• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.504-516
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• 2018

Many countries have tried to reform financing systems toward UHC and paid attention to the function of strategic purchasing. This study was performed to examine theoretical foundations and the function of strategic purchasing. And we examined the functions of strategic purchasing in Korea based on the framework proposed by Preker(2005). For this purpose, we reviewed literature related to purchasing. we defined the strategic purchasing as strategic activities to provide health care services people need within a given budget, which is carried out by certain organizations, purchasing organizations. These activities include selecting appropriate providers, designing and operating the payment system, setting the price, and determining the target populations and their needs etc. The relationships among government, purchasers and healthcare providers can be explained by the principal-agent theory. In addition to Preker's framework, we emphasized the importance of the infrastructure such as decision making support systems, information systems, health care resource management systems, or expenditure monitoring systems. The National Health Insurance Service and the Health Insurance Review & Assessment Service play major roles in performing strategic purchasing.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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• pp.576-590
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• 1996

Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-highways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.

• Journal of Environmental Health Sciences
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• v.41 no.4
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• pp.241-248
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• 2015

Objectives: This study was conducted to provide scientific and effective information on phytoncides, which are associated with forest healing, and to activate recreational forests. Methods: The target sites were natural recreation forests, a forest park and an arboretum, and the control sites were three urban parks. The samples were collected at a volume of 6.0 L and a flow rate of 0.1 L/min for one hour using a low volume pump and the solid adsorbent sampling method. The phytoncide compounds adsorbed in the Tenax TA tube were analyzed by a automatic heat desorption unit and GC-MS. Results: By type of recreational forest, the annual concentrations of phytoncide (monoterpene) for the forest park showed the highest concentration with $1.450{\mu}g/m^3$, while those for the arboretum showed the lowest concentration at $0.892{\mu}g/m^3$, and thus the concentration of the forest park was approximately 1.6 times higher than the arboretum. The season showing the highest concentration of phytoncides was summer (June) and the forest park was the highest among the recreational forests. The concentrations of major components for phytoncide showed in descending order: ${\alpha}-pinene$, ${\beta}-pinene$, camphene, 3-carene and limonene. The seasonal concentration of ${\alpha}-pinene$, camphene and ${\beta}-pinene$ by type of recreational forest increased in April, which is characterized by low temperature and humidity, and the seasonal concentration of camphene decreased with higher humidity. The meteorological factors which had the high correlation with the concentration of total terpene were temperature and humidity. $CO_2$ and $O_2$ showed an inverse correlation. Conclusion: The major components of phytoncide were ${\alpha}-pinene$, ${\beta}-pinene$, camphene, 3-carene and limonene in descending order of concentration. Further and systematic study on the chemical nature of individual phytoncides, and on the effect of phytoncides on humans needs to be performed.

• Journal of Preventive Medicine and Public Health
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• v.42 no.6
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• pp.416-423
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• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• Journal of dental hygiene science
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• v.5 no.1
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• pp.13-17
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• 2005

This research was conducted in order to collect and arrange an oral health information needed the school oral hygiene as a part of a long term local community oral hygiene development to promote the oral health of the residents in Sung-Nam. After gathering the information of oral hygiene of 12-year old schoolchildren in Sung-Nam, these conclusions are reached: (1) The experience of dental caries in permanent teeth of 12-year old schoolchildren in Sung-Nam was revealed 74.7%, proportion of children with one or more caries in permanent teeth was 36.2%, and DMFT index was 2.75. (2) DT rate was 28.4% in total and regional difference has been revealed. In Sujung-Gu, DT rate was 36,8% and this was nearly as twice as 19.8% in Bundang-Gu. (3) For permanent teeth, fillings requirements for one surface were 26.6%, more that two surfaces were 13.3%. In addition, artificial crown treatment requirements were 1.8%, dental pulp treatment was 5.3%, and extraction requirement was 2.2%. In contrast, holders of pit and fissure sealant were only 27.1%. (4) In Sung-Nam, oral hygiene education campaign for 12-year old schoolchildren needs to be continued. Simultaneously, early stage examination and preventive approaches for decayed teeth such as pit and fissure sealant need to be considered for schoolchildren who have high tendency of dental caries and who are in areas which show high percentage of dental caries occurrence.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.1-8
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• 2001

Objectives : To gather information about the factors which influence the interest and intention of admission into charging nursing hones for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. Methods : A face-to-face interview survey was carried out with 320(men 159, women 165) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. Results : The mean age and years of education of the study population was 67.0 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children id the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission$(3.07{\pm}1.39)$ into a CNH was lower than that of interest$(3.22{\pm}1.33)$(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons$(\beta=-0.107)$, lower level of activity in daily life$(\beta=-0.447)$, and longer years of education$(\beta=-0.447)$ with 32.7% of $R^2$. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred 'elderly hospital' or 'elderly health center' to CNH. Conclusions : Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, though CNH.

