• Title/Summary/Keyword: 의료정책

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Impact of Awareness and Educational Experiences on Cardiopulmonary Resuscitation in the Ability to Execute of Cardiopulmonary Resuscitation among Korean Adults (한국 성인에서 심폐소생술에 대한 인지, 교육경험이 그 시행능력에 미치는 영향)

  • Lee, Jae-Kwang;Kim, Jeongwoo;Kim, Kunil;Kim, Keunhyung;Kim, Dongphil;Kim, Yuri;Moon, Seonggeun;Min, Byungju;Yu, Hwayoung;Lee, Chealim;Jeong, Wonyoung;Han, Changhun;Huh, Inho;Park, Jung Hee;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.43 no.4
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    • pp.234-249
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    • 2018
  • This study was performed to identify the impact of awareness and educational experiences on cardiopulmonary resuscitation in the ability to execute of cardiopulmonary resuscitation among Korean adults. This study used original data of 2014 Community Health Data Survey. 228,712 participants in this survey were resident in South Korea who is aged 19 or older on July 2014. Participants in this survey were sampled an average of 900 residents(target error ${\pm}3percent$) per community health center of Korea. Data were analyzed by using R 3.1.3 employing chi-squared test, fisher's exact analysis, and logistic regression analysis. Ability to execute CPR was significantly higher in males(3.34 time), higher the education level (1.61 times), the white color occupation (1.14 times), the higher the income level (1.07 times), the higher the education level (0.91 times), non-hypertensive patients (1.12 times), non-diabetic patients (1.16 times), non-dyslipidemic patients (0.86 times), non-stroke patients (0.30 times), CPR education experience group (3.25 times), CPR experience group with manikin-based training (4.30 times), higher subjective health status (1.08 times, 1.16 times) respectively. This study identified that awareness, educational experience, and mannequin-based learning experience of CPR impacted on the ability to execute CPR. Responding to education-related factors could contribute to reducing the rate of out-of-hospital acute cardiac arrest by improving the ability to execute CPR of the general public.

The Determinants of Consumption Characteristics and Patterns of Elderly Households (고령자 가구의 소비특성 및 소비패턴 결정요인)

  • Kim, Jinhun
    • 한국노년학
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    • v.36 no.3
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    • pp.905-926
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    • 2016
  • Although the concept of the elderly varies depending on scholars and laws, as consumption expenditure is deeply associated with income due to the nature of this study, 55 years old was set as the low limit standard for the elderly according to Prohibition of Discrimination on Age in Employment and Employment Promotion for the Aged Act and the elderly households were limited to single-elderly person household and an elderly couple family household for this study. It is considered consumption characteristics as a significant analysis subject in terms of social welfare because it could be understood as an expressed need which was a reflection of desire. Therefore, the present study aimed to investigate the consumption characteristics of the elderly households by stereotyping the consumption pattern of the elderly households, and find the determining factors for consumption patterns and thus contribute to the establishment of related policies through the expressed needs of the elderly households. K-means of cluster analysis was performed by putting the consumption expenditure of the elderly households to investigate inherent structural type of consumption pattern of the elderly households, which were the investigation subjects. As a result, four groups were stereotyped and named as below: 'health care-centered type', 'saving-centered type', 'livelihood-centered type', and 'food expenses-centered type' Binary Logistic Regression analysis was used to identify the factors that influence the decision of consumption pattern of the elderly households. The result of study showed that the elderly households faced all different needs and problems and thus there is a need for various approach plans to solve this situation. In particular, although the elderly have been viewed as economically poor people so far, the study showed that there were also kind of prepared households through saving. Overall, livelihoodcentered type accounted for the highest portion and, as a factor that influenced this, marital state and household income played an important role. Therefore, it is considered that more active efforts to increase the income of the elderly households are needed. In addition, age, owning of house and subjective health state were found to also have significant influence. Through these results of the study, the elderly's own improvement of awareness on health, presentation of overall standard for health state of the elderly, securement of the elderly's access to cultural life, and financial management coordination for improvement of quality of life, development and dissemination of jobs suitable for the elderly, and dissemination of communal life household, which is a cooperation residential type, were presented as institutional task in the conclusion.

