• 제목/요약/키워드: Health Care Accessibility

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자택임종 증가를 위한 호스피스제도 개선 방안: 한국과 미국의 호스피스제도 비교를 중심으로 (Hospice System Improvement Measures to Increase the Accessibility of Voluntary Home Death: A Comparison of the South Korean and American Hospice Systems)

  • 한다정;최영순;이동현
    • 한국콘텐츠학회논문지
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    • 제22권6호
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    • pp.567-579
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    • 2022
  • 본 연구의 목적은 한국과 미국의 자택 임종률 차이에 영향을 미치는 요인을 호스피스 제도 측면에서 파악하여, 사람들이 선호하는 자택임종 증가를 위한 호스피스 제도 개선 방안을 모색하는 것이다. 연구방법은 한국과 미국의 호스피스 제도를 대상으로 사례연구 접근방법 중 하나인 최대유사체계를 활용하였다. 연구결과, 양국 모두 공보험에 의해 운영되고 있었고, 서비스를 받을 수 있는 시점과 호스피스 대상 환자임을 의사 2명으로부터 확인받는 절차는 동일하였다. 반면 주요 차이점은 한국은 주로 입원형 호스피스를 이용하지만 미국은 대다수가 '일반가정형'을 이용하고 있었고, 호스피스 보조원 및 가사 도우미 서비스 등을 통해 가정 내 일상생활에 대한 돌봄도 지원하고 있었다. 또한 환자를 돌보는 가족 등을 대상으로 보호자 휴식을 위한 '단기입원형'을 운영하고 있었고, 호스피스 대상 질환에는 제한이 없었다. 따라서 사람들이 선호하는 자택임종 증가를 위한 호스피스 제도 개선 방안은 가정형 호스피스의 서비스 범위 확대 및 활성화와 더불어 가정 내 일상생활에 대한 돌봄과 보호자 휴식을 위한 서비스 제공 등이 필요하며, 호스피스 대상 질환에도 제한이 없어야 할 것이다.

한국의 장애인 환자 치과 진료를 위한 국민 건강 보험 가산제도의 종류 및 청구 현황 (THE ADDITIONAL POINT SYSTEM OF NATIONAL HEALTH INSURANCE FOR DENTAL TREATMENT IN PATIENTS WITH A SPECIAL HEALTH CARE NEED IN KOREA)

  • 권도윤;남옥형;김미선;최성철;김광철;최재영;이효설
    • 대한장애인치과학회지
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    • 제14권1호
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    • pp.11-16
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    • 2018
  • In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

보육시설 실내디자인 현황과 사용자 선호성향 - 실내분위기, 마감재, 색채를 중심으로 - (Current Interior Design and User Preference for Child Care Facilities - Focused on Interior Atmosphere, Finishing Materials and Colors -)

  • 하숙녕;천진희
    • 한국실내디자인학회논문집
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    • 제17권3호
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    • pp.111-122
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    • 2008
  • As Korea has undergone rapid modernization, urbanization and industrialization, women's social participation has increased. Accordingly, child care facilities have shown continuous growth in numbers. However, according to research, child care facilities in Korea lag behind those in other nations in terms of quality. Given that, it seem urgent to enhance the quality of child care facilities and improve their indoor environment. Above all, overall atmosphere, colors and finishing materials are connected directly with educational effects as well as feelings and health of facility users. This study assesses the current state of child care facilities and preferences by focusing primarily on interior atmosphere, materials and colors. For This Study, 7 facilities were surveyed, and 46 subjects were participated for this study. The findings suggest that "pretty" style is preferred to "natural" style. As regards flooring material, wood floor is preferred. It is recommended to lay pastel colored carpet or PVC flooring material to the wood floor. As for wall, it is desirable to divide the wall spaces by adding wood and painting to simple wallpapers. In case of the ceiling noise absorptive material is recommended to use instead of wallpapers. For the doors, it is desirable to use contrasting materials and colors given accessibility for children. In the meantime, rather than strong primary colors, soft color or pastel colors are desirable for furniture. This study has limitations because of insufficiency of case study samples. However, it is significant in that the study results may be used as primary source of information to improve the environment of child care facilities.

