• 산경연구논집
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• 제10권7호
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• pp.71-82
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• 2019

Purpose - This study aims to identify the priorities of medical service quality improvement by customer satisfaction characteristics and potential customer satisfaction improvement (PCSI) index based on the dualistic quality classification of Kano Model (1984) for Comprehensive Health Screeening Center in General Hospitals and Centers only for Comprehensive Health Screening and suggest a direction for future improvement. Research design, data, and methodology - Through advanced research on health screening medical service quality, this study set four service quality factors, including tangible, human, process and supportive factors, and 39 measurement items. Based on these items, the study used 117 questions, which consist of dualistic quality factors, customer satisfaction coefficients, positive and negative questions for PCSI index and questions for current satisfaction. 300 effective samples were collected for adults in their 20s who experienced health screening service in Seoul, Gyeonggi-do and Incheon within the past two years. Collected data were input in the quality evaluation duality table to categorize quality factors and calculate customer satisfaction coefficients by Timko(1993). The study also analyzed PCSI index in comparison with current satisfaction and identified priorities in quality improvement. Results - It was found that the most urgent factors to improve the quality in both groups were adequate waiting hours and emergency response for complications, which are process factors classified as unitary quality. It is urgently needed to improve the quality as the PCSI index was high in supportive factors (complaint response team) as attractive quality in Comprehensive Health Screening Center in General Hospitals and in process factors (prevention of infection) as unitary quality in Centers only for Comprehensive Health Screening. As the PCSI index was low in space use as a tangible factor, it was found that the current level can be maintained instead of improvement. Conclusions - To improve the health screening medical service quality, it is required to focus on process factors (adequate waiting hours, emergency response for complications, prevention of infection) and supportive factors (complaint response team) among service qualities perceived by users. It is proposed to ensure continuous efforts to manage and reinforce priorities as a direction for future improvement in health screening service.

• 지역사회간호학회지
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• 제4권1호
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• pp.25-37
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• 1993

This study was designed to identify the performance of occupational health services of 37 industries located in Kyung in area. The data was collected by a structured questionnaire developed by the Academic society of Community Nursing. This analysis had two factors, one was related to six of the industries, and the other was the actual assignment procedures of the health team members. This study was undertaken from December 4, 1992 to January 21, 1993. The results of the study were as follows: 1. The study group was primarily manufacturing industries which employed 300-1,000 employees. 2. The actual assignment state of occupation health team members with the exception of nurses was not kept to the regulations of the industrial safety health law. 3. The following was the analysis of the performance of occupational health services with two factors: 1). The larger the size of the six industries, the more the performance of health education, health assessment, and health screening. 2) The actual. practice of occupational health team members working environmental measurement, was more frequently performed by a nurse other than health team members together. 4. 1) The subscription rate of the laborers for primary health screening was 94%, and of these 10% had the need of secondary health screening. As a results of the secondary health screening the degrees were 'A' 45%, 'C' 92%, 'R' 21%. Of these degrees 'C', 'R' 4% were follow up cases. 2) 43% of laborers needed special health screening and .of these the subscription rate was 99%. The main item of the special health screening was physical factors. After the special health screening 46% required .follow up, 30% required medical treatment, only reporting 18%, change work 8%, suspension from work place 2%.

• Journal of Preventive Medicine and Public Health
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• 제44권3호
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• pp.101-110
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• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

• 한국전자통신학회논문지
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• 제7권3호
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• pp.687-692
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• 2012

우리나라 40세 이상 성인들에서 대장암의 건강검진 관계성을 파악하여 이들의 대장암 검진 이행에 영향을 미치는 변수를 확인하고자 수행되었다. 조사도구는 국민건강영양조사 제4기 2차년도 자료를 이용하였다. 주요 변수는 국민건강수준, 건강관련의식 및 행태, 식품 및 영양섭취실태에 대해 12,528명을 대상으로 실시하였다. 대장암검진 대상자인 40세 이상 성인 남, 여 4,703명을 연구대상으로 하였다. 연구결과는 대장암 검진 이행여부와 관련성이 있는 변수로는 성별, 연령, 거주 지역, 건강기능 식품 복용여부, 건강검진 수검여부, 암 과거력 등 이었다. 배우자 유무, 교육수준별, 가구 월 총소득, 민간보험, 규칙적 운동여부에서는 관련성이 없었다. 대장암검진 수검을 높이기 위해서는 무료 암검진 확대실시와 암검진의 간편한 검사법에 대한 체계적이고 효과적인 교육과 홍보가 수행되어야 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5125-5129
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• 2012

Economic decision models are being increasingly used to assess medical interventions. Advances in this field are mainly due to enhanced processing capacity of computers, availability of specific software to perform the necessary tasks, and refined mathematical techniques. We here estimated the incremental cost-effectiveness of ten strategies for colon cancer screening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and profit of chemotherapy in Iran. We used a Markov model to measure the costs and quality-adjusted life expectancy of a 50-year-old average-risk Iranian without screening and with screening by each test. In this paper, we tested the model with data from the Ministry of Health and published literature. We considered costs from the perspective of a health insurance organization, with inflation to 2011, the Iranian Rial being converted into US dollars. We focused on three tests for the 10 strategies considered currently being used for population screening in some Iranians provinces (Kerman, Golestan Mazandaran, Ardabil, and Tehran): low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 39%, 60% and 76%, and mortality by 50%, 69% and 78%, respectively, compared with no screening. These approaches generated ICER (incremental cost-effectiveness ratios) of $9067, $654 and $8700 per QALY (quality-adjusted life year), respectively. Sensitivity analyses were conducted to assess the influence of various scales on the economic evaluation of screening. The results were sensitive to probabilistic sensitivity analysis. Colonoscopy every ten years yielded the greatest net health value. Screening for colon cancer is economical and cost-effective over conventional levels of WTP8.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2899-2902
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• 2015