Factors Influencing Sexuality Knowledge and Gender Sensitivity During Adolescents and Early Adulthoods (청소년기 및 초기 성인기의 성지식과 성인지 감수성에 영향을 미치는 요인)

  • Hae Su Na;Sun Goo Lee;Kang Min Baek;Woo Young Im;Seung-Gul Kang;Seong-Jin Cho;Kyoung-Sae Na;Jae Myeong Kang;Seo-Eun Cho;Seung Min Bae
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.25-32
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    • 2023
  • Objectives : This study investigated the level of sexuality knowledge and gender sensitivity and factors influencing on them among Korean high school and college students. Methods : 129 questionnaires from high school and college students with consent forms, collected from July to December of 2022, were analyzed. After identification of participants' gender, age, major, their report of the practicality of sex education, and their experience of violence or sexual assaults, participants' level of sexuality knowledge and gender sensitivity were compared. Results : Females showed higher gender sensitivity, regardless of age and group (p=0.004). The early adulthood group (≥19 years old) showed higher sexuality knowledge and gender sensitivity, compared to those adolescents (<19 years old). Among college students, those who majored in health science were identified with higher sexuality knowledge and gender sensitivity, compared to non-health science major students(p<0.001; p=0.005). Conclusions : This study revealed the significant differences in sexuality knowledge and gender sensitivity according to sex, age, and majors in adolescents and early adults. Therefore, it seems to be necessary to consider the differences in sexuality knowledge and gender sensitivity among age, sex, and majors when establishing public policy or legislation for sex crimes, including digital sex crimes.

A Study on the Quality of Life of Elderly People with Dementia and the Environmental Factor of Facilities (치매노인의 삶의 질과 시설 환경 요인에 관한 연구)

  • Park, Sejeong;Kim, Hangon
    • 한국노년학
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    • v.29 no.4
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    • pp.1361-1381
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    • 2009
  • There have lately been a variety of social issues in our society due to rapid social changes. Specifically, how to approach elderly people who suffer from dementia is never an easy task, and few in-depth studies have ever focused on their quality of life due to that. The purpose of this study was to examine the quality of life of elderly people with dementia and the relationship between their quality of life and the environments of facilities for them in an attempt to lay the foundation for the development of compatible programs tailored to the environments of the facilities and for relevant policy setting. It's ultimately meant to improve the quality of life of the elderly with dementia and the environments of facilities for them. The subjects in this study were elderly people with dementia who were housed in senior residential and medical welfare facilities in Daegu and Gyeongsangbukdo. The collected data were analyzed with a SPSS 12.0 program, and frequency analysis, cross-tabs and multiple logistic regression analysis were utilized. As a result, facility environments were identified as one of the variables that had a significant impact on the quality of life of the elderly people with dementia. There are some suggestions about how to boost their quality of life: First, good environments should be prepared in consideration of the characteristics of elderly people with dementia in order for themto be satisfied with their own quality of life, and the way of looking at their potentials should be changed. Second, it's found that main caregivers affected the quality of life of the elderly people with dementia, and the kind of programs that focus on the improvement of the relationship between elderly people with dementia and their main caregivers is required. Third, there should be a change in the environments of the facilities. The facilities should be well equipped to successfully respond to the symptoms of elderly people with dementia. To redress their poor accessibility to the facilities, infrastructure involving nursing homes and professional personnels should be built by utilizing the Internet, and the facilities and local community should make concerted efforts to provide quality care to elderly people in want of it.

How Did the COVID-19 Pandemic Affect Mobility, Land Use, and Destination Selection? Lesson from Seoul, Korea

