• The Korean Journal of Health Service Management
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• v.1 no.1
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• pp.1-15
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• 2007

CRM의 장점은 원하는 고객에 대해서 마케팅 노력을 기울일 수 있고 그 결과로 마케팅 비용을 줄이고 효율을 높일 수 있는 것이다. 그리고 마케팅 전략 수립에 대한 방법의 변화와 그 수행방법의 변화가 CRM에 있기 때문에 여기에 따른 절차와 문화, 조직구조까지 변화 시킬 수 있다. 이를 방지하기 위하여 CRM교육이 필요하며, 그 중요성을 인식하고 실행하여야 한다. 그리고 경영환경에 적합한 마케팅 전략 수립이 필수적이다. CRM의 정확한 이해와 적합한 수행이 있어야만 병원경영의 목표달성에 도움이 된다. 그러나 CRM자체의 문제가 없는 것도 아니다. 무엇보다 전문 인력이 부족하면 시스템 구축과 마케팅이나 컨설팅 인력을 확보하여 프로젝트의 부실화를 방지하여야 한다. 다음은 실업자들의 업무패턴을 파악하고 사용자의 편의를 고려한 적용이 있어야 한다. 고가의 비용을 투입하여 CRM을 실행하였다 해도 사용자 교육의 미비가 생기면 효율이 감소될 것이다. 역시 CRM의 적용에 있어서 호환이 되지 않으면 통합비용으로 별도의 비용이 지출해야 하므로 비용의 증가를 감수하여야 한다. 환자의 의료의 질에 대한 만족은 환자의 주관적 개념으로 동일한 의료서비스에 대하여 환자들은 저마다 다르게 의료의 질을 평가하게 된다. 대부분의 환자들은 자신의 욕구와 의료의 질에 대한 기대를 가지고 병원을 방문하여 의료의 질을 평가하게 된다. 대부분의 환자들은 자신의 욕구와 의료의 질에 대한 기대를 가지고 병원을 방문하여, 그것을 의료제공자가 충족시키는 정도가 환자의 만족도를 결정하게 된다. 의료의 질은 의료서비스에 대한 만족과 밀접한 관련이 있다. 의료의 질과 만족은 강하게 연관이 있으면서도 양자는 분명히 다르다. 의료의 질에 대한 평가와 만족도는 매우 일치도가 높다고 볼 수 있다. 이것은 의료의 질적 수준이 높으면 환자만족도도 높다는 것을 의미한다. 따라서 본 연구는 병원의 환자관리를 위한 CRM 마케팅의 전기를 실증적으로 역설하고 이의 도입을 통한 효과와 문제점, 이에 대한 대응방안을 제시하고, 모범적인 CRM운영 사례를 제시함과 동시에 효과적인 의료의 질 경영을 구현하고 이것이 환자의 의료서비스 만족도를 높이는 결과인 것을 모색하는 것이 본 연구의 목적이다.

• Research in Community and Public Health Nursing
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• v.19 no.4
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• pp.649-659
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• 2008

Purpose: The purpose of this study is to investigate working time of nurses in urban public health center branch, especially for nurses for visiting health service and chronic disease management. Method: Daily note. which was developed by this research team. was distributed to nurses at 7 urban public health center branches to be filled out them for 2 weeks during 2 month from June 2007 to August 2007. We analyzed 121 daily notes recorded by visiting nurses and 65 daily notes written by chronic disease management nurses were analyzed. Result: The total working time for visiting nurses at urban public health center branches was 589.85 minutes per day on the average. They spent 147.13 min in actual visiting nursing services, 149.36 min in documenting, 66.94 in preparing, 77.69 min in transferring, and 11.84 min in referring. The total working time for chronic disease management nurses at urban public health center branches was 582.92 minutes per day on the average. They spent 148.77 min in actual chronic disease management services, 120.62 min in documenting, 42.46 min in group education, 37.38 in preparing, and 10.38 min in referring. Conclusion: Based on the results of this study, it is recommended to improve documenting systems and to increase community resources linkage were recommended through the results of this study. The results of this study are expected to be used to plan staffing at urban public health center branches in the future.

• Journal of Preventive Medicine and Public Health
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• v.29 no.4 s.55
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• pp.721-732
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• 1996

This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year$(1994.4.13\sim1995.4.12)$ at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows ; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8 % of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.

