• Tuberculosis and Respiratory Diseases
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• 제70권4호
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• pp.307-314
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• 지역사회간호학회지
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• 제15권3호
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• pp.365-375
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• 2004

Purpose: This study intends to make a database for hypertensive patients and middle-aged women who are visiting the Yeojoo County Health Center. While building up the database, the study reviewed the current assessment tools used in the health center, developed appropriate health care programs, and designed a computerized health care system. Method: The modeling of a database for the system was constructed by MS-Access for DBMS (Database Management System) and Visual Basic. The system is to be used only in the health center by being designed as a client server method, making it possible for many public employees to be interconnected, and enables them to retrieve and search data from the database simultaneously. Results: The health management system systematically follows nursing processes including assessment, diagnosis, intervention and evaluation. Diagnosis. once it is done according to the self determined criteria, saves time and provides appropriate health information for the members. Also, the health education program was developed to follow up on the health status of the members on a continuous basis. Conclusion: Based on these results, it is required to evaluate health care programs provided for the members by using the database system and to develop more practical health care programs. It is also necessary to connect the system to other databases. which contain information about members.

• 보건행정학회지
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• 제16권3호
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• pp.19-36
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• 2006

The purpose of this study was to assess adequately equipped with convenience facilities for the disabled in 160 healthcare institutions in Jongno district, Seoul. Healthcare institutions were equipped an average of 3.7 facilities out of 10. General hospitals had an average of 5.0 facilities, which was higher than an average of 3.6 facilities for private clinics (p<0.05). Of 160 healthcare institutions, only 13 (8.1%) offered easy access to the outpatient setting from the entrance for wheelchair users, highlighting difficult wheelchair access within hospitals. To provide easy access to medical service for the disabled, more accessible designs need to be adopted as part of the effort to improve public facilities for the disabled. Also, universal designs could be applied for newly constructed roads, structures and transportation vehicles to maximize accessibility for the disabled. Increased accessibility for the disabled in the community will eventually increase the use of healthcare institutions.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권4호
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• pp.29-38
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• 2020

Purpose: The first thing to be done in promoting community care is local diagnosis. Therefore, this study attempted to derive the physical infrastructure to be diagnosed, and to develop diagnostic items and diagnostic indicators applicable to this. Methods:: First, the physical infrastructure related to the community care is derived. And the diagnosis items are derived using the checklist of 'community support and health services' in the WHO Guide for Global age-friendly cities. Next, by analyzing previous studies, we develop diagnostic indicators for each diagnostic item and explore their applicability. Results: As a result of deriving the physical infrastructure for each area of housing, health service, and nursing care for community care, 22 facilities were derived for 9 types. Diagnosis items for the facilities are 1)regional equity, 2)proximity between facilities, 3)transportation access, 4)regional use, 5)barrier-free design, 6)diversity of facilities, and a total of 14 diagnostic indicators was derived. We reviewed and suggested the applicability of diagnostic items and indicators by each physical infrastructure. Implications: For the realization of community care, local diagnosis should not be limited to sim- ply grasping the presence or absence of facilities and the total amount. Instead it should strengthen capabilities by conducting diagnosis to understand the performance of facilities.

• Industrial Engineering and Management Systems
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• 제7권2호
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• pp.133-142
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• 2008

The Emergency Department (ED) is an integral part of hospitals. Admissions from the ED account for a significant proportion for a hospital's activity. Ensuring a timely and efficient flow of patients through the ED is crucial for optimising patient care. In recent years, ED overcrowding and its impact on patient flow has become a major issue facing the health sector. Simulation is rapidly becoming a tool of choice when examining hospital systems due to its capacity to involve numerous factors and interactions that impact the system. An analytical simulation model is used to investigate potential impacts by changing the following aspects of ED (physical layouts; number of beds; number and rate of patient arrivals; acuity of illness or injury of patients; access to radiology and pathology services; hospital staffing arrangements; and access to inpatient beds). Results of a significant numerical investigation at a hospital are also presented.

• 지역사회간호학회지
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• 제28권2호
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• pp.129-143
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• 2017

Purpose: The purpose of this study is to explore factors which influence adoption, implementation and continued use of tele-healthcare systems. Methods: Qualitative research was conducted by in-depth interviews with 17 professionals from various fields of organizations involved in developing and implementing tele-healthcare systems. Data were analysed thematically, using a conceptual model of diffusion of innovations. Results: The system users were reacted positively to the 3 attributes out of 9 which decided the adoption of innovation. In addition, it is required to redesign the tele-health care system simpler and easier so that the system users can access to the system much more easily regardless of space and time limitations. From the design stage on an individual level, it is necessary to conduct detailed needs analysis and listen to users who are at the center of innovation diffusion. On an organizational level, it is necessary to actively prepare for possible problems during system implementation, educate the users and build communication channels continuously. Conclusion: This study has identified the factors affecting the innovation of tele-health care systems and contributed to the understanding of the operation of tele-health care systems by the diffusion of innovation theory in community health posts.

