• Journal of agricultural medicine and community health
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• v.49 no.3
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• pp.216-234
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• 2024

Background: Hapcheon-gun, Gyeongsangnam-do, is designated as an emergency medical vulnerable area, facing significant challenges in transporting and treating emergency patients. A detailed analysis of the regional emergency medical system is required to identify effective solutions. Methods: This study employed a mixed-methods approach, combining quantitative data from the National Emergency Medical Information System and emergency activity logs with qualitative data from focus group interviews involving 24 stakeholders, including medical staff, paramedics, civil servants, and local residents. Results: Quantitative findings indicated an aging population in Hapcheon-gun, with a growing number of elderly emergency room users. Despite the utilization of local emergency medical institutions, a lack of trust and preference for urban hospitals led even patients with mild conditions to seek care at higher-level facilities. Following the COVID-19 pandemic, transport distances and times for patients using 119 emergency services increased. Qualitative analysis identified several issues: limited capacity of local institutions, challenges in patient transport due to misaligned emergency medical zones, an increase in severely ill patients, and the absence of a coordinated emergency medical consultative body. Recommendations include strengthening local institutions through government support, realignment of emergency zones, legal reforms, the establishment of a continuous consultative body, and enhancing the capacity of medical staff, paramedics, and residents. Conclusion: Improving the emergency medical system in Hapcheon-gun will require targeted efforts in institutional strengthening, legal and administrative support, and capacity-building initiatives.

• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.5-9
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• 1976

The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

• Journal of the Korean Society of School Health
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• v.4 no.2
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• pp.176-192
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• 1991

School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

• Journal of Korean Port Research
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• v.11 no.2
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• pp.321-337
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• 1997

Rapid change in the technological environment of marine transportation and the development of the ocean shipping industry have fostered a revolution in the port system. This in turn has caused major changes in the function and use of port in Korea. Aside from this. Mokpo Port, however continues to decline, because the existing port facilities and related subsystem are already obsolete with no chance of regaining operational effectiveness and treatment for proper implementation. Although a few studies have been done on the Mokpo Port, has not been found, any reseach for the analytical approach to the transportation system of it. This paper aims to make an extensive analysis of the physical distribution system in Mokpo Port focusing on the coordination of subsystems such as navigational aids system, quay handling and transfer system, storage system and inland transport system. The base of introduced simulation tool here is the queueing theory. The overall findings are as follows; 1. Among those vessels called at Mokpo Port in 1994, the average size of oceangoing vessels is 4,922.1 G/T, and the domestic is 317.8 G/T. The average arrival interval and service time of the domestic vessels are 6.0 hours and 24.1 hours respectively marking the berth occupation rate over 100%. Those for oceangoing vessels are 34.5 hours, 120.0 hours and 37.2%. In order to maintainin the berth occupation rate to 70% the capacity considering the 1994 of domestic piers must be extended to 145% and oceangoing vessels must be increased to 165% year called. 2. The capacity of approaching channel is enough to handle the total traffic volume. 3. Tugs are sufficiently being provided to handle all ships requiring their services 4. The capacity of storage and inland transportation systems are sufficient to handle the throughput and the yard stroage utilization rate of No.1 $\cdots$ No.5 is 4.5% and No.6 1S 30% of 1993's. 5. The utilization rate of LLc(Level Looping Crane) and PNT(PNeumaTic) are 2.7% and 18.8%, respectively. Practical solution and proposal for improvement of Transportation System in Mokpo Port are as follows; 1. To avoid the congestion in domestic pier introduction of a new port operation system is necessary allowing the domestic vessel to use the oceangoing pier. 2. To establish the port management information system to improve the efficiency of port operation. 3. To build a new storage system for high valued cargos including modernization of the present storage and handling system. 4. To insure the safety of navigation in approaching channel, The Vessel Traffic System including separation scheme is introduced. 5. To interest enormously on public relation to ship owner's association, shippers and consignees by showing that they can save cost and ship turnaround time in order to promote the call to Mokpo Port. At last, to be strategically change the function of Mokpo Port to the Leisure, Fishing & Ferry as well as Maritime port.

• Environmental and Resource Economics Review
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• v.26 no.1
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• pp.103-121
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• 2017

The domestic ESCO project was introduced in 1992 as one of the energy efficiency improvement programs. In recent energy market, the changes in the market conditions such as smart grid, renewable energy, and the importance of demand response became important issues. As the diversified business models are required, examples of overseas exercises are examined. Business areas in Europe or the US where the ESCO industry has been active include measures to improve the efficiency of energy facilities in all areas, ranging from energy supply facilities and energy services to end users. This type of ESCO overseas business model can be classified into various types such as project execution method, supplier demand management, financing method, climate change and emission rights, new and renewable energy, and other criteria. In this study, we propose to adopt IEC (Integrated Energy Contracting) contract method in domestic ESCO market for additional business models. Current convention of listing the specific individual business types being allowed by regulation turned out to be obstacles to the revitalization of the related market. In order to achieve the goal of energy conservation, it is recommended, instead, to revise the current funding guidelines to be a negative system.

