• Health Policy and Management
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• v.30 no.1
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• pp.120-125
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• 2020

Unmet healthcare needs lead to increased disease severity, increased likelihood of complications, and worse disease prognosis. To examine the latest status of unmet healthcare needs in South Korea, the four different data configured with nationally representative sample of South Korean population were used: the Korea Health and Nutrition Examination Survey (KNAHANES, 2007-2018), the Community Health Survey (CHS, 2008-2018), the Korea Health Panel Survey (KHP, 2011-2016), and the Korean Welfare Panel Study (KOWEPS, 2006-2018). The proportion of individuals reporting unmet healthcare needs were 7.8% (KNHANES, 2018), 8.8% (CHS), and 10.8% (KHP, 2016). Annual percentage change which characterizes trend for the follow-up period was -9.1%, -3.2%, and -6.8%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES, 2018), 1.2% (CHS, 2018), 2.5% (KHP, 2016), and 0.5% (KOWEPS, 2018). Annual percentage change which characterizes trend for the follow-up period was -10.3%, -12.0%, -11.3%, and -18.8, respectively. The low-income population and the elderly population were vulnerable groups reporting the highest rate of unmet health care needs. The rate of unmet healthcare needs has been declining since the past decade, still, the disparity between different income groups and age groups suggests that there are many challenges to address.

• Health Policy and Management
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• v.31 no.2
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• pp.225-231
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• 2021

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, the four different data which is composed of nationally representative sample of South Korean population were used; the Korea Health and Nutrition Examination Survey (KNAHANES, 2007-2019), the Community Health Survey (CHS, 2008-2019), the Korea Health Panel Survey (KHP, 2011-2017), and the Korean Welfare Panel Study (KOWEPS, 2006-2019). The proportion of individuals reporting unmet healthcare needs were 5.8% (KNHANES), 5.3% (CHS), and 11.6% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.5%, -8.0%, and -6.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.1% (KNAHANES), 0.7% (CHS), 2.4% (KHP), and 0.4% (KOWEPS). The APC was -10.5%, -14.2%, -12.2%, and -19.6%, respectively. Compared to last year, the rate of unmet healthcare needs has declined in general. However, the low-income and the elderly population were reporting the highest rate of unmet health care needs, and the disparity between lowest and highest groups were remained. These results suggest that adequate benefit coverage is needed for low-income and elderly population.

• Health Policy and Management
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• v.33 no.1
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• pp.107-113
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• 2023

Unmet healthcare is an important indicator for measuring accessibility of healthcare services. We analyzed the following four data from a nationally representative sample of South Korean population: Korea Health and Nutrition Examination Survey (KNHANES, 2007-2021), Community Health Survey (CHS, 2008-2021), Korea Health Panel Survey (KHP, 2011-2019), and Korean Welfare Panel Study (KOWEPS, 2006-2021). The proportion of individuals reporting unmet healthcare needs were 6.0% (KNHANES), 5.1% (CHS), and 13.1% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.4%, -9.4%, and -5.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES), 0.5% (CHS), 2.7% (KHP), and 0.4% (KOWEPS). The APC was -10.4%, -16.1%, -11.5%, and -19.1%, respectively. Compared to the previous year, the rate of unmet healthcare needs decreased slightly, but the rate of unmet health care needs due to cost tended to increase. Overall, higher rates of unmet healthcare needs were reported in the low-income and the elderly population. Although it was confirmed through the APC that the rate of unmet healthcare experience has decreased over the past decade, it can be seen that there is still a disparity by income level and age. These results suggest the need for an appropriate health benefit coverage policy for the low-income and the elderly.

• Health Policy and Management
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• v.20 no.2
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• pp.1-16
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• 2010

Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

• Perspectives in Nursing Science
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• v.6 no.1
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• pp.67-76
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• 2009

Recently, small and medium-sized hospitals which are located in rural areas have many difficulties in securing high quality nurses. That is because working environments for nurses in small and medium-sized hospitals in rural areas are poor compared with those of big hospitals in urban. As a result, the migration of nurses from small and medium-sized hospitals in rural areas to big hospitals in urban is continuously happening. In general, big hospitals provide nurses with high level of salary and fringe benefits. To prevent the migration of nurses, chief executive officers of small & medium hospitals in rural areas have been interested in improving nurses' working conditions including wages. Also, they have raised nurses' salary and improved working conditions. But, basically these individualized efforts have some limit. In connection with this, medical interest groups have produced various voices in terms of interpretation and solutions for these issues. However, from the future perspectives, it seems evident that two approaches for both manpower supply and demand plans of nurses are necessary. They should contain not only accurate estimation of the supply-demand of nursing manpower but also the improvement of working conditions and wages of nurses. Estimation of nursing manpower supply-demand depends on the standards and criteria being used. Supply and demand may be met or not in accordance with the points emphasized on the decision. In the articles, issues regarding nursing manpower, levels of salary, other working conditions and social support system for child care are discussed. According to Joe's report (2005), most health institutions did not meet the guidelines of nurse staffing in Medical Law. The wages of nurse vary on every hospital and there is a big difference in wages' range. The average starting salary for a nurse is 22 million won a year. In case of tertiary hospitals, it reaches up to 30 million won a year. Nurse as a profession should have a strong responsibility and should take care of the patients for 24 hours with three working shifts. Also, most of them are female who have the burden of child rearing. Therefore, it is suggested to increase the salary, to provide comfortable working conditions, and to have social support system for nurses with household affairs.

