• 한국병원경영학회지
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• 제27권1호
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• pp.1-10
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• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

• 보건행정학회지
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• 제33권1호
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• 한국환경보건학회지
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• 제25권3호
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• pp.1-6
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• 1999

This study was conducted to survey trihalomethane(THMs) levels in finished water of J water treatment plant and examine its reduction by powder activated carbon(PAC) treatment. Samples were collected weekly based and head-space technique was employed to determine THMs levels by G.C-ECD. THMs levels in finished waters were highest in August and showed close relationship with water temperature. All the samples satisfied the drinking water limit(100 ${\mu}$g/l) for THMs. The individual formation rates of THMs were 64.8% for CHCl$_3$, 28.4% for CHCl$_2$BR, 6.5% for CHClBr$_2$ and 0.3% for CHBr$_3$, respectively and showed little monthly difference. The reduction efficiency of THMs formation by PAC treatment was 67% during July and August. Bromine substituents were more efficiently reduced than CHCl$_3$ by PAC.

• 여성건강간호학회지
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• 제23권2호
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• pp.78-88
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• 2017

Purpose: This study aimed to understand meaning and essentials in work experiences of delivery room nurses. Methods: A phenomenological perspective was used for this qualitative research. Ten delivery room nurse with more than 3 years of work experience participated in this study. Data were collected through individual in-depth interviews with the nurses, between December 2012 and April 2013. Data were analyzed using Colaizzi's method. Results: Nine theme clusters and four categories emerged from the data as follows: 1) factors influencing career decision-making, 2) gap between reality and expectations, 3) difficulties with working in the delivery room, and 4) motivation to work in the delivery room. Conclusion: Based on the results of this study, strategies to improve working environment of the delivery room nurses are necessary. Also, better policy are required to firmly establish the role of the delivery room nurses' role as recognized professionals.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1996년도 제48차 추계 학술대회 연제집
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• pp.273-274
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• 1996

• 한국안전학회지
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• 제31권3호
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• pp.162-167
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• 2016

As the simple empirical and phenomenological model applied to the analysis of leakage and explosion of chemical substances does not regard numerous variables, such as positional density of installations and equipment, turbulence, atmospheric conditions, obstacles, and wind effects, there is a significant gap between actual accident consequence and computation. Therefore, the risk management of a chemical plant based on such a computation surely has low reliability. Since a process plant is required to have outcomes more similar to the actual outcomes to secure highly reliable safety, this study was designed to apply the CFD (computational fluid dynamics) simulation technique to analyze a virtual prediction under numerous variables of leakages and explosions very similarly to reality, in order to review the computation technique of the practical safety distance at a process plant.

• 한국안전학회지
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• 제28권1호
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• pp.109-116
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• 2013

The objective of this study is to develop a new system that is simpler to be used to keep the safe workplace at the small food manufacturers which employees less than 10 persons. The number of these small food manufacturers is 13,853 and account for almost 80% of all food manufacturers. Most of these companies do not pay attention to safety and thus keep high accident potential. It is very important to persuade these companies to manage safety but they can hardly handle the complicated requirements of safety, health, quality, food quality, and musculoskeletal disorders intervention. This system is intended to develop a system which can be easily implemented but comprehensive to reflect main points in safety management, musculoskeletal disorders intervention,. ISO 9001, ISO 14001, KOSHA 18001, GAP and ISO 22000.

• Structural Monitoring and Maintenance
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• 제11권2호
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• pp.149-171
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• 2024

Drive-by monitoring (also known as indirect monitoring or mobile sensing) of bridges has obvious advantages when compared to other approaches of Structural Health Monitoring. The underlying concept involves leveraging the coupling between the vertical vibrations of the bridge and those generated in the passing vehicle. In this scenario, the vehicle serves as both the initiator and recipient of the vibrations, which can provide information on the structural condition of the bridge. In the literature, a wide range of methods has been proposed, primarily focused on highway bridges. However, limited research has been published to assess the suitability of indirect methods for monitoring railway bridges, bounded to numerical studies based on theoretical simulations and, rarely, on experimental investigations. The aim of this work is to contribute to filling this gap and explore the feasibility of implementing drive-by monitoring for railway bridges using in-service vehicles and discuss its potential applicability, from theoretical and practical point of view, with illustration through real case studies from the Moroccan railway network.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.127-134
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• 2005

Purpose: Currently, there is a variety of systems available for predicting prognosis of trauma patients such as trauma score, Injury severity score (ISS) and acid-base variables. But it is not clear that the initial acid-base variables are predictors of prognosis in trauma patients at the emergency department. The objective of this study is to compare the base deficit, lactate and strong ion gap as an early predictor of mortality in trauma patients. Methods: Retrospective record review of 136 trauma patients needed to admit to intensive care unit via emergency department (June 2004 to February 2005). Data included age, injury mechanism, ISS, Revised trauma score (RTS), Multiple organ dysfunction score (MODS), Acute physiology and chronic health evaluation III (APACHE III), Glasgow coma scale (GCS), laboratory profiles, calculated anion gap and strong ion gap. Patients were divided into survivors and non-survivors, shock group and non-shock group with comparison by t-test;significance was assumed for p<0.05. Correlation between acid-base variables and mean arterial blood pressure (MABP) was evaluated. Results: There was a significant difference between the RTS (p=0.00), APACHE III (p=0.00), MODS (p=0.00), GCS (p=0.00) of survivors and non-survivors. There was no significant difference between the ISS (p=0.082), lactate (p=0.541), base excess (p=0.468) and SIG (p=0.894) of survivors and non-survivors. There was a significant difference between the RTS (p=0.023), APACHE III (p=0.002), lactate (p=0.000), base excess (p=0.000) and SIG (p=0.000) of shock and non-shock group. There was no significant difference between the ISS (p=0.270), MODS (p=0.442) and GCS (p=0.432) of shock and non-shock group. The base excess was most correlated to MABP (r2=0.150). Conclusion: Initial base deficit, serum lactate and SIG are not predictors of mortality in moderate to severe trauma patients. Initial base deficit, serum lactate and SIG are correlated with the mean arterial blood pressure in trauma patients in emergency department.

• 보건행정학회지
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• 제24권3호
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• pp.205-218
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• 2014

Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.