• Journal of Bio-Environment Control
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• v.31 no.4
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• pp.366-375
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• 2022

The monitoring of electricity consumption using Internet of Things (IoT) technology is attracting attention as a technology to reduce operation costs of smart farms. In this study, we propose a method to apply a real-time electrical consumption monitoring system (the e-Gauge system) and utilization of the collected data real-time while a melon-producing smart farm is in operation. For this purpose, the electrical consumption data for the individual smart-farm facilities such as boilers, nutrient distribution systems, automatic controllers, circulation fans, boiler controllers, and other IoT-related utilities were collected during three months of melon cultivation period. By using the monitoring results, the electrical energy consumption pattern was analyzed as an example, and necessary considerations needed to optimally utilize the measurement data were suggested. This paper will be useful in lowering the technological implementation barriers for new researchers to build a electrical consumption monitoring system and reducing trial and errors in the usage of the generated data.

• Research in Community and Public Health Nursing
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• v.1 no.1
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• pp.582-594
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• 1989

The purpose of this study is to analyze the factors affecting the school health teachers' self-confidence. This study was conducted with 87 school health teachers working in Jeonbuk province, from September to December, 1986, The results are follows; 1. Demographic characteristics of school health teachers 1) Age mean ; 34, range; 23-54 2) School Nursing experience mean; 11 years, range; 0-24 3) Clinical experience mean; 1.5 years, range: 0-13 2. Status of school health resources & nursing activities 1) Personnel resource school health teacher: pupils : 1 : 1,436 'classes=1:31 'general teacher=1:39 2) Budget Total school operating budget: School health budget : 100 : 4.2 (52.2 thousand Won) Half of the school health budget expend on medicine. 3) Clinic 80% of all schools have health clinic seperately. 71.32 of all schools have less than $35m^2$, 23.9%, $36-66m^2$. 4) Only 20% of all schools have organization for health 5) Average of clinic visitor for 1 year; 2,084 Major problem is on digestive system. And other problem: respiratory, skin, musculo - skeletal system, dental problem, etc... 6) Literal message for 1 year; 12 times. For health education (4), vaccination (3), examination of parasites (2), etc... 3. The degrees of the school health teachers' self-confidence 1) Program planning & evaluation; 2.9. 2) Clinic management; 2.8 3) Health education; 2.8 4) Management of school environment; 2.7 5) Health care services; 2.5. 6) Operating of school health organization; 2.3 4. Significances to self-confidence on school health nursing activities 1) Program planning & evaluation: home message (r=.228, p<.05) No. of clinic visitor (r=.220, p<.05) expending time for clinic management (r=.229, p<.05) religion (t: 2.5, p<.05) level of school (F=6.3, p<.005) 2) Clinic management: age of school health teacher (r=-.202, p<.05) school health experience (r=-.211, p<.05) salary step (r=.187, p<.05) expending time for clinic management (r=.315, p<0.1) marital status (t=3.97, p<.005) level of school (F=3,139, p<0.5) 3) Management of school environment: level of school (F=3.899, p<.05) expending time for clinic management (r=-,216, p<0.5) 4) Health care service: age of school health teacher (r=-.186, p<.05) marital status (t= 3.67, pH.005) 5) Health education: expending times for clinic management (r=-.252, p<05) level of school (F=5.343, p<.01) 6) Operating of health organization; age of school health teacher (r=-.258, p<.01)salary step (r=.188, p<.05) Based on the above results, the suggestions are as follows; 1. Need to raise ,appointment rate school health teacher. 2. Need to raise self-confidence on school health nursing activities through the inservice education or re-inforcement. 3. Need to secure adequate budget for school health. 4. Participation of school health teacher and support of school master for school health services are required. 5. Need for use the health clinic seperately, adequate facilities and free utilization by visitors.

• Journal of the Korean Regional Science Association
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• v.39 no.3
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• pp.65-83
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• 2023

The purpose of this study is to conceptually define "spatial inclusivity" and empirically examine the impact of disability severity and spatial inclusivity on social participation among individuals experiencing physical discomfort. The social and spatial environment of the residential area is crucial for individuals with disabilities who face limited activity range and complex barriers due to physical constraints. In this study, spatial inclusivity from the perspective of people with disabilities is defined as establishment of equal relationships with non-disabled individuals within the local community, as well as the availability of basic facilities and services in a safe urban space that allows for access and utilization. This concept consists of three dimensions: individual networks, social environment, and physical environment. The physical environment encompasses safety levels, natural environment, living environment, public transportation conditions, medical services in residential areas. We used the 2019 Community Health Survey to examine the relationship between disability severity, spatial inclusivity, and social participation using a two level regression model. The findings are as follows: Firstly, personal relationships at the individual level and the physical environment at the local level have a positive impact on social participation. Secondly, when identifying dividing the physical environment into five sub-factors, no significant influence of individual factors is found. Thirdly, trustworthy and friendly social environment at the local level has a negative impact on social participation. These results provide empirical evidence that spatial inclusivity has an effect on the social participation of individuals with disabilities and suggest implications for urban planning to create and enhance conditions for the social participation of individuals with disabilities.

• Journal of Home Health Care Nursing
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• v.7 no.1
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.57-95
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• 1972

This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.