• The Journal of Korean Obstetrics and Gynecology
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• v.21 no.3
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• pp.132-142
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• 2008

Purpose: This research was designed to study that VEGA DFM 722 is proper index in postpartum women. Methods: The subjects were 81 postpartum women who admitted for postpartum care in Oriental Hospital of Woosuk University from 20, May 2005 to 28, October 2005 and 83 general women who taken Medical Health Examination from 29, January 2005 to 22, July 2006. The women took the test of VEGA DFM 722 and CBC. The SPSS 12.0 for windows was used to analyse the data and the independent samples t-test and paired samples t-test were used to verify the results. Results: The following results were obtained 1. The heights of zone 1, 2, 3 of postpartum women group significantly higher than that of general women group. The height of zone 6 of postpartum women group significantly higher than that of general women group. But, there were no significant differences in the heights of zone 4, 5, 7. 2. The heights of zone 1, 2, 3 of second test significantly lower than that of first test in postpartum women. But, there were no significant differences in the heights of zone 4, 5, 6, 7. Conclusion: The results suggest that postpartum women has upper heat and lower cold compared with general women. And after oriental postpartum care, disparity in upper heat and lower cold was decreased in postpartum women.

• Journal of the Korean Geographical Society
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• v.50 no.3
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• pp.325-338
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• 2015

Telemedicine, which gives or receives medical information via ICT (information and communication technology), is regarded as innovation in a medical field and its application is various according to offline conditions. For example, the utilization of telemedicine in Korea is unfair because of the administrative discretion, which is the basic unit of telemedicine for its practical operation, in spite of the same diagnostic area. With this mind, this study investigates the cause of regional differences of telemedicine through a case of Kangwon province. Furthermore, the crucial matter is that regional differences of telemedicine are associated with digital divide; therefore, this research considers digital divide triggered by telemedicine. The core results are as follows. First, there are little measures such as increase of the staff, economic compensation for public officials, education of telemedicine facilities; accordingly, only regions, where can accept these insufficient conditions, manage the telemedicine system. Second, the interesting of a mayor or a governor and a head of a health center as a highest decision maker has something to do with different utilization of telemedicine. Third, public health doctors play a role as practical operators in telemedicine, but their stance is skeptic about telemedicine somewhat because of the relationship with the medical association opposing the implementation of telemedicine, unimproved regional health care condition, etc. Forth, it seems that the digital divide caused by the regional differences of the present telemedicine utilization does not led to tangible results and is not turned to another disparity so far, the proper measures are required considering that various health care services based on telemedicine will be extended.

• Korean Journal of Health Education and Promotion
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• v.21 no.1
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• pp.297-317
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• 2004

As many precedent studies have shown, most children grow receiving influence from their parents. The purpose of this study was to serve as a basis for better preventive approach by finding out the relationship between the attention-deficit hyperactivity disorder(ADHD) of elementary school children and maternal behavior characteristics. Moreover, the purpose of this study was to present basic materials for developing program of children and create good relationship between child and parents for better education. For the purposes, two hypotheses were posed. Hypothesis 1： There would be a significant disparity in maternal behavior between the ADHD group and the non-ADHD group. Hypothesis 2： The environment could have an influence on maternal behavior characteristics. The subjects in this study were 71 mothers who had children with ADHD and 69 mothers who had non-ADHD, who selected from mothers of third to sixth graders in elementary school in Kyonggi, Suwon. The instruments used for the diagnosis of ADHD was DSA-IV. The data were analyzed with ANOVA(Analysis of Variance) by SPSSWIN Program. The findings of this study were as fellows： First, Hypothesis 1 was accepted. The mothers who had ADHD children had rejective behavior characteristics in while the mothers group who had non-ADHD children had controling behavior characteristics but there was no significant difference in affectionate attitude and autonomic attitude. Second, hypothesis 2 was accepted generally. The psychological and physical environment had correlation with maternal behavior characteristics. Especially, there was a significant correlational relationship between the maternal satisfaction for their life and rejection of maternal behavior. The following conclusion could be made from the above mentioned findings. First, The maternal behavior characteristics resulted in severe ADHD for children which justified the need of proper education for mothers to care children wellbeing. Second, The environment of psychology had an influence on maternal behavior. This showed that it is essential to develope educational program and counselling system for mothers

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.26-37
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• 2022

Purpose: Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. Methods: Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000-2006); (2) quality evaluation introduction stage (2008-2014); and (3) quality evaluation maturity stage (2016-2020). Results: The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. Conclusion: It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.

• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.198-215
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• 2018

Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combination of long-acting ${\beta}_2-agonist$/long-acting muscarinic antagonists (LABA/LAMA) as the first-line treatment option in the majority of symptomatic patients with COPD. This review provides an indirect comparison of available LABA/LAMA fixed-dose combinations (FDCs) through discussion of important efficacy and safety data from the key literature, with the objective of providing physicians with a framework for informed decision-making. LABA/LAMA FDCs provided greater benefits compared with placebo and similar or greater benefits compared with tiotropium and salmeterol/fluticasone in improving lung function, dyspnea, health-related quality of life, reducing rescue medication use and preventing exacerbations, although with some variability in efficacy between individual FDCs; further, tolerability profiles were comparable among LABA/LAMA FDCs. However, there is a disparity in the amount of evidence generated for different LABA/LAMA FDCs. Thus, this review shows that all LABA/LAMA FDCs may not be the same and that care should be taken when extrapolating individual treatment outcomes to the entire drug class. It is important that physicians consider the efficacy gradient that exists among LABA/LAMA FDCs, and factors such as inhaler devices and potential biomarkers, when choosing the optimal bronchodilator treatment for long-term management of patients with COPD.