• Journal of Preventive Medicine and Public Health
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• v.39 no.2
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• pp.149-158
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• 2006

Objectives : We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. Methods : We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and nonmedical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value. Results : The present value of cumulative cost savings per patient with CRF from the societal perspective would be $18,555,000{\sim}29,410,000$ Won or $72,104,000{\sim}112,523,000$ Won if Kremezin delays the initiation of dialysis by 1 or 4 years. Conclusions : The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.46-60
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• 2004

Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.434-441
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• 2010

Background: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. Methods: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. Results: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. Conclusion: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

• Journal of Society of Preventive Korean Medicine
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• v.15 no.3
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• pp.115-125
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• 2011

Objectives : The aim of this study is to investigate the relevant factors which determine the use of oriental healthcare services among subjects with chronic illnesses. Method : This study utilized the data from the Korean National Health and Nutrition Examination Survey in 2005. Out of all the participants of the survey, 11,665 individuals who are older than 19 years old and have one or more chronic diseases were included in this study. Results : The factors that affect utilization of oriental healthcare services were significantly associated with gender, educational level, job, personal income, the number of chronic illnesses, experiences of nontreatment or delayed treatment and admission experiences for the last one year(p<.001). Although some of these factors need further studies, the determining factors for the use of oriental healthcare services are the presence of chronic illness and the number of chronic disease. That is, the chronically ill are more likely to seek oriental healthcare services. And the more chronic diseases the clients have the higher probability of seeking oriental healthcare services was found. Conclusions : The results suggest that the national integrated care services should be established for diverse development of policy regarding the quality of care of chronic illness and cost-effectiveness.

• Korean Parent-Child Health Journal
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• v.16 no.1
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• pp.1-10
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• 2013

Purpose: This study is descriptive research to identify characteristics and childbirth experience of women who selected delivery with midwives. Methods: The research methods included structured questionnaires, open questions and charts and data were collected from March 2009 to May 2010 at one midwifery clinic. The 108 data of primipara and multipara were analyzed using descriptive statistics and grouping in same meaning. Results: The general characteristics of participants were age of 31~35, housewife, college or university graduate, religion 'yes', and economic state 'middle'. The obstetric characteristics of participants were abortion rate of 23.1%, none complication to pregnancy and delivery of 97.2%, and none postpartum complication. This study was analyzed using positive experiences of 3 categories, that is 'comfortable and natural childbirth', 'satisfaction and trust to personal care of midwives', and 'experience of baby-and-family-centered childbirth' and negative experiences of 3 categories, that is 'improvement of healthcare environment', 'insufficient facilities and nursing care', and'burden of cost'. Conclusion: This study is significant, since it investigates in the absence of domestic research on the characteristics of women who delivered at midwifery clinic. Thus, this study provided basic data on the characteristics of women who delivered at midwifery clinic.

• Journal of Home Health Care Nursing
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• v.18 no.1
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• pp.13-19
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• 2011

Purpose: The aim of this study was to evaluate patient satisfaction and indirect marketing effects (recommendation, hospital re-visit intention) and additionally to calculate the expected incomes by clinical nurse specialists (CNS). Methods: Sixty-six patients who had lower varicose vein removal surgery performed at two general hospitals from August 1 to November 30, 2008, were recruited. The effects were evaluated by degree of patient satisfaction, the number of personal recommendations given, rate of hospital re-visit intention, and indirect marketing effects. Indirect marketing effects were calculated as the total cost of surgery multiplied by the score of other variables. Results: The patient satisfaction score was 0.82 for CNS and 0.43 for general nurses (GN). The number of personal recommendations given was 2.5 for CNS and 1.1 for GN. The rate of hospital re-visit intention was 0.31 for CNS and 0.21 fot GN. The ratio of expected incomes between CNS and GN is 2.07 to 1. Conclusion: We found that when a CNS serves a patient, satisfaction, number of personal recommendations, hospital re-visit intention, and indirect marketing effects were higher than those of GN. These results show that CNS have dominant roles and functions and that the effects of CNS employment can be measured using economics parameters.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.92-104
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• 1998