일인 가구의 성별에 따른 미충족 의료현황과 관련 요인 (Unmet healthcare needs and related factors according to gender differences in single-person households)

  • 채현주;김미종
    • 여성건강간호학회지
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    • 제26권1호
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    • pp.93-103
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    • 2020
  • Purpose: This study was conducted to identify unmet healthcare needs among man and woman one-person households and to explore related factors by gender. Methods: Data were drawn from the 2017 Korea National Health and Nutrition Examination Survey. The final sample consisted of 820 one-person households. The statistical analysis, conducted in SPSS version 20.1, included complex sampling analysis; descriptive statistics, the chi-square test, and logistic regression. Results: The demographic and socioeconomic characteristics of women in one-person households were significantly different from those of men in one-person households. Women in single-person households were mainly in their 70s or older and married, and they tended to have a low education level, low income, and no formal occupation. Unmet healthcare needs were experienced by 17.3% of women in one-person households and 13.5% of men in one-person households, which was not a statistically significant difference (χ2=2.17, p=.139). Factors related to unmet healthcare needs were subjective health status and unmet dental care needs in single-person-household men. By contrast, having experienced impairment within the past year, stress, and unmet dental care needs were factors related to unmet healthcare needs in single-person-household women. Conclusion: As one-person households become increasingly common, more attention needs to be paid to them and our understanding of them needs to be improved. Women in one-person households, in particular, are especially vulnerable, as they experience more unmet healthcare needs.

우리나라 공공의료의 쟁점과 해결책 (Issues Facing the National Health Insurance System in Korea and Their Solutions)

  • 이은혜
    • 의학교육논단
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    • 제24권1호
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    • pp.10-17
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    • 2022
  • South Korea is not a wasteland of publicly funded health care-instead, it has a good medical social security system known as the national health insurance (NHI). The NHI of Korea has three unique features; (1) low premiums, low insurance fees, and low coverage; (2) obligatory designation of medical institutions; (3) and allowance of non-benefit services. These features have made hospitals and doctors interested in profit-seeking. However, the commercialization of medical institutions has taken place in both private- and public-established sectors. A basic problem of commercialization is the co-existence of the obligatory designation of medical institutions and non-benefit services. The problem became worse in the Kim Dae-Jung government because it officially permitted non-benefit services. Since 2000, the Korean government has consistently pursued benefit extension policies, but the coverage rates of the NHI have stagnated. In addition, premiums and current medical expenses have markedly increased because policy-makers have emphasized accessibility to the NHI, while ignoring important principles of medical social security such as a needs-based approach and patient-referral system. In order to resolve the commercialization problem, the obligatory designation of medical institutions to the NHI should be changed to a contract system, and non-benefit services should be prohibited at NHI institutions. We must re-establish the patient-referral system via a needs-based approach. We also need to build a primary healthcare system and public health policies. We should make a long-term plan for healthcare reform.

인천광역시 고령자의 보건의료이용에 영향을 미치는 요인: 한국의료패널자료를 이용하여 (Factor Affecting the Health Care Use of the Elderly in Incheon Metropolitan City: By using Korea Health Panel Data(version 1.5))

  • 원경아;양민아;박지혁
    • 한국노년학
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    • 제40권4호
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    • pp.747-760
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    • 2020
  • 본 연구는 한국의료패널을 통해 인천광역시 고령자의 보건의료이용 행태 예측요인을 확인하여 고령자의 보건의료접근성을 높이거나 보건의료이용의 효율성을 높일 수 있는 서비스 또는 제도를 개발하는데 필요한 기초자료를 마련하는 것을 목적으로 한다. 한국의료패널 중 인천광역시에 거주하는 60세 이상 대상자 총 305개의 자료를 SPSS와 AMOS를 이용하여 분석하였다. 분석 결과, 개인속성과 건강수준, 건강수준과 보건의료이용행태에서 유의미한 상관이 나타났다. 또한, 구축된 연구모형의 적합도 및 효과 분석을 통해 개인속성 요인, 생활습관, 건강수준이 모두 보건의료서비스 이용에 직·간접적으로 유의미한 영향을 미치고 있음을 확인하였다. 이를 통해 인천시가 다른 지역들에 비해 보건의료서비스 수요 및 공급에서 불균형이 심한 편이므로 고령화 사회에 맞춰 인천시의 보건의료체계 정립이 필요함을 알 수 있었으며, 인천시 거주 고령자에게 제공할 보건의료서비스의 방안과 관련 정책 제도 수립 시 본 연구 결과를 기초자료로 활용할 수 있을 것이다.