• Journal of agricultural medicine and community health
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• v.36 no.3
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• pp.157-166
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• 2011

Objectives: Anxiety and depression are known to be associated with hypertension, and blood pressure can vary spontaneously throughout the day. The aim of this study was to evaluate anxiety, depression and 24-hour ambulatory blood pressure (24-h ambulatory BP) in employees at their worksite. Methods: A total of 107 volunteers among 136 employees at a hotel in Gyeongju, Korea were enrolled in this study between December 2009 and March 2010. The Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to assess anxiety and depression, respectively. Blood pressure was measured using a 24-h ambulatory BP monitoring system. Results: No significant differences in either BAI or BDI scores were found when hypertensive individuals were compared to normotensive individuals. The frequency of diastolic non-dipper was significantly higher in individuals with depressive symptoms compared to those without (p<0.05). Depression was significantly associated with diastolic non-dipper (OR: 6.85, 95% CI: 1.50-30.01). Conclusions: The results of this study indicate that depression should be considered when deciding upon blood pressure control regimens, and appropriate additive psychotherapy may be beneficial in the treatment of hypertensive patients.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.245-268
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• 1999

It is necessary that the old should have the physical and social ability to perform their daily life. This study is to grasp their degree of disability and problems and suggest their solutions. It surveyed the 87 old people over 65 years old from September 1st until September 30th, in 1997. The findings are as follows. 1) The activities of daily living(ADL) to find their degree of physical disability shows that their average performance ability is 75.9% of all the action while 24.1% of all the old people needs the others' help. As they get older and older, the aged drop off in their physical ability, which is related to a statistical sense (p<0.001). 2) The social disability shows that the aged have their great difference from 9.2% to 85.1% in their instrumental activities of daily living(IADL), intellectual ability and social role. 3) A simple analysis shows that the activities of daily living are, in a statistical sense, related to age(p<0.001), the use of elder's hall(p<0.001), the understanding degree of health(p<0.01) and so forth. 4) A simple analysis shows that the instrumental activities of daily living are, in a statistical sense, related to age(p<0.001), the degree of education(p<0.05), the life of leisure(p<0.001), the understanding degree of health and so forth. 5) A multivariate logistic regression analysis shows that the disability of daily living is related to age, the visit of elder's hall, the period of solitary living, instrumental activities of daily living is age and the visit of elder's hall, and social role is the visit of elder's hall and the decree of education, while intellectual activity has no related variables in a statistical sense.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.141-158
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• 1994

To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.353-377
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• 2000

This study was performed to investigate the performance state and improvement countermeasure of Primary Health care Posts(PHPs). The operation reports of PHPs(1996 330 PHPs, 1999 313 PHPs) located in Kyongsangbuk-Do and data collected by self-administered questionnaire survey of 280 community health practitioners(CHPs) were analyzed. The major results were as follows: Population per PHP in 1999 decreased in number compared with 1996. But population of the aged increased in number. The performance status of PHP in 1999 increased compared with 1996. A hundred forty one community health practitioners(50.4%) replied that the fiscal standing of PHP was good. Only 1.4% replied that the fiscal standing of PHP was difficult. For the degree of satisfaction in affairs, overall of community health practitioners felt proud. The degree of cooperation between PHP and public health institutions was high and the degree of cooperation of between PHP and private medical institutions was high. The degree of cooperation between PHP and Health Center was significantly different by age of CHP, the service period of CHP, and CHP's service period at present PHP. Over seventy percent of CHPs replied that they had cooperative relationship with operation council, village health workers, community organization. CHPs who drew up the paper on PHP's health activity plan were 96.4 % and only 11.4% of CHPs participated drawing up the report on the second community health plan. CHPs who grasped the blood pressure and smoking status of residents over 70% were 88.2%, 63.9% respectively and the grasp rate of blood pressure fur residents were significantly different according to age and educational level of CHP. CHPs received job education in addition continuous job education arid participated on research program in last 3 years were 27.5%, respectively. CHPs performed the return health program for residents in last 3years were 65.4%. Over 95% of CHPs replied that PHPs might be necessary and 53.9% of CHPs replied that the role of PHPs should be increased. CHPS indicated that major reasons of FHPs lockout were lack of understanding for PHP and administrative convenience, CHPs were officials in special government service governors intention of self-governing body. CHPs suggested number of population in health need such as the aged and patients with chronic disease, opinion of residents, population size, traffic situation and network in order as evaluation criteria for PHP and suggested results of health performance, degree of relationship with residents, results of medical examination anti treatment, ability for administration and affairs in order as evaluation criteria for CHP. CHPs replied that the important countermeasures for PHPs under standard were affairs improvement of PHPs and shifting of location to health weakness area in city. Over 50% of CHPs indicated that the most important thing for improvement of PHPs was affairs adjustment of CLIP. And CHPs suggested that health programs carried out in priority at PHP were management of diabetes mellitus and hypertention. home visiting health care, health care for the aged. The Affairs of BLIP should be adjusted to satisfy community health need and health programs such as management of diabetes mellitus and hypertention, home visiting health care, health care for the aged should be activated in order that PHPs become organization reflecting value system of primary health care.

