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      Developing key performance indicators for guaranteeing right to health and access to medical service for persons with disabilities in Korea: Using a modified Delphi

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          Abstract

          Recently, the Act on Guarantee of Right to Health and Access to Medical Service for Persons with Disabilities was implemented to legally define the health care system for persons with disabilities (PWDs) and the guarantee of access to medical care in Korea. This study aimed to develop specific goals and performance indicators to establish a system to guarantee right to health and access to medical service for PWDs. The first procedure was the establishment of the performance indicators, and the second was the content validity verification of the established performance indicators. To establish the performance indicators, we used the policy indicators of the government to improve the health of the Korean people. The indicators that needed to be newly developed were established based on literature review and expert consultation. Three Delphi surveys were conducted to verify the content validity of the established performance indicators. The content validity index (CVI) was obtained for the importance and possibility of the performance indicators. The indicators using the existing policy indicators are “proportion of public health centers” and “rate of health checkup of PWDs,” and newly developed indicators are “establishment of facilities for PWDs in health care facilities (buildings and personnel)” and “diagnosis of autism spectrum disorder in early childhood (average age and awareness).” The final performance indicators consist of a total of six areas, 22 sub-areas, and 40 individual indicators. The final performance indicators in this study can be used as basic data for continuously identifying the health status of PWDs in Korea and establishing the national policy for their health promotion. This study is also expected to serve as a framework to guarantee the right to health and access to medical service for PWDs rather than simply containing declarative content.

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          Most cited references11

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          Determination and quantification of content validity.

          M Lynn (1986)
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            On the comparable quantification of health risks: lessons from the Global Burden of Disease Study.

            Extensive discussion and comments on the Global Burden of Disease Study findings have suggested the need to examine more carefully the basis for comparing the magnitude of different health risks. Attributable burden can be defined as the difference between burden currently observed and burden that would have been observed under an alternative population distribution of exposure. Population distributions of exposure may be defined over many different levels and intensities of exposure (such as systolic or diastolic blood pressure on a continuous scale), and the comparison distribution of exposure need not be zero. Avoidable burden is defined as the reduction in the future burden of disease if the current levels of exposure to a risk factor were reduced to those specified by the counterfactual distribution of exposure. Choosing the alternative population distribution for a variable, the counterfactual distribution of exposure, is the critical step in developing a more general and standardized concept of comparable, attributable, or avoidable burden. We have identified four types of distributions of exposure that could be used as the counterfactual distributions: theoretical minimum risk, plausible minimum risk, feasible minimum risk, and cost-effective minimum risk. Using tobacco and alcohol as examples, we explore the implications of using these different types of counterfactual distributions to define attributable and avoidable burden. The ten risk factor assessments included in the Global Burden of Disease Study reflect a range of methods and counterfactual distributions. We recommend that future assessments should focus on avoidable and attributable burden based on the plausible minimum risk counterfactual distribution of exposure.
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              Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework.

              The Mental Health Strategy for Canada identified a need to enhance the collection of data on mental health in Canada. While surveillance systems on mental illness have been established, a data gap for monitoring positive mental health and its determinants was identified. The goal of this project was to develop a Positive Mental Health Surveillance Indicator Framework, to provide a picture of the state of positive mental health and its determinants in Canada. Data from this surveillance framework will be used to inform programs and policies to improve the mental health of Canadians.
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                Author and article information

                Contributors
                Role: Writing – original draft
                Role: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                7 December 2018
                2018
                : 13
                : 12
                : e0208651
                Affiliations
                [001]Department of Medical Education and Medical Humanities, Kyung Hee University School of Medicine, Dongdaemun-gu, Seoul, Korea
                Medical University Graz, AUSTRIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-0553-5381
                Article
                PONE-D-18-24267
                10.1371/journal.pone.0208651
                6286001
                30532250
                e8be3668-1c9f-4dab-8150-777aa47dd447
                © 2018 Lee, Park

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 23 August 2018
                : 20 November 2018
                Page count
                Figures: 2, Tables: 1, Pages: 12
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100003625, Ministry of Health and Welfare;
                Award ID: 2017008
                Award Recipient :
                This research was supported by the R&D grant (No. 2017008) on rehabilitation by the Korean National Rehabilitation Center Research Institute, Ministry of Health and Welfare. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Public and Occupational Health
                Disabilities
                Biology and Life Sciences
                Population Biology
                Population Metrics
                Death Rates
                Medicine and Health Sciences
                Health Care
                Health Care Policy
                Research and Analysis Methods
                Database and Informatics Methods
                Health Informatics
                Medicine and Health Sciences
                Health Care
                Health Statistics
                Medicine and Health Sciences
                Diagnostic Medicine
                Cancer Detection and Diagnosis
                Cancer Screening
                Medicine and Health Sciences
                Oncology
                Cancer Detection and Diagnosis
                Cancer Screening
                Medicine and Health Sciences
                Health Care
                Health Education and Awareness
                People and Places
                Geographical Locations
                Asia
                Korea
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

                Uncategorized
                Uncategorized

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