Secular Trend of Twin Birth Rate in Metropolitan Cities of Korea, 2000-2019

Objectives: To analyze the seven metropolitan cities of twin birth rate per 100 births (TBR) from 2000 to 2019 in Korea.Methods: We used the 2000-2019 birth certificated data (3,949,097 births) of seven metropolitan cities from Statistics Korea. The data of extra-marital birth and information missing cases (maternal and paternal age and triplet birth) were excluded. The odds ratio and 95% confidence intervals were calculated using logistic regression to describe the regional variance of TBR adjusted for maternal age, age difference between couple and maternal educational backgrounds.Results: During this period (2000-2019 years), the highest TBR by region was observed in Ulsan and Seoul metropolitan city (3.0), and the lowest TBR in Deagu metropolitan city (2.6). The TBR increased by 275 percent from 1.74 in 2000 to 4.79 in 2019. During the period from 2000-2004 to 2015-2019, there was the highest increment of TBR in Ulsan metropolitan city (odds ratio: 1.78; 95% confidence interval: 1.64-1.92) and Busan metropolitan city (1.74; 1.65-1.83), and the lowest increment in Daegu metropolitan city (1.24; 1.17-1.31), after adjustment by logistic regression for demographic variables. During the period 2015-2019 years, there was a significant increase the odds ratio of TBR in Ulsan metropolitan city (1.39), Busan metropolitan city (1.33), Seoul metropolitan city (1.25) and Incheon metropolitan city (1.23), as compared with the TBR of Deagu metropolitan city.Conclusions: Over the past two decades, TBR have risen dramatically in metropolitan cities of Korea. Regional variance of TBR was observed among metropolitan cities in Korea. There is a need for more research to understand the socio-demographic and medical factors associated with regional differences. The national birth registration system needs to be reformed to monitor whether twin births are spontaneous or assisted pregnancy.

Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions

Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.

Addressing COVID through PCD: policy coherence for vulnerability in development and its relationship to the coronavirus pandemic

PurposeThe purpose of this article is to understand how coronavirus impacts relate to existing vulnerabilities in different world regions.Design/methodology/approachThe article utilizes quantitative analysis to examine regional variations in coronavirus risk assessment. It then qualitatively employs a policy coherence for development (PCD) approach to analyze how public policies contribute to or mitigate vulnerability, defined as the product of exposure to external shocks, institutional coping capabilities and risk associated with social divisions in societies.FindingsThe research presented below shows that significant regional variance exists in terms of coronavirus risk, based on statistical analysis of the INFORM COVID-19 Risk Report prepared by the European Commission. The PCD analysis highlights important relationships between public policy strategies and the construction of both underlying vulnerabilities and coronavirus impacts.Practical implicationsThe PCD approach presented here focuses on the reconciliation of trade-offs. It shows how policy interactions affect vulnerabilities and suggests that coherent policy strategies aimed at reducing vulnerabilities are necessary in order to adequately respond to the coronavirus pandemic.Originality/valueThis analysis frames vulnerability as a socially constructed condition and through implementation of a PCD approach, it indicates how policy strategies contribute to or mitigate vulnerabilities. In doing so, it intends to contribute conceptually to the literature on vulnerability by showing how policy incoherences contribute to the construction of this condition. Empirically, the originality of this article is its statistical analysis of regional variance of coronavirus risk and the qualitative analysis of policy strategies in representative cases and how they have affected vulnerabilities and coronavirus impacts.