• 보건교육건강증진학회지
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• 제1권1호
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• pp.83-97
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• 1983

The present study is to provide information for the improvement of school health services through research on the current condition of its organization and practice in universities, colleges and junior colleges. The scope of this study is consisted of four components including health organizations/units, school health services, environmental sanitation and health education for the 30 universities, the 20 colleges and the 32 junior colleges in Korea. The major findings are summarized as follows: (1) Among the sampled schools, around 73% of them have the health service organization/unit. When we break down health service organization/unit into the types by the level of school, around 73% of the universities have formal organization called "health center" and 20.0% of them have an informal organization called "health room". For the colleges level, 30.0% of them have the "health center" and 40.0% of them have the "health room". The figure of junior colleges is a quite different from universities and colleges, 56.3% of junior colleges have the "health room" only but the other have no service organization at all. (2) It was found that only 22.0% of 82 schools have the health committee for the school health services. It might be necessary to have a kind of expert committee to establish an annual health service program, budget and health policy in the school. (3) Approximately 29% of those schools having formal health organizations/units appointed directors as a medical persons. 13.4% of the sampled schools are appointed doctors (including the dentists) at health service organization/unit, 9.8% are appointed pharmacist and 65.9% are appointed nurses. Therefore, the data imply that the school health services are depending mainly on nurses. (4) The major activities of school health services are covering primary medical care (84.1%), health counseling (72.0%), physical examination (68.3%), vaccination (58.5%), tuberculosis control (54.9%), parasite control (29.3%) and dental health case(9.8%). Also 69.5% of the schools have the program on the environmental sanitation and the health education program. (5) In regard to health budget taking account of 34 schools, approximately 92% of them have less than 5,000 won per students and only 8.8% of them have more 10,000 won per students. At the average health budget per students is 4089.8 won in universities, 1617.1 won in colleges and 475.0 won in junior colleges. (6) The students enjoy the benifit of medical insurance at 11.0% of 82 schools surveyed. They are all universities. (7) The study found that 56 universities, colleges and junior colleges provide the annual physical examination. Only 21.4% of them have provided it for all students and school employees. (8) 64.3% of the 56 schools surveyed keep a record of the regular physical examinations. Records must be utilized as the basic data for the evaluation of the student's health condition and so the individual student is encouraged to take care of his own health. (9) At the 59 schools which practice health counseling, the main concerns of the counsellees are venereal disease, tuberculosis and psychoneurosis. This shows the need to practice health education in the area of preventive medicine. (10) 69.5% of the 82 universities, colleges and junior colleges surveyed are concerned with supervision of the environmental sanitation in their school, but non-professionals are in charge at 70.1% of them. This indicates negligence in environmental sanitation. (11) 53.7% of the 82 schools responded that they have no special instructive measure for the students' health and 54.9% are found to be negative in the use of a health education method. This reveals a problem. They are not positive to the recognition of their function as the initiative organization for the students' health. (12) The supplementary education for the faculty of the school health services is executed only at 8.5% of all the schools surveyed.

• 한국의료질향상학회지
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• 제4권1호
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• pp.116-124
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• 1997

Background : As parking problem caused by increasing owner-driver and patients concentrating to a general hospital is becoming one of the dissatisfactions in medical care. It is time that a general hospital should solve the parking problem in a desirable way. The purpose of this survey is to let the clients understand the basic motivation of the pay parking and develop the better parking system. Methods : Clients of a tertiary care hospital in Chon-ju were surveyed by means of a questionnaire. All in all, 193 subjects answered the questionnaire. Results : In relation to previous experiences, 39.6% of the subjects experienced inconvenience with confused parking lot and the shortage of parking space. Under the current parking system, the subjects who felt the available parking space was enough were more than those who didn't 62.7% of the subjects answered that they could find the parking lot easily. 33.2% of the subjects mentioned that it was not easy to drive in the parking area ; The reasons were pointed out the shortage of space, disordered parking, and insufficient guide. 12.8% of the subjects satisfied with the current administering system of parking lot. The outpatients were more affirmative than the admitted patients about the charging system. As for the parking fee, 64% of the subjects answered that it is expensive, and 89.5% of the subjects thought imposing of parking fee is irrational. Conclusion : To say as a whole, the basic purpose of the charging system are more or less accepted. However, the management details like parking facilities and payment method are dissatisfactory, so it is necessary to improve the management system. It is also noted that the inpatients showed more negative attitude than the outpatients with the charging system. To secure a more convenient parking, the parking system should be considered in relation to the information service, kind guidance, improve facilities, personnel cooperation, fix outpatient scheduling system, etc.