  • Lee, Jiwon;Gim, Tae-Hyoung Tommy;Park, Yunmi;Chung, Hyung-Chul;Handayani, Wiwandari;Lee, Hee-Chung;Yoon, Dong Keun;Pai, Jen Te
    • Land and Housing Review
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    • v.14 no.4
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    • pp.77-93
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    • 2023
  • The COVID-19 pandemic has brought about significant social changes through government prevention and control measures, changes in people's risk perceptions, and lifestyle changes. In response, urban inhabitants changed their behaviors significantly, including their preferences for transportation modes and urban spaces in response to government quarantine policies and concerns over the potential risk of infection in urban spaces. These changes may have long-lasting effects on urban spaces beyond the COVID-19 pandemic or they may evolve and develop new forms. Therefore, this study aims to explore the potential for urban spaces to adapt to the present and future pandemics by examining changes in urban residents' preferences in travel modes and urban space use due to the COVID-19 pandemic. This study found that overall preferences for travel modes and urban spaces significantly differ between the pre-pandemic, pandemic, and post-pandemic periods. During the pandemic, preferences for travel modes and urban spaces has decreased, except for privately owned vehicles and green spaces, which are perceived to be safe from transmission, show more favorable than others. Post-pandemic preferences for travel modes and urban spaces are less favorable than pre-pandemic with urban spaces being five times less favorable than transportation. Although green spaces and medical facilities that were positively perceived during the pandemic are expected to return to the pre-pandemic preference level, other factors of urban spaces are facing a new-normal. The findings suggest that the COVID-19 pandemic has had a significant impact on urban residents' preferences for travel modes and urban space use. Understanding these changes is crucial for developing strategies to adapt to present and future pandemics and improve urban resilience.

Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

The Advancement of Underwriting Skill by Selective Risk Acceptance (보험Risk 세분화를 통한 언더라이팅 기법 선진화 방안)

