• Proceeding of Spring/Autumn Annual Conference of KHA
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• 2008.11a
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• pp.327-331
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• 2008

In Korea, welfare needs brought on by the rapidly growing of elderly population. Also, the senior group with spare time, wealth and health is increasing. Currently, the people have known about needs welfare system for improving quality of life during senescence personally and socially. In addition to the senior friendly industry, having distinction with simple approach medical services, will be great expanding after 2010. And there will be a new welfare services plan supporting long term care insurance for senior citizens. But we don't have prepared systematically organized senior friendly industry and products yet. So, the purpose of the study is to analyze systematically the classification characteristics of the senior friendly products according to the difficulty of daily living for senior citizens. Above all, the study finds out the senior friendly products characteristics according to the consumer's various situations about health and housing space. Therefore the result of the study reveals that the simulation guidelines for choosing the products depend on the customer's needs are essential and useful to improve senior friendly industry. And the post evaluation data of senior friendly products would be put to practical use in the industry.

• Korean Medical Education Review
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• v.21 no.2
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• pp.80-91
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• 2019

The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

• Korean Journal of Hospice Care
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• v.1 no.1
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• The Korean Journal of Health Service Management
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• v.1 no.1
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• pp.59-74
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• 2007

Considering the characteristics of the Korean family which maintain a close connection with their patients from the moment of their falling sick to hospitalization to discharge, the family is the most important environmental factor of the social supporting system, and is the important object of the client as well as activity system. The medical social work intends to meet the practical needs of aged chronic patients, providing them and their family with a professional human service. The end of this study is to find out the hardships of both the aged chronic patients and their family as well as their needs for the social welfare service, and to search out the way of comprehensive social work service. The summary of the analysis of the survey is as follows: 1. The needs of aged chronic patients are divided into those of the solution of the problems of falling ill, social welfare program and discharge. Those needs arc affected by the various factors of the types of hospitals, the patients' age, the kinds of insurance, and the supporting systems, etc. Accordingly, the assessment of the needs of the patients are asked to be done comprehensively in accordance with the kinds of diseases and social environments. 2. The importance of the family to the aged chronic patients is evident. The family plays a decisive role in the patients' hospitalization and discharge, the family being an important supporting system and making it necessary to take an approach to client system. The family has difficulty in getting connection of community resources, in adapting to social life after the patient's discharge, and in paying the treatment. The family suffers the secondary hardships more than the burden of the treatment expenses. 3. For this reason various interventions are needed to reduce the stress caused by supporting and nursing patients. Thus the social welfare service for the aged chronic patients and their family needs the following prepositions: 1. It is the characteristics of the aged chronic patients that they need continuous care and that the strengths of the patients and their family cannot be too much emphasized, and that comprehensive assessment based on the connection 'with the community and the mutual interchange 'with the environment, is much emphasized. 2. The family of the aged chronic patient is a resources system as well as a client one. 3. Another characteristic of the aged chronic patients is that with the resources connection in mind, it needs an active intervention of social workers in the community. With these prepositions considered, the development of practical social work service for the aged chronic patients is thought urgently needed.

• Nutrition Research and Practice
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• v.18 no.2
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• pp.269-281
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• 2024

BACKGROUND/OBJECTIVES: The objective of this study was to compare dietary habits and mental health among middle school students in urban and rural areas based on bedtime, and to provide evidence supporting appropriate bedtime for Korean middle school students in relation to their healthy dietary habits and mental well-being. SUBJECTS/METHODS: The study population consisted of 25,681 second-year middle school students who participated in the Korea Youth Risk Behavior Survey in 2020-2022. Participants were asked about their bedtime and wake-up time during the past 7 days and were classified into five categories. The study compared the general characteristics, academic factors, dietary habits, and mental health of urban and rural students based on their bedtime. RESULTS: Bedtime was found to be later in the following order: urban female students, rural female students, urban male students, and rural male students. As bedtime got later, the rates of smoking and alcohol consumption increased. Students who went to bed before 11 p.m. had lower academic performance, while rural male students who went to bed after 2 a.m. had lower academic performance. Later bedtime was associated with increased smartphone usage, skipping breakfast, consuming fast food, and drinking carbonated beverages. Later bedtime was also associated with higher perceived stress levels, particularly among students who went to bed after 2 a.m., higher rates of suicidal ideation, experiencing sadness and despair, as well as the prevalence of clinically significant anxiety disorders. CONCLUSION: These results suggest that middle school students who go to bed too late have higher rates of smoking and alcohol drinking, as well as unhealthy eating habits, stress, suicidal ideation, sadness, and anxiety. Therefore, it is necessary to provide educational and social institutional support to promote adequate sleep for the health of adolescents.

