PDF
Objectives

Over the past several years, the incidence of hepatitis A infection has been increasing rapidly in the young-adult population in Korea. We examined the effects of area-level socioeconomic status and environmental hygiene on the incidence of hepatitis A.

Methods

This study is based on the registered national population of Korea and the national health insurance data from 2004 to 2008. A total of 73 459 individuals were confirmed to have had hepatitis A. The standardized incidences of hepatitis A in 232 districts adjusted for sex and age of people were calculated for each year, and the rate ratios of the incidence rates were estimated according to area-level socioeconomic status and environmental hygiene using multiple Poisson regression models.

Results

The incidence rates of hepatitis A infection were 15.6 (per 100 000) in 2004, 19.0 (per 100 000) in 2005, 27.2 (per 100 000) in 2006, 25.1 (per 100 000) in 2007, and 61.7 (per 100 000) in 2008. The analysis of the area-level effects showed that residential areas of the less deprived than other regions, areas with higher levels of education, and heavily populated areas were significantly associated with increased risk.

Conclusions

There is a very strong possibility that both area-level socioeconomic status and environmental hygiene play a role in increasing the risk of hepatitis A infection in Korea. Therefore, to reduce hepatitis A infection, we need a nationwide strategy that considers these area-level characteristics.

Summary

Citations

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Prevalence of Positive Carriage of Tuberculosis, Methicillin-resistant Staphylococcus aureus, and Vancomycin-resistant Enterococci in Patients Transported by Ambulance: A Single Center Observational Study
Young Sun Ro, Sang Do Shin, Hyun Noh, Sung-Il Cho
J Prev Med Public Health. 2012;45(3):174-180.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.174
  • 8,942 View
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  • 6 Crossref
AbstractAbstract PDF
Objectives

An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE) in patients transported by ambulance.

Methods

This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection.

Results

The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively.

Conclusions

A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

Summary

Citations

Citations to this article as recorded by  
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Association Between Serum Uric Acid Level and Metabolic Syndrome
Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh
J Prev Med Public Health. 2012;45(3):181-187.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.181
  • 16,162 View
  • 173 Download
  • 52 Crossref
AbstractAbstract PDF
Objectives

Serum uric acid levels have been reported to be associated with a variety of cardiovascular conditions. However, the direct association between uric acid levels and metabolic syndrome remains controversial. Thus, we evaluated the association of serum uric acid levels and metabolic syndrome in a community-based cohort study in Korea.

Methods

We performed cross-sectional analysis of baseline data of 889 males and 1491 females (aged 38 to 87) who participated in baseline examinations of the Korean Genome and Epidemiology Study: Kanghwa study. Blood samples were collected after at least an 8 hour fast. Uric acid quartiles were defined as follows: <4.8, 4.8-<5.6, 5.6-<6.5, ≥6.5 mg/dL in males; and <3.8, 3.8-<4.3, 4.3-<5.1, ≥5.1 mg/dL in females. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III Criteria with adjusted waist circumference cutoffs (90 cm for males; 80 cm for females). The association between serum uric acid quartiles and metabolic syndrome was assessed using multivariate logistic regression.

Results

The odds ratio for having metabolic syndrome in the highest versus lowest quartiles of serum uric acid levels was 2.67 (95% confidence interval [CI], 1.60 to 4.46) in males and 2.14 (95% CI, 1.50 to 3.05) in females after adjusting for age, smoking, alcohol intake, body mass index, total cholesterol, HbA1c, albumin, γ-glutamyltransferase, blood urea nitrogen, and log C-reactive protein. The number of metabolic abnormalities also increased gradually with increasing serum uric acid levels (adjusted p for trend < 0.001 in both sexes).

Conclusions

Higher serum uric acid levels are positively associated with the presence of metabolic syndrome in Korean males and females.

Summary

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Health Conditions Sensitive to Retirement and Job Loss Among Korean Middle-aged and Older Adults
Susan Park, Sung-Il Cho, Soong-Nang Jang
J Prev Med Public Health. 2012;45(3):188-195.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.188
  • 8,770 View
  • 79 Download
  • 14 Crossref
AbstractAbstract PDF
Objectives

This study was conducted to examine the association between health condition and leaving the labor market among middle-aged and older adults in South Korea.

Methods

Data was obtained from individuals aged 45 years and older participating in the 2006 and 2008 Korean Longitudinal Study of Ageing. We used various health measures including chronic diseases, comorbidities, traffic accident injuries, disabilit of instrumental activities of daily living, depressive symptoms, and self-rated health. The odds ratios of job loss, and retirement, versus employment were calculated using multinomial logistic regression by each health measure.

