• Journal of Korean Academy of Nursing
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• v.20 no.2
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.206-225
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• 2012

General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

• Journal of the Korean Home Economics Association
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• v.32 no.1
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• pp.199-210
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• 1994

My purpose in the paper is to research on what is the most productive education method for the Students for Future Dietitian(SFD) to be applied during there field training & practice. Furthermore it is an attempt to elucidate what is the most necessary education program for the field training & practice for SFDs. Five questionnaires were given to SFDs dealing with nutrition purchase hygienic facilities and official management in order to check and evaluate the current situation and problems on the education of field training & practice for SFDs Also I chose 140 SFD's who had been working in the field for at least one week or one month in 1992 and statistical processing were utilized and analyzed by SAS package. One of the most notable problems SDFs faced with during meal planning it is the fact that they had been educated and requested for the cut of food expenditure rather than the supply of scientifically balanced-nutrition meals for working people, SFDs also faced with of information on the quantity and facilities management from the dietitian in the company. my research revealed that dietitian's teaching method for SFDs still remains in a very primitive way and accordingly the efficient way to solve these problems shall be established by a computerized education program through which dietitians can provide well-balanced meals for working people when they are assigned to the company. In this regard we must consider that we have to enact certain law to be applied to a dietitian. In another words we should emphasize actual experiences of SFDs' knowledge accumulated through the field training & practice before they work at the company. Consequently it is a time to reconsider the importance of well-balance dietitian program offering an opportunity for SFD which can contribute to improvement of health's condition for the working people.

• Journal of Nutrition and Health
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• v.14 no.2
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• pp.87-96
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• 1981

This report was the result of Food and Nutrition Intake Survey of 210 adults of 43 rural households in 7 villages located on Kyung Nam, Korea. It was intended to provide baseline information on the nutrintional status and inequality, the change of food consumption pattern of different rural socioeconomic classes. The survey results were as follows; 1. All the nutrient intakes(except Ca) were above RDA in landlord classes, but those were extremely poor in tenancy and rural laborer classes. Ca was the most deficient nutrient in all classes. 'Vitamin A' was deficient in most of the classes. 2. In per capita food consumption expenditure, the highest was in landlord class, next capitalist farmer and middle class farmer, the lowest were rural laborer and tenancy. There were highest consumption of vegetables and fish in landlord class, and milks and oils in capitalist farmer. The consumption of rice fruits, meats, eggs, and seasoning were relatively proportionated to the income. 3. In the change of food consumption, the most increased items were beverages and meats in capitalist farmer, fish and fruits in landlord, rice in the other classes. 4. In the correlation with food consumption, education level showed the highest correlation with meats, oils, and in contrast, land sire showed the highest correlation with cereals. Engel's coefficient was positively correlated to cereals, but negatively correlated to fish and meats.

• Journal of Environmental Impact Assessment
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• v.27 no.3
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• pp.322-333
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• 2018

This study was carried out to measure atmospheric environmental improvement effect and estimate its social benefit of thermal power plants through Environmental Impact Assessment (EIA) for quantitative analysis about operational performances of EIA. In this study, 'EIA outcome' is defined as whether or not the system is implemented, therefore, environmental standard to be followed by each project and consultation contents were compared. In total 60 cases of thermal power plant construction projects that have been consulted over the past 10 years since 2010, major air pollutants have been significantly reduced after the implementation of EIA. The $PM_{10}$ reduced annual 3,745 tons, $NO_2$ by 74,569 tons, and $SO_2$ by 37,647 tons, which were estimated at approximately 240 billion won~5 trillion 967 billion won per year for social benefit. This means the total cost of power plant operations will be cut to 7 trillion 192 billion won~178 trillion 994 billion won over a 30-year period. The reduced amount of air pollutants emitted by energy generation facilities across the country is worth 50%, and its economic value is larger than the annual Current Health Expenditure in Korea. This is meant by the fact that all projects are subject to uniform criteria under the existing relevant regulation, but that each project plans are optimized according to the characteristics of target areas and projects through the process of EIA.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.365-374
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• 2015

The goal of this study was 1) to compare the physical activity between the normal(NO) and obese (OB) group at baseline and 2) to investigate responses of the physical activity to a 24-week walking exercise program in both groups. A total of 29 middle-aged women was classified NO and OB group based on the BMI($25kg/m^2$). Walking exercise was designed to energy expenditure of 500 kcal per day, with a frequence of 3 days per week for 24 weeks. Body composition(Weight, BMI, BF(%), Hip, WHR) were measured at the baseline and after the walking exercise program(24 week). Physical activity were measured during 24 week for wellness convergence in the digital age. In conclusion, the current findings of this study indicate that 1) physical activity is not difference in both groups at baseline 2) 24-week walking exercise program is an effective means of improving physical activity in both NO and OB groups.

• Journal of Society of Preventive Korean Medicine
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• v.7 no.1
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• pp.17-28
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• 2003

We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

• 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 Technology Innovation
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• v.17 no.1
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• pp.1-48
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• 2009

Recently we have found some symptoms that R&D fiscal incentives might not work well what it has intended through the analysis of current statistics of firm's R&D data. Firstly, we found that the growth rate of R&D investment in private sector during the recent decade has been slowdown. The average of growth rate (real value) of R&D investment is 7.1% from 1998 to 2005, while it was 13.9% from 1980 to 1997. Secondly, the relative share of R&D investment of SME has been decreased to 21%('05) from 29%('01), even though the tax credit for SME has been more beneficial than large size firm, Thirdly, The R&D expenditure of large size firms (besides 3 leading firms) has not been increased since late of 1990s. We need to find some evidence whether fiscal incentives are effective in increasing firm's R&D investment. To analyse econometric model we use firm level unbalanced panel data for 4 years (from 2002 to 2005) derived from MOST database compiled from the annual survey, "Report on the Survey of Research and Development in Science and Technology". Also we use fixed effect model (Hausman test results accept fixed effect model with 1% of significant level) and estimate the model for all firms, large firms and SME respectively. We have following results from the analysis of econometric model. For large firm: i ) R&D investment responds elastically (1.20) to sales volume. ii) government R&D subsidy induces R&D investment (0.03) not so effectively. iii) Tax price elasticity is almost unity (-0.99). iv) For large firm tax incentive is more effective than R&D subsidy For SME: i ) Sales volume increase R&D investment of SME (0.043) not so effectively. ii ) government R&D subsidy is crowding out R&D investment of SME not seriously (-0.0079) iii) Tax price elasticity is very inelastic (-0.054) To compare with other studies, Koga(2003) has a similar result of tax price elasticity for Japanese firm (-1.0036), Hall((l992) has a unit tax price elasticity, Bloom et al. (2002) has $-0.354{\sim}-0.124$ in the short run. From the results of our analysis we recommend that government R&D subsidy has to focus on such an areas like basic research and public sector (defense, energy, health etc.) not overlapped private R&D sector. For SME government has to focus on establishing R&D infrastructure. To promote tax incentive policy, we need to strengthen the tax incentive scheme for large size firm's R&D investment. We recommend tax credit for large size film be extended to total volume of R&D investment.