• Journal of dental hygiene science
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• v.11 no.6
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• pp.513-520
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• 2011

The purpose of this study was to examine elderly people's oral health behaviors and education needs. The subjects in this study were 195 senior citizens who were users of senior cultural centers and senior welfare agencies in Seoul and Incheon. After a survey was conducted, the collected data were analyzed by the statistical package SPSSWIN 19.0. The findings of the study were as follows: 1. Gender, academic credential and monthly mean income were identified as the general characteristics to impact on their oral health attitude. 2. The senior citizens who ever received oral health education had a better knowledge(p<0.05) and took a better attitude(p<0.01). 3. As for a time for toothbrushing, many brushed their teeth after breakfast(74.9%) and dinner(71.8%). Utilized Oral hygiene devices were interdental brushes(21.5%), dental floss(13.8%). As many as 62.5% felt they had a dry mouth, and the most prevalent way for them to cope with it was drinking water often(68.2%). 79.5% didn't get their teeth cleaned on a regular scaling. 4. The rate of regular scaling was higher in the elderly groups that ever received oral health education and whose knowledge scores was above the average(p<0.05). 5. In relation to the necessity of oral health education, 87.2% felt the need for that, and as many as 79.0% intended to receive that education. Their favorite period of education was 6months(41.0%), and the greatest group hoped to receive that education for an hour(55.4%). The largest group wanted to learn about prevention of oral diseases, followed by toothbrushing, denture management, dry mouth. Given the findings of the study, senior welfare centers and senior cultural centers should offer oral health education programs as part of lifelong education to provide systematic and prolonged education for the elderly to improve their oral health care to promote their oral health.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.91-100
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• 2004

Objectives: This study was conducted to compare the present community health practitioners(CHPs)'s operating activities with their activity in 1989. Methods: Data were obtained two hundred seventy eight CHPs by self-administered questionnaire regarding duty traits, job satisfaction, and others. Results: The number of CHPs was 255 in 1989 and 224 in 2000. Age of CHPs in 2000 was much higher than that in 1989, and married women was 64.9% in 1989 and 95.9% in 2000. Both the primary duty of CHPs in 1989 and that in 2000 was medical service, and others(maternal health, infant health, family planning, and tuberculosis management, etc) are decreased in 2000, and community health service was added to duty of CHPs in 2000. 55% of CHPs in 1989 satisfied with their job, whereas about 80% of CHPs in 2000 satisfied with their job. The CHPs perceived that their primary necessary duty among requisite duty are medical practice(57.7%), health education(31.4%), and community health service(10.9%), in contrast, unnecessary duty are family planning(68.8%), tuberculosis management(11.1%), infant health(6.3%) maternal health(5.6%). Conclusions: These results suggest that there are such alteration of job satisfaction, needs and obstacles in duty traits of CHFs. These trend of duty traits are major issues to be caught for the health service in primary health post.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.131-143
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• 1999

This study was attempted to find the mutual relationship between leisure activities and life satisfaction by the aged persons in a rural area. The data was obtained by interview with questionnaire and the data from 209 persons aged over 65, residing in Dohwa-myeon and Podu-myeon, Koheung-kun, Chollanam-do were analysed. The survey was carried out from Feb. 16th to May 3rd in 1998 and the results are as follows: 1. The survey showed that the major leisure activities were TV watching followed by talking with friends, club activities, taking a walk, visiting friends' or relatives' home and breeding domestic animals. 2. The types of leisure activities were classified into 8 patterns as active self-enlightenment, passive self-enlightenment, temporal amusements, passive self-activities, cozy introspective activities, friend oriented activities, family oriented activities and religious activities. Among the above 8 patterns active self-enlightenment type contributed most to the life satisfaction. 3. The major factors affecting leisure activities were sex, age, average income, religion and educational status. And the major factors affecting life satisfaction were sex, age average income, educational status and a state of health. In conclusion the more the aged persons participated in leisure activities, the better they felt life satisfaction.