Results

In our cross-sectional and longitudinal analysis, health problems related to physical disabilities had the greatest effect on leaving the worksite. A shift in health condition from good to poor in a short period was a predictor of increased risk of unemployment but a persistent pattern of health problems was not associated with unemployment. Women with health problems showed a high probability of retirement, whereas among men, health problems instantly the possibility of both job loss and retirement.

Conclusions

Health problems of middle aged and older workers were crucial risk factors for retirement and involuntarily job loss. Especially functional defect and recent health problems strongly and instanty affected employment status.

Summary

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Associations of Serum Ferritin and Transferrin % Saturation With All-cause, Cancer, and Cardiovascular Disease Mortality: Third National Health and Nutrition Examination Survey Follow-up Study
Ki-Su Kim, Hye-Gyeong Son, Nam-Soo Hong, Duk-Hee Lee
J Prev Med Public Health. 2012;45(3):196-203.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.196
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AbstractAbstract PDF
Objectives

Even though experimental studies have suggested that iron can be involved in generating oxidative stress, epidemiologic studies on the association of markers of body iron stores with cardiovascular disease or cancer remain controversial. This study was performed to examine the association of serum ferritin and transferrin saturation (%TS) with all-cause, cancer, and cardiovascular mortality.

Methods

The study subjects were men aged 50 years or older and postmenopausal women of the Third National Health and Nutrition Examination Survey 1988-1994. Participants were followed-up for mortality through December 31, 2006.

Results

Serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality for either men or postmenopausal women. However, all-cause, cancer, and cardiovascular mortality were inversely associated with %TS in men. Compared with men in the lowest quintile, adjusted hazard ratios for all-cause, cancer, and cardiovascular mortality were 0.85, 0.86, 0.76, and 0.74 (p for trend < 0.01), 0.82, 0.73, 0.75, and 0.63 (p for trend < 0.01), and 0.86, 0.81, 0.72, and 0.76 (p for trend < 0.01), respectively. For postmenopausal women, inverse associations were also observed for all-cause and cardiovascular mortality, but cancer mortality showed the significantly lower mortality only in the 2nd quintile of %TS compared with that of the 1st quintile.

Conclusions

Unlike speculation on the role of iron from experimental studies, %TS was inversely associated with all-cause, cancer and cardiovascular mortality in men and postmenopausal women. On the other hand, serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality.

Summary

Citations

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Brief Report
Is Caffeine Intake Associated With Urinary Incontinence in Japanese Adults?
Fumi Hirayama, Andy H. Lee
J Prev Med Public Health. 2012;45(3):204-208.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.204
  • 9,341 View
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  • 11 Crossref
AbstractAbstract PDF
Objectives

To investigate whether caffeine intake is associated with urinary incontinence (UI) among Japanese adults.

Methods

A total of 683 men and 298 women aged 40 to 75 years were recruited from the community in middle and southern Japan. A validated food frequency questionnaire was administered face-to-face to obtain information on dietary intake and habitual beverage consumption. Urinary incontinence status was ascertained using the International Consultation on Incontinence Questionnaire-Short Form.

Results

Mean daily caffeine intake was found to be similar between incontinent subjects (men 120 mg, women 94 mg) and others without the condition (men 106 mg, women 103 mg), p=0.33 for men and p=0.44 for women. The slight increases in risk of UI at the highest level of caffeine intake were not significant after adjusting for confounding factors. The adjusted odds ratios (95% confidence interval) were 1.36 (0.65 to 2.88) and 1.12 (0.57 to 2.22) for men and women, respectively.

Conclusions

No association was evident between caffeine intake and UI in middle-aged and older Japanese adults. Further studies are required to confirm the effect of caffeine in the prevention of UI.

Summary

Citations

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Corrigendum
Corrigendum: Suicide Rate Differences by Sex, Age, and Urbanicity, and Related Regional Factors in Korea
Kyu-Seok Cheong, Min-Hyeok Choi, Byung-Mann Cho, Tae-Ho Yoon, Chang-Hun Kim, Yu-Mi Kim, In-Kyung Hwang
J Prev Med Public Health. 2012;45(3):209-209.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.209
Corrects: J Prev Med Public Health 2012;45(2):70
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Summary

JPMPH : Journal of Preventive Medicine and Public Health