Background: Cervical cancer is one of the most common cancers among women worldwide, and in Thailand is the second most common cancer among women. In 2008, a national cervical cancer screening programme was implemented in Thailand, but coverage remains relatively low. Objectives: The purpose of the study was to investigate whether cervical cancer screening uptake is associated with the area of residency in Thailand. Materials and Methods: A case-control study was carried out in women aged 30 to 60 year-old, who live in Sikhiu district, Nakhon Ratchasima province, Thailand. Structured-questionnaires were used to interview 226 women (cases) who had attended cervical cancer screening in the last five years and 226 women (controls) who had not. Multiple logistic regression was used to investigate the association between the area of residency and cervical cancer screening uptake. Results: After controlling for parity, marital status and duration of hormonal contraceptive use, an association between the area of residence and cervical cancer screening uptake could not demonstrated ($OR_{adj}$ 1.27, 95%CI: 0.79, 2.04). Conclusions: We found no evidence to suggest remoteness to health care center led to lower cervical cancer screening uptake.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3263-3267
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• 2013

Background: The importance of cervical screening has been addressed in numerous studies. However, reviews conducted to explore of strategies to promoting attendance for cervical screening have been limited. This study aimed to explore strategies to promote attendance for cervical screening. Materials and Methods: A literature search from databases (1994-2011) was undertaken to include papers that identified strategies related to the cervical screening. Results: Twenty-four papers were included in this review. The review of existing strategies identified valuable information on cervical screening and areas that could be improved in meeting womens' needs. Conclusions: The review highlighted important aspects of cervical screening that could be further addressed by promoting strategies to attendance. Assessing women's health beliefs, inpatient cervical cancer screening, nurse-led screening, and cognition-emotion focused programs are among the strategies to promote attendance for pap smear testing.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3773-3779
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• 2012

Objective: Despite government efforts to increase participation in gastric cancer screening, the rate is still suboptimal in Korea. Therefore, we explored barriers to and predictors of gastric cancer screening participation among a nationally representative sample. Methods: We used the Health Interview Survey sub-dataset derived from the Fourth Korean National Health and Nutrition Examination Survey 2008 (KNHANES IV) to evaluate participation in gastric cancer screening and factors associated with attendance in individuals age ${\geq}40$ years. We enrolled 4,464 subjects who completed the questionnaire and were not previously diagnosed with gastric cancer. Four groups of factors were considered potential predictors of gastric cancer screening in a multivariate analysis: sociodemographic, health behavior, psychological and cognitive, and dietary factors. Results: Overall, 41.3% complied with the gastric cancer screening recommendations. Younger age, lower education level, living without a spouse, frequent binge drinker, and current smoker were significantly associated with less participation in gastric cancer screening. Conclusions: To improve participation in gastric cancer screening, more focused interventions should be directed to vulnerable populations, such as groups with low socioeconomic status or unhealthy behavior. In addition, there should be new promotional campaigns and health education to provide information targeting these vulnerable populations.

• 보건의료산업학회지
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• 제10권4호
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• pp.87-95
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• 2016

Objectives : The aim of this study was to investigate the degree of awareness of the national cancer screening program by the Korean public and define its relationship with cancer screening intention. Methods : The study collected data by conducting an online survey from April 19 to 24, 2016, and received a total 354 responses. Additionally, we performed frequency analysis, chi-square test, and logistic regression analysis. Results : Based on the results for the degree of awareness for the national cancer screening program, 151 (42.7%) people were aware of the program, while 203 (57.3%) were not aware the program. From the chi-square test and logistic regression analysis, marital status and awareness of the national cancer screening program were found to have a statistically significant influence on screening intention. Conclusions : An increase in the screening rate should be established with a systematic promotion plan for the national cancer screening program.

• Genes and Genomics
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• 제40권12호
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• pp.1339-1349
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• 2018

Cerebral palsy (CP) is a non-progressive neurological disease, of which susceptibility is linked to genetic and environmental risk factors. More and more studies have shown that CP might be caused by multiple genetic factors, similar to other neurodevelopmental disorders. Due to the high genetic heterogeneity of CP, we focused on investigating related molecular pathways. Ten children with CP were collected for whole-exome sequencing by next-generation sequencing (NGS) technology. Customized processes were used to identify potential pathogenic pathways and variants. Three pathways (axon guidance, transmission across chemical synapses, protein-protein interactions at synapses) with twenty-three genes were identified to be highly correlated with CP. This study showed that the three pathways associated with CP might be the molecular mechanism of pathogenesis. These findings could provide useful clues for developing pathway-based pharmacotherapies. Further studies are required to confirm potential roles for these pathways in the pathogenesis of CP.