• 한국의료질향상학회지
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• 제1권1호
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• pp.32-43
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• 1994

The 'Pharmacy and Therapeutic Committee' decided to restrict the use of vancomycin which was categorized into restricted antimicrobials, among general, reserved and restricted antimicrobials. The committee also established prescribing guidelines of vancomycin in Seoul National University Hospital, May, 1991. Especially, the restricted antimicrobials should be used after approval by infectious disease specialist physician. A retrospective drug use evaluation (DUE) on vancomycin has been conducted to compare with the previous vancomycin DUE study in 1990. 'Criteria for DUE on vancomycin' was modified from Am J Hosp Pharm. Total 65 charts of patients were retrospectively reviewed from July 1991 to June 1992 in Seoul National University Children's Hospital. The justification of use was improved from 56% to 75% comparing with the previous study. In analyzing process indicators, several criteria including body temperature monitoring, WBC monitoring and use of concomitant antibiotics were well documented, but serum creatinine monitoring, culture and sensitivity test and level monitoring were infrequently performed, while the accepted level has been improved. Accepted level for appropriate initial dosage and duration of therapy were decreased. In outcome analysis, blood culture after discontinuing the drug was relatively well documented compared with the previous study. As the results, the approval vancomycin use was shown to be effective and rational in antibiotic therapy. And it is suggested that the above findings should be communicated to the medical staff, and a active intervention, such as feedback control, also be necessary for rational drug use.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3111-3116
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• 2016

Background: The goal of this study was to compare the rate of recurrence and occurrence of complications in colorectal cancer patients after two kinds of laparoscopy and laparotomy. Materials and Methods: A follow-up study was carried out among 358 patients who suffered from colorectal cancer from 2012-2014. The data were gathered from colorectal research center in Shiraz, Shahid Faghihi hospital, and analyzed using the chi-square test, logistic regression, and multinomial regression. Results: The average age of these patients was $56.3{\pm}14.6$, 55.0% being men. Moreover, 57.8% of them underwent laparoscopy surgery and 42.2% of the patients underwent laparotomysurgery and the conversion rate was 58.0% which ultimately was put under the category of laparotomy surgery. After biennial median follow-up, differences in the occurrence of complications such as bleeding (hemorrhage), fever, intestine blockage and wound infection in these two kinds of surgery werestatistically significant (P<0.05). However, the rate of recurrence and the patients' ultimate status (alive without disease, alive with disease, and death) did not significantly differ between these two surgery groups. Conclusions: Post-operation complications were laparoscopy surgery were less than those in laparotomy. However, the outcomes such as patients' ultimate status and recurrence were similar between the two groups.

• 대한간호학회지
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• 제28권1호
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• pp.26-36
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• 1998

This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2)to survey whether there exists a Hospital Ethics Committee(HEC), 3)to research what consideration are formally taken in selecting recipients, and 4)to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with an HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time. and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second. we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least. there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.

• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.264-271
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• 2023

Objectives: Hanging is a common method of attempted suicide. This study investigated the epidemiological profile of attempted and completed suicides by hanging in southern Iran. Methods: This cross-sectional study was performed on 1167 suicide attempts by hanging between 2011 and 2019. All data related to suicide attempts by hanging were collected from the Fars Suicide Surveillance System. The trends in suicide cases and the mean age of attempted and completed suicides were plotted. The chi-square test was used to identify suicide-related factors. Crude rates of incidence, mortality, and standardized fatality during the study period were calculated. Finally, logistic regression was used to identify the predictors of death in individuals who attempted suicide. Results: The mean age of those who attempted suicide was 33.21±16.82 years; the majority were male (80.5%). The rate of attempted and completed suicide by hanging were 3.50 and 2.79 per 100 000 people, respectively. The case-fatality rate was calculated as 79.34%. The results of our study indicated an increasing trend in suicide attempts by hanging. The likelihood of death was 2.28 times higher in individuals with a previous history of suicide attempts and 1.85 times higher in those with a psychological disorder. Conclusions: The findings of this study suggest an increasing trend in attempted and completed suicide by hanging, especially among individuals with a history of suicide attempts and psychological disorders. It is necessary to take action to reduce the rate of suicide attempts and identify the underlying causes of suicide attempts by hanging.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10071-10077
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• 2015

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. Conclusions: Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

• 한국직업건강간호학회지
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• 제22권2호
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• pp.171-178
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• 2013

Purpose: This study was conducted to determine the effect of the performance of Workplace Health Manager at the workplace on presenteeism in the workers. Methods: Three months before this study, between June 2010 and September 2010, a self-reporting survey of 316 employees in 136 workplaces in each of each hired a Workplace Health Manager was performed at their workplace with explanations of the purpose and methods of this study after their consent was obtained. Results: The average performance score of the Workplace Health Manager as graded by the employees was 3.8 out of 5 points. The duties of the Workplace Health Manager which received higher grades were posting of the Material Safety Data Sheets (MSDS), health education, and future management with respect to the results and procedure of health care-related work. According to the employees' survey, the score for presenteeism was evaluated as 14.3 out of 30 points. Based on the presenteeism analysis results, when (1) the employee was a male, (2) the workplace was established and managed by Industry Safety and Health Committee, (3) the employees were aware of the role of Workplace Health Managers, and (4) Workplace Health Manager fulfilled his/her role actively and successfully, presenteeism was observed to a lesser extent. Conclusion: According to the results of the study, presenteeism was observed to a lesser extent when the Workplace Health Manager actively performed his/her role.

• 한국병원경영학회지
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• 제25권4호
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• pp.38-47
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• 2020

Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

• 한국의료질향상학회지
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• 제22권1호
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• pp.11-26
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• 2016

The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.