• Journal of the Society of Disaster Information
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• v.19 no.4
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• pp.859-868
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• 2023

Purpose: In order to enhance safety, the Korea Navy is making efforts to introduce a safety and health management system and to develop a risk assessment system, while safety accidents keeps occurring. A development plan was proposed through an inspection of the Safety Management System(SMS). Method: To diagnose the Korea Navy's safety management system, changes in the safety environment, documentation system, and safety and health management system operation were reviewed, points to be improved were found, and improvement directions were derived. Result: There is a need for an SMS standard that can present the Korea Navy's safety policy and safety management direction, and a safety program that provides guidelines for implementing it in a standardized manner. To this end, we were able to confirm the feasibility of linking the requirements of the US Navy's SMS and the international standard ISO 45001 standard together with the Korea Navy's safety management system. Conclusion: The Korea Navy's safety management system needs to clearly present safety policies and standards, and have public confidence and effectiveness in safety work through a standard program that can implement them, and for this, the development of a Navy SMS is necessary.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.99-103
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• 2017

The primary responsibility for the oral hygiene of the disabled is usually the parents. Dental care of the disabled is early detection and recovery of lesions and continuous management. For this to be successful it is necessary to use diagnostic tool that can detect the early stages of dental caries which is difficult to detect with the naked eye. It is also important to educate and motivate the caregivers on oral hygiene management. Quantitative Light-induced Fluorescence-Digital (Billuminator, Inspektor Researh Systems BV, Amsterdam, The Netherlands), which provides overall caries inspection and visual information, can be useful for caregiver education. A 3-year-old girl who was hospitalized with Pallister-Killian syndrome, Hypothyroidism visited our clinic with chief complaint of rugged upper incisors. This girl had multiple dental caries and oral hygiene was very poor. Periodic QLF-D images were taken to provide caregiver education and oral hygiene management was improved. A 13-year-old girl with cerebral palsy visited our clinic for regular check up. Using QLF-D, we explained to the parents that there is a need for treatment of dental caries, and education of oral hygiene management was conducted. Improvement of oral hygiene in the disabled can be achieved through caregiver education. QLF-D is a diagnostic device that can detects early caries by irradiating light in the visible ray area to the teeth. It can also detects microleakage of restoration, plaque and calculus without disclosing agent. Clinicians can use the QLF-D to perform a general oral examination for the disabled. Also, QLF-D can be used to store visual information and educate caregivers. The accumulation of information using QLF-D makes it possible to provide feedback on oral care of parents, which is more advantageous for caregivers education.

• Journal of Preventive Medicine and Public Health
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• v.43 no.6
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• pp.535-542
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• 2010

Objectives: Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. Methods: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009, a selfadministrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. Results: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. Conclusions: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.

• Journal of the Society of Disaster Information
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• v.1 no.1
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• pp.3-26
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• 2005

In recent years, there is growing concern about the potential use of biological agents in war or acts of terrorism accompanied an increased realization that rapid preparedness and response are needed to prevent or treat the human damage that can be caused by these agents. The threat is indeed serious, and the potential for devastating numbers of casualties is high. The use of agents as weapons, even on a small scale, has the potential for huge social and economic disruption and massive diversion of regional and national resources to combat the threat, to treat primary disease, and to clean up environmental contamination. Biological weapons are one of weapons of mass destruction (or mass casualty weapons, to be precise. since they do not damage non-living entities) that are based on bacteria, viruses, rickettsia, fungi or toxins produced by these organisms. Biological weapons are known to be easy and cheap to produce and can be used to selectively target humans, animals, or plants. Theses agents can cause large numbers of casualties with minimal logistical requirements (in wide area). The spread of disease cannot be controlled until there is awareness of the signs of infection followed by identification of agents; and if the organism is easily spread from person to person, as in the case of smallpox, the number of casualties could run into the tens of thousands. Biological weapons could be used covertly, there can be a lot of different deployment scenarios. A lot of different agents could be used in biological weapons. And, there are a lot of different techniques to manufacture biological weapons. Terrorist acts that make use of Biological Agents differ in a number of ways from those involving chemicals. The distinction between terrorist and military use of Biological Weapon is increasingly problematic. The stealthy qualities of biological weapons further complicate the distinction between terrorism and war. In reality, all biological attacks are likely to require an integrated response involving both military and civilian communities. The basic considerations when public health agencies establish national defence plan against bioterrorism must be 1) arraying various laws and regulations to meet the realistic needs, 2)education for public health personnels and support of concerned academic society, 3)information collection and cooperative project with other countries, 4)Detection and surveillance(Early detection is essential for ensuring a prompt response to biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines) and 5) Response(A comprehensive public health response to a biological or chemical terrorist event involves epidemiologic investigation, medical treatment and prophylaxis for affacted persons, and the initiation of disease prevention or environmental decontamination measures). The purpose of this paper is providing basic material of preparedness and response for biological terrorism in modern society.