Background : Hospitals in Korea are in trouble at ecomomic matters because of low cost of medical insurance, and consumers' demand for high quality. The management of inpatient clothing is very difficult. Especially the management of patient's clothing size is very difficult because the case mix of patients in wards is very different from the stocked clothing size. Because of the economic matters, the ward does not prepare enough size of clothing. The nurses in ward are in trouble with managing the clothing. So the nurses want free size patient clothing for ease management of clothing size. Method : The experimental inpatinets clothing is designed for in 170cm height refer to Korean standard. The fit of 8 subjects from 150 cm to 185 cm wearing experimental were evaluated by clothing specialists, nurses and patients. Result : 75.8% of evaluators like free size clothing. This results show that the fit of subjects from 160cm to 180cm was good in general but subjects with 150cm, 155cm, 185cm height showed poor fit.

• Quality Improvement in Health Care
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• v.23 no.2
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• pp.81-94
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• 2017

Purpose:The purpose of this study was to evaluate the effects of periurethral cleaning with water or antiseptics in preventing catheter-associated urinary tract infections through systemic review Methods:The randomized clinical trials published between 2000 and 2016 were searched using domestic and international databases, and five randomized studies were selected for this study. The quality of study was assessed by assessment tool from the cochrane's Risk of Bias and meta-analysis was performed using the Cochrane Review Manager software Version 5.3 (RevMan) Results: The two groups of antiinfectants used in this study include povidone-iodine and chlorhexidine, water and chlorhexidine vs water and chlorhexidine. there was no significant difference in urinary tract infection rate between the two groups. Conclusion: Based on the findings, periurethral cleaning with water is safer and cost-efficient than using antiseptics. and it can make reduce a patient's discomfort.

• International conference on construction engineering and project management
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• 2005.10a
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• pp.353-359
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• 2005

The infrastructure in korea has been improved drastically since July 7th, 1970 which was the first highway completed date in Korea (Seoul-Pusan). This is one of the major factors for the competitiveness of a country. Now the total length of highway in Korea is more than 2000km. However Korea is 11th in the trade volume in the world, the SOC level of Korea is around 20th at most in the world (IMD 2004). The infrastructure in Korea comparing other developed countries is far below, which gives the impact of cost of goods, even twice expensive in transporting goods through highways, railways and ports etc. Now the government budget is gradually spending more for welfare and health care side. The most of additional expense of welfare is increasing rather than SOC budget is decreasing or staying as it is as 2003. The government may think that the level of SOC is enough in point of view of preference input of budget such as welfare and health care etc. However the SOC level in Korea is far form the competitiveness of the country. The main points of this paper is to show that where Korea is in point of SOC level to go for developed country, and what to do to facilitate BOT, BTO and BTL projects. Korean government has tried to improve the practice of PPI (Private Participation of Infrastructure) with the Act on Private Capital Inducement in 1994 and the Act on Private Investment in 1997.

• Journal of dental hygiene science
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• v.9 no.3
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• pp.345-351
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• 2009

The aim of this study is understanding the relationship between degree of knowledge and actual condition on oral health care to raise people's attention on oral health care and to develop a oral health care program and respondents are 121 diabetes patients. The conclusion of this study is as follows; 1. In terms of degree of Knowledge, women have better knowledge on dental healthcare than men. People aged between 20 and 50 have relatively good knowledge and the longer patients fight against diabetes the more they know about oral healthcare. 2. In actual oral healthcare condition, only 21.5% of patients use rolling method. Patients who have good knowledge have relatively high frequency of dental treatment. Most patients see dentists for their oral healthcare consultation. 3. All the respondent group hesitate to have dental treatment because of expensive cost. Surprisingly. most patients with good knowledge answers that diabetes has nothing to do with dental disease. 4. In terms of degree of knowledge and having oral healthcare program, diabetes patients who are having programs has better knowledge. 5. Respondent group which has middle level of knowledge in oral healthcare give high marks on oral healthcare but does not show statistical significance.