  • Lee, Chan-Hee
    • The Journal of the Korean life insurance medical association
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    • v.24
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    • pp.49-78
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    • 2005
  • Ⅰ. 연구(硏究) 배경(背景) 및 목적(目的) o 우리나라 보험시장의 세대가입율은 86%로 보험시장 성숙기에 진입하였으며 기존의 전통적인 전업채널에서 방카슈랑스의 도입, 온라인전문보험사의 출현, TM 영업의 성장세 等멀티채널로 진행되고 있음 o LTC(장기간병), CI(치명적질환), 실손의료보험 등(等)선 진형 건강상품의 잇따른 출시로 보험리스크 관리측면에서 언더라이팅의 대비가 절실한 시점임 o 상품과 마케팅 等언더라이팅 측면에서 매우 밀접한 영역의 변화에 발맞추어 언더라이팅의 인수기법의 선진화가 시급히 요구되는 상황하에서 위험을 적절히 분류하고 평가하는 선진적 언더라이팅 기법 구축이 필수 적임 o 궁극적으로 고객의 다양한 보장니드 충족과 상품, 마케팅, 언더라이팅의 경쟁력 강화를 통한 보험사의 종합이익 극대화에 기여할 수 있는 방안을 모색하고자 함 Ⅱ. 선진보험시장(先進保險市場)Risk 세분화사례(細分化事例) 1. 환경적위험(環境的危險)에 따른 보험료(保險料) 차등(差等) (1) 위험직업 보험료 할증 o 미국, 유럽등(等) 대부분의 선진시장에서는 가입당시 피보험자의 직업위험도에 따라 보험료를 차등 적용중(中)임 o 가입하는 보장급부에 따라 직업 분류방법 및 할증방식도 상이하며 일반사망과 재해사망,납입면제, DI에 대해서 별도의 방법을 사용함 o 할증적용은 표준위험율의 일정배수를 적용하여 할증 보험료를 산출하거나, 가입금액당 일정한 추가보험료를 적용하고 있음 - 광부의 경우 재해사망 가입시 표준위험율의 300% 적용하며, 일반사망 가입시 $1,000당 $2.95 할증보험료 부가 (2) 위험취미 보험료 할증 o 취미와 관련 사고의 지속적 다발로 취미활동도 위험요소로 인식되어 보험료를 차등 적용중(中)임 o 할증보험료는 보험가입금액당 일정비율로 부가(가입 금액과 무관)하며, 신종레포츠 등(等)일부 위험취미는 통계의 부족으로 언더라이터가 할증율 결정하여 적용함 - 패러글라이딩 년(年)$26{\sim}50$회(回) 취미생활의 경우 가입금액 $1,000당 재해사망 $2, DI보험 8$ 할증보험료 부가 o 보험료 할증과는 별도로 위험취미에 대한 부담보를 적용함. 위험취미 활동으로 인한 보험사고 발생시 사망을 포함한 모든 급부에 대한 보장을 부(不)담보로 인수함. (3) 위험지역 거주/ 여행 보험료 할증 o 피보험자가 거주하고 있는 특정국가의 임시 혹은 영구적 거주시 기후위험, 거주지역의 위생과 의료수준, 여행위험, 전쟁과 폭동위험 등(等)을 고려하여 평가 o 일반사망, 재해사망 등(等)보장급부별로 할증보험료 부가 또는 거절 o 할증보험료는 보험全기간에 대해 동일하게 적용 - 러시아의 경우 가입금액 $1,000당 일반사망은 2$의 할증보험료 부가, 재해사망은 거절 (4) 기타 위험도에 대한 보험료 차등 o 비행관련 위험은 세가지로 분류(항공운송기, 개인비행, 군사비행), 청약서, 추가질문서, 진단서, 비행이력 정보를 바탕으로 할증보험료를 부가함 - 농약살포비행기조종사의 경우 가입금액 $1,000당 일반사망 6$의 할증보험료 부가, 재해사망은 거절 o 미국, 일본등(等)서는 교통사고나 교통위반 관련 기록을 활용하여 무(無)사고운전자에 대해 보험료 할인(우량체 위험요소로 활용) 2. 신체적위험도(身體的危險度)에 따른 보험료차등(保險料差等) (1) 표준미달체 보험료 할증 1) 총위험지수 500(초과위험지수 400)까지 인수 o 300이하는 25점단위, 300점 초과는 50점 단위로 13단계로 구분하여 할증보험료를 적용중(中)임 2) 삭감법과 할증법을 동시 적용 o 보험금 삭감부분만큼 할증보험료가 감소하는 효과가 있어 청약자에게 선택의 기회를 제공할수 있으며 고(高)위험 피보험자에게 유용함 3) 특정암에 대한 기왕력자에 대해 단기(Temporary)할증 적용 o 질병성향에 따라 가입후 $1{\sim}5$년간 할증보험료를 부가하고 보험료 할증 기간이 경과한 후에는 표준체보험료를 부가함 4) 할증보험료 반환옵션(Return of the extra premium)의 적용 o 보험계약이 유지중(中)이며, 일정기간 생존시 할증보험료가 반환됨 (2) 표준미달체 급부증액(Enhanced annuity) o 영국에서는 표준미달체를 대상으로 연금급부를 증가시킨 증액형 연금(Enhanced annuity) 상품을 개발 판매중(中)임 o 흡연, 직업, 병력 등(等)다양한 신체적, 환경적 위험도에 따라 표준체에 비해 증액연금을 차등 지급함 (3) 우량 피보험체 가격 세분화 o 미국시장에서는 $8{\sim}14$개 의적, 비(非)의적 위험요소에 대한 평가기준에 따라 표준체를 최대 8개 Class로 분류하여 할인보험료를 차등 적용 - 기왕력, 혈압, 가족력, 흡연, BMI, 콜레스테롤, 운전, 위험취미, 거주지, 비행력, 음주/마약 등(等) o 할인율은 회사, Class, 가입기준에 따라 상이(최대75%)하며, 가입연령은 최저 $16{\sim}20$세, 최대 $65{\sim}75$세, 최저보험금액은 10만달러(HIV검사가 필요한 최저 금액) o 일본시장에서는 $3{\sim}4$개 위험요소에 따라 $3{\sim}4$개 Class로 분류 우량체 할인중(中)임 o 유럽시장에서는 영국 등(等)일부시장에서만 비(非)흡연할인 또는 우량체할인 적용 Ⅲ. 