• Korea Journal of Hospital Management
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• v.28 no.3
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• pp.1-14
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• 2023

Purposes: It is very important to establish a clinical data warehouse based on a common data model to offset the different data characteristics of each medical institution and for drug surveillance. This study attempted to establish a clinical data warehouse for Dankook university hospital for drug surveillance, and to derive the main items necessary for development. Methodology/Approach: This study extracted the electronic medical record data of Dankook university hospital tracked for 9 years from 2013 (2013.01.01. to 2021.12.31) to build a clinical data warehouse. The extracted data was converted into the Observational Medical Outcomes Partnership Common Data Model (Version 5.4). Data term mapping was performed using the electronic medical record data of Dankook university hospital and the standard term mapping guide. To verify the clinical data warehouse, the use of angiotensin receptor blockers and the incidence of liver toxicity were analyzed, and the results were compared with the analysis of hospital raw data. Findings: This study used a total of 670,933 data from electronic medical records for the Dankook university clinical data warehouse. Excluding the number of overlapping cases among the total number of cases, the target data was mapped into standard terms. Diagnosis (100% of total cases), drug (92.1%), and measurement (94.5%) were standardized. For treatment and surgery, the insurance EDI (electronic data interchange) code was used as it is. Extraction, conversion and loading were completed. R language-based conversion and loading software for the process was developed, and clinical data warehouse construction was completed through data verification. Practical Implications: In this study, a clinical data warehouse for Dankook university hospitals based on a common data model supporting drug surveillance research was established and verified. The results of this study provide guidelines for institutions that want to build a clinical data warehouse in the future by deriving key points necessary for building a clinical data warehouse.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• Journal of agricultural medicine and community health
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• v.31 no.3
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• pp.219-236
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• 2006

Objectives: To develop a model of a official management system for agricultural disease, injury and accidents, We analyzed current Korean status and management system about occupational injury and accident of farmers. Methods: For national management systems of industry safety and health and current status of occupational injuries and accidents of farmers, related literature such as books, theses, articles, and web documents were collected and analyzed. Results and Conclusion: The regulations of protecting occupational injury and accidents of farmers are suggested as follows: (1)insurance and compensation act for occupational injury and accident of farmers, (2)setting standards of occupational injuries and accidents of farmers, (3)mandating the usage of safety devices for agricultural vehicles and equipments, (4)reporting occupational injuries and accidents that occur among farmers, (5)registering pesticides and assessing safety usage, (6)implementing safety training, (7)supporting personal protective equipments and agricultural safe facilities etc.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.23-34
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• 2016

South Korea's state health insurer, the National Health Insurance Service (NHIS), is in the process of a compensation suit against tobacco industry. The tobacco companies have habitually endeavored to ensure favorable outcomes in litigation by misusing scientific evidence or recruiting scientists to support its interests. This study analyzed strategies that tobacco companies have used during the NHIS litigation, which has been receiving world-wide attention. To understand the litigation strategies of tobacco companies, the present study reviewed the existing literature and carried out content analysis of petitions, preparatory documents, and supporting evidence submitted to the court by the NHIS and the tobacco companies during the suit. Tobacco companies misrepresented the World Health Organization (WHO) report's argument and misused scientific evidence, and removed the word "deadly" from the title of the citation. Tobacco companies submitted the research results of scientists who had worked as a consultant for the tobacco industry as evidence. Such litigation strategies employed by the tobacco companies internationally were applied similarly in Korean lawsuits. Results of tobacco litigation have a huge influence on tobacco control policies. For desirable outcomes of the suits, healthcare professionals need to pay a great deal of attention to the enormous volume of written opinions and supporting evidence that tobacco companies submit. They also need to face the fact that the companies engage in recruitment of scientists. Healthcare professionals should refuse to partner with tobacco industry, as recommended by Article 5.3 of the WHO Framework Convention on Tobacco Control.