• 보건행정학회지
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• 제30권3호
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• pp.277-285
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• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제12권4호
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• pp.1832-1853
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• 2018

The personal health record (PHR) system is a promising application that provides precise information and customized services for health care. To flexibly protect sensitive data, attribute-based encryption has been widely applied for PHR access control. However, escrow, exposure and abuse of private keys still hinder its practical application in the PHR system. In this paper, we propose a coordinated ciphertext policy attribute-based access control with user accountability (CCP-ABAC-UA) for the PHR system. Its coordinated mechanism not only effectively prevents the escrow and exposure of private keys but also accurately detects whether key abuse is taking place and identifies the traitor. We claim that CCP-ABAC-UA is a user-side lightweight scheme. Especially for PHR receivers, no bilinear pairing computation is needed to access health records, so the practical mobile PHR system can be realized. By introducing a novel provably secure construction, we prove that it is secure against selectively chosen plaintext attacks. The analysis indicates that CCP-ABAC-UA achieves better performance in terms of security and user-side computational efficiency for a PHR system.

• 한국병원경영학회지
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• 제9권4호
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• pp.45-69
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• 2004

The purpose of this study is to identify the nature of the inpatient service quality of national university hospital, and based on that, to examine the relationship of hospital inpatient's perceived quality, overall satisfaction, customer loyalty(intention of revisiting, intention of oral transmitting). To carry out these objectives, first we analyzed the dimensions of inpatient care service quality using SERVQUAL scale. The SERVQUAL scale is based on the gap theory, that is, the difference of patients' expectations and the actually received medical care service in hospital. On the basis of this theory, we measured the inpatient's perceived service quality, overall patient satisfaction and customer loyalty. Data were collected by self-administered questionnaires at a 809 bed national university hospital. These questionnaires measuring the service quality were distributed to 400 inpatients. The data samples are 347 cases in final. The response rate was 86.8%. Firstly, to categorize inpatient service quality in hospital, the factor analysis was performed on 48 items. The reliability and validity of these items was evaluated. Finally to explore the relationship of service quality, overall satisfaction, and customer loyalty, the multiple regression and logistic regression analysis are used. This study shows firstly, the dimension of inpatient service quality was categorized into 7 dimensions, that is, kindness, medical service, nurse caring, environment, facilities, appropriateness and access. Secondly, the reliability and validity of inpatient service quality items was satisfied. Thirdly, as a result of multiple regression analysis, the effect of inpatient's perceived service quality, especially, nurse caring(P<0.01), environment (P<0.01), facilities, appropriateness and access variables(P<0.05), on overall satisfaction was statistically significant. Lastly, in case of the effect on customer loyalty as a intension of oral transmitting, medical service(P<0.05), environment(P<0.01) and overall satisfaction(P<0.01) are statistically significant. Also, in case of intension of revisiting, medical service, environment, access, and overall satisfaction variables are significant factors. In conclusion, to maintain the satisfaction and customer loyalty on national university hospitals, the efforts to improve the inpatient service quality, especially, environment, medical service, and access factors might be needed.

• 한국식품영양학회지
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• 제21권4호
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• pp.583-591
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• 2008

The principal objective of this study was to assess the demands of the development program of silver health care professionals for elderly individuals residing in the Northern Gyeonggi-do area. To this end, a survey was conducted to investigate college students and employees related with elderly individuals in the area regarding their recognition, interest, and involvement in the labor training program. In the case of college students, the health education they had received was only 1 to 2 hours, from a school lecture(35%). The content of health education they desired was exercise(34%) and stress management skills(28%). The sources of health information they received included mass media(77%) and the internet(12%), and they trusted the information they received from health professionals(45%), and the mass media(34%). In the case of health professionals who were working at silver care facilities, the sources of health information to which they had access were mass media(51%), internet(14%), reliable health professionals(56%), mass media(22%), and books related to health (18%). The principal issues they reported as being relevant to the elderly were dementia(39%), hypertension(14%), arthritis (11%), and they reported that the most important personnel for elderly in the future would be care managers(44%), and care helpers(21%). 88% of subjects believed that there was a need for a silver welfare integrated information system. 43% of subjects used the internet, 77% of them required in-service training programs for the welfare of the elderly. Via this developmental program of silver health care professionals, a variety of new job opportunities can be provided in the future, and a program related to the silver service industry must be established as soon as possible.