국내보험시장(國內保險市場) 현황(現況)및 문제점(問題點) 1. 환경적위험도(環境的危險度)에 따른 가입한도제한(加入限度制限) (1) 위험직업 보험가입 제한 o 업계공동의 직업별 표준위험등급에 따라 각 보험사 자체적으로 위험등급별 가입한도를 설정 운영중(中)임. 비(非)위험직과의 형평성, 고(高)위험직업 보장 한계, 수익구조 불안정화 등(等)문제점을 내포하고 있음 - 광부의 경우 위험1급 적용으로 사망 최대 1억(億), 입원 1일(日) 2만원까지 제한 o 금융감독원이 2002년(年)7월(月)위험등급별 위험지수를 참조 위험율로 인가하였으나, 비위험직은 70%, 위험직은 200% 수준으로 산정되어 현실적 적용이 어려움 (2) 위험취미 보험가입 제한 o 해당취미의 직업종사자에 준(準)하여 직업위험등급을 적용하여 가입 한도를 제한하고 있음. 추가질문서를 활용하여 자격증 유무, 동호회 가입등(等)에 대한 세부정보를 입수하지 않음 - 패러글라이딩의 경우 위험2급을 적용, 사망보장 최대 2 억(億)까지 제한 (3) 거주지역/ 해외여행 보험가입 제한 o 각(各)보험사별로 지역적 특성상 사고재해 다발 지역에 대해 보험가입을 제한하고 있음 - 강원, 충청 일부지역 상해보험 가입불가 - 전북, 태백 일부지역 입원급여금 1일(日)2만원이내 o 해외여행을 포함한 해외체류에 대해서는 일정한 가입 요건을 정하여 운영중(中)이며, 가입한도 설정 보험가입을 제한하거나 재해집중보장 상품에 대해 거절함 - 러시아의 경우 단기체류는 위험1급 및 상해보험 가입 불가, 장기 체류는 거절처리함 2. 신체적위험도(身體的危險度)에 따른 인수차별화(引受差別化) (1) 표준미달체 인수방법 o 체증성, 항상성 위험에 대한 초과위험지수를 보험금삭감법으로 전환 사망보험에 적용(최대 5년(年))하여 5년(年)이후 보험 Risk노출 심각 o 보험료 할증은 일부 회사에서 주(主)보험 중심으로 사용중(中)이며, 총위험지수 300(8단계)까지 인수 - 주(主)보험 할증시 특약은 가입 불가하며, 암 기왕력자는 대부분 거절 o 신체부위 39가지, 질병 5가지에 대해 부담보 적용(입원, 수술 등(等)생존급부에 부담보) (2) 비(非)흡연/ 우량체 보험료 할인 o 1999년(年)최초 도입 이래 $3{\sim}4$개의 위험요소로 1개 Class 운영중(中)임 S생보사의 경우 비(非)흡연우량체, 비(非)흡연표준체의 2개 Class 운영 o 보험료 할인율은 회사, 상품에 따라 상이하며 최대 22%(영업보험료기준)임. 흡연여부는 뇨스틱을 활용 코티닌테스트를 실시함 o 우량체 판매는 신계약의 $2{\sim}15%$수준(회사의 정책에 따라 상이) Ⅳ. 언더라이팅 기법(技法) 선진화(先進化) 방안(方案) 1. 직업위험도별 보험료 차등 적용 o 생 손보 직업위험등급 일원화와 연계하여 3개등급으로 위험지수개편, 비위험직 기준으로 보험요율 차별적용 2. 위험취미에 대한 부담보 적용 o 해당취미를 원인으로 보험사고(사망포함) 발생시 부담보 제도 도입 3. 표준미달체 인수기법 선진화를 통한 인수범위 대폭 확대 o 보험료 할증법 적용 확대를 통한 Risk 헷지로 총위험지수 $300{\rightarrow}500$으로 확대(거절건 최소화) 4. 보험료 할증법 보험금 삭감 병행 적용 o 삭감기간을 적용한 보험료 할증방식 개발, 고객에게 선택권 제공 5. 기한부 보험료할증 부가 o 위암, 갑상선암 등(等)특정암의 성향에 따라 위험도가 높은 가입초기에 평준할증보험료를 적용하여 인수 6. 보험료 할증법 부가특약 확대 적용, 부담보 병행 사용 o 정기특약 등(等)사망관련 특약에 할증법 확대, 생존급부 특약은 부담보 7. 표준체 고객 세분화 확대 o 콜레스테롤, HDL 등(等)위험평가요소 확대를 통한 Class 세분화 Ⅴ. 기대효과(期待效果) 1. 고(高)위험직종사자, 위험취미자, 표준미달체에 대한 보험가입 문호개방 2. 보험계약자간 형평성 제고 및 다양한 고객의 보장니드에 부응 3. 상품판매 확대 및 Risk헷지를 통한 수입보험료 증대 및 사차익 개선 4. 본격적인 가격경쟁에 대비한 보험사 체질 개선 5. 회사 이미지 제고 및 진단 거부감 해소, 포트폴리오 약화 방지 Ⅵ. 결론(結論) o 종래의 소극적이고 일률적인 인수기법에서 탈피하여 피보험자를 다양한 측면에서 위험평가하여 적정 보험료 부가와 합리적 가입조건을 제시하는 적절한 위험평가 수단을 도입하고, o 언더라이팅 인수기법의 선진화와 함께 언더라이팅 인력의 전문화, 정보입수 및 시스템 인프라의 구축 등이 병행함으로써, o 보험사의 사차손익 관리측면에서 뿐만 아니라 보험시장 개방 및 급변하는 보험환경에 대비한 한국 생보언더라이팅 경쟁력 강화 및 언더라이터의 글로벌화에도 크게 기여할 것임.