비만 진료 프로그램에 대한 수용성 태도 분석 (Review on Acceptability of Patients towards Obesity Treatment Program)

  • 이엄지;김서영;임영우;박영배
    • 한방비만학회지
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    • 제19권1호
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    • pp.42-55
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    • 2019
  • Objectives: Acceptability of patients towards obesity treatment program is associated with better weight loss outcomes. The purpose of this study was to review previously published study results of the predictive factors associated with patients' acceptability in obesity treatment. Methods: Authors searched for the articles related to acceptability reported as continuation, attendance and adherence, published from 2011 to 2018 found on Pubmed, Scopus, Research Information Sharing Service, and Koreanstudies Information Service System. A total of 23 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to detail categories. Results: Regarding the continuation of the treatment, unchangeable factors such as younger age, lower educational level, male sexuality and lower accessibility to physical activity predicted lower continuation. Furthermore, changeable factors such as early and half weight loss, better accessibility to the treatment and financial incentives for retention predicted higher continuation rate. Greater degree of attendance was predicted by unchangeable factors such as economical affordability, and changeable predictors such as half weight loss and proximity to the clinic. Main factors of adherence to the recommendation were unchangeable predictors such as weight loss experience, and changeable predictors such as more physical activity and appropriate dietary habits. Negative psychological state predicted lower continuation, attendance and adherence rate. Conclusions: Our review results suggest that unchangeable and changeable predictors of acceptability of patients should be carefully examined during treatments of obesity.

Perceived Service Quality among Outpatients Visiting Hospitals and Clinics and Their Willingness to Re-utilize the Same Medical Institutions

  • Jung, Min-Soo;Lee, Keon-Hyung;Choi, Man-Kyu
    • Journal of Preventive Medicine and Public Health
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    • 제42권3호
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    • pp.151-159
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    • 2009
  • Objectives : This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. Methods : Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. Results : The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. Conclusions : The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.

Research on the Senior Food Industry and Revitalization: focusing on HMR products

  • JeungSun LEE;Seong Soo CHA
    • 식품보건융합연구
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    • 제9권5호
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    • pp.1-5
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    • 2023
  • As the elderly population is rapidly increasing not only domestically but also globally, convenience foods for the elderly population are receiving attention. Therefore, the senior food market continues to grow rapidly both domestically and overseas. In relation to this, this study seeks to explore convenience food preferences through the growth status of the convenience food market and the demand for convenience food among the elderly population. We would like to consider various factors that influence the increase in convenience food consumption among the elderly population. This study uses meta-analysis and systematic literature research to find ways to revitalize the convenience food market targeting the elderly population. As a result of the analysis, it was mentioned that in order to revitalize the convenience food market for the elderly population, it is important to develop products with high nutritional value, suitable for the physical characteristics of the elderly population, and low price, and to consider convenience and accessibility. Through a multifaceted approach, we aim to increase the need for convenient food products that meet the needs of the elderly population, contribute to improving the health and well-being of the elderly, and further efficiently manage the health of the elderly nationally and globally.

농촌여성(農村女性)의 건강실태(健康實態)에 관한 연구(硏究) (The Health Status of Rural Farming Women)

  • 박정은
    • 농촌의학ㆍ지역보건
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    • 제15권2호
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    • pp.97-106
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    • 1990
  • 1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

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