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The Characteristics and Fates of Pulmonary Tuberculosis Patients Seen at Medical Department of A Medium Sized General Hospital (부산에 한 중형 종합 병원 내과에서의 폐결핵 환자의 양상과 귀결)

  • Kim, Young-Hyo;Park, Ki-Chan;Bae, Seong;Lee, Sang-Hun;Chun, Myung-Ho;Lee, Sang-Ki;Jun, Kwang-Su;Lee, Chan-Se
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.417-424
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    • 1992
  • Background: There were many reports about the clinical aspect and outcomes of pulmonary tuberculosis in health center but few in a medium sized general hospital. The purposes of this study were to find any characteristic differencies in the patients and the general outcomes of the treatments and also to give some suggestive points for the insurance policy making. Methods: We made a retrograde analysis of the medical records of 1981 patients (male 992 female 1,059) who attended our clinics of the 4th internal department, Daedong general hospital during two years from January 1989 to December 1990. Result: 1) Of 1981 patients, 96 were diagnosed as pulmonary tuberculosis taking relatively large proportion in the prevalence. The ratio of prevalence between male and female was 7.81% to 2.27%. The 61.46% were the first diagnosis & initial treatment cases and the remaining 38.54% were the retreatment cases with no statistical significance between sex. 2) The most prevalent age group was between 21~40 years old and the prevalence rate was 45.45% of male and 76.76% of female. The lowest age group in male patient was above 61 showed 3.03%, and there was no female patients above age 60 years old. This phenomena could be thought as the negligence for the treatment of pulmonary tuberculosis in the old age groups rather than true tuberculosis prevalence and it could be proved by the higher rates towards old age groups in the national tuberculosis prevalence survey. 3) There were 57.07% of the minimal case, 48.96% of the moderate, 18.75% of the far advanced. The sputum examination showed 37.07% were culture positive, 46.88% were the negative, and 15.63% of the patients had no stutum examination. Moreover, uncoperatives among the far advanced cases were notable showing 22.22% of the stutum examination, where 16.13% in the minimal cases. The stutum positive rate among the initial treatment cases were 41.07% and 55.00% for the retreatment cases. The sputum no examination rates were 17.86% and 12.50% respectively. 4) The classfication of the mode of disease onset showed 68.75% with gradual onset, 9.38% hemoptic, 3.13% acute pneumonic and 18.75% was found through the radiologic examination in various occasions. 5) The percentages of patients who continued their treatment for more than 8 month were 35.71% (for initial treatment), 25.00% (for retrement), 16.13% (for the minimal), 27.78% (for the far advanced). 6) The group of patients who were treated more than 8 months showed the negative conversion rate of 80% on sputum and marked improvement on chest x-ray in 56.67%. However, in far advanced or retreatment cases, the rate of negative conversion on sputum and the rate of improvement on chest x-ray were low being 60% and 20% for the former and 60% and 10% for the latter, each respectively. Conclusion: It would be strongly emphasized that the improvement of National medical insurance system and social welfare system in Korea must be definite to improve overall treatment and control of tuberculosis diseases as well as physician's devotious National tuberculosis control policy.

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The Knowledge, Attitude, and Utilization Experience of Community Health Practitioners on Complementary Therapies (보완요법에 대한 보건진료원의 지식, 태도와 활용 경험)

  • Hwang, Sung-Ho;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.87-105
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    • 2002
  • In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.

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