• 동의생리병리학회지
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• 제29권5호
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• pp.386-393
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• 2015

Bian-zheng(辨證) of Korean Medicine(KM) is based on four examinations(四診) of Korean medical doctor. The interrogation or questioning(問診) provides the most information of four examinations. The symptom obtained from the interrogation or questioning is the main basis of the Bian-zheng. KM is understood in the whole state of the body of a specified time without seeing the disease exist. So the observable symptom is disease itself. Symptom in KM is used as an important basis for the diagnosis. But if the interview when memories are not sure of the correct answer does not get much easier to find exactly the symptoms. So when recording original symptom(素證) and daily subjective symptom can be helpful for care. In this paper, we propose daily living symptom record system as a method that can be applied to the health care according to the importance of collecting the symptom in the KM. Daily living symptom record system can record the symptom in the individual to awaken daily. The system stores the symptom in structure and provides an open shared services. So it can be used as a symptom of other systems, such as PHR, EMR, CDSS. In addition, Doctor may be able to help in the treatment determined by reference to shared symptom.

• 한국치위생학회지
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• 제20권5호
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• pp.707-716
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• 2020

Objectives: This study aims to provide basic data for high-quality dental services. In addition, we will promote the operation of preventive dentistry that implements preventive measures. It was conducted to study the change of patient's treatment behavior and treatment cost due to the discontinuation of preventive dentistry in university dental hospitals. Methods: This study collected data using the integrated medical information system of the C University Dental Hospital. From September 1, 2017 to August 31, 2019, data were analyzed using frequency, percentage, mean, standard deviation, chi-square test using SPSS version 24.0 statistical program, and T-test. Results: There was a significant difference in the number of preventive dental treatment cases from 58.3% of preventive dental operation periods to 41.7% of preventive dental operation periods. As a result of comparing the medical expenses, the total medical expenses during the preventive dental operation period decreased from 521,308,872 won to 379,724,995 won during the discontinuation period, 141,583,877 won. The number of medical treatments by treatment behavior decreased 3,835 (28.4%) from a total of 13,520 preventive dental operation periods to 9,685. Conclusions: This study is meaningful as the first study to confirm the change in the treatment behavior and the change in the cost of treatment due to the discontinuation of the operation of preventive dentistry at university dental hospitals. In conclusion, it is thought that there is a possibility of the lack of accessibility and the limitation of professional preventive care due to the discontinuation of preventive dentistry.

• 보건의료산업학회지
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• 제3권2호
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• pp.29-43
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• 2009

The purpose of this study is to provide basic material about the improvement method of the hospital evaluation system by grasping recognition, corresponding behavior to evaluation, influence and problems about the hospital evaluation system with respect to the employee of mid sized hospitals having relatively poorer environment. In this study were used 518 questionnaires to hospital employee working at 20 general hospitals in Pusan, Kyungnam with less than 500 beds and having experience of the hospital evaluation during 2005~2007. As a result of the research, they felt the investigation tool used for the hospital evaluation has too many items and it could be difficult to reflect characteristics of each hospital. It appeared that utilization of the report result after the hospital evaluation was helpful for grasping a part necessary for hospital improvement and the present level of hospitals and increase of interest about medical service quality improvement of the a hospital director or hospital employee. They trusted the result of the hospital evaluation to some degree, and recognized it helps the patients to select a hospital and increase rights-to-know. Hospital employee recognized the necessity and showed high interest and participation, but they didn't sympathize in the propriety and the feasibility of the hospital evaluation items. High degree evaluated hospital employee receive hospital evaluation system positively and think hospital services to be improve after taking hospital evaluation. The hospital evaluation should make the hospital to effort to achieve medical quality improvement to its purpose. Also, systematic reformation will be necessary to reflect characteristics of the hospital that has relatively small scale or locates in poor environment.

• 인터넷정보학회논문지
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• 제15권5호
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• pp.33-41
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• 2014

본 연구는 효과적인 SNS의 교육적 활용 방안을 제안하고자 SNS의 사용률이 높은 대학생들을 대상으로 구체적인 SNS의 교육적 활용 방법에 대한 의견과 그 이유에 대해 조사하였다. NVivo S/W를 이용하여 개방형 응답을 분석하였으며, 교육 주체별 SNS의 교육적 활용 방법을 가시화 하고자 교수자 영역과 학습자 영역, 공통 영역으로 범주화 하였다. 그 결과 공통 영역에는 의견 교류 및 토론, 정보 공유, 학습내용에 대한 질의응답, 설문조사, 친밀감 형성, 상담 등이 포함되었으며, 교수자 영역에는 공지사항 전달, 수업자료 제공, 실시간 평가(퀴즈), 출석 체크, 과제평가 및 피드백 등이 포함되었고, 학습자 영역에는 과제활동(그룹별/개인별), 공유자료를 이용한 예습 및 복습, 동영상을 이용한 자율학습, 과제에 대한 동료평가 및 피드백, 강의 평가 등이 포함되었다.

• 아동학회지
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• 제2권
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• pp.83-103
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• 1981

1. Outline of the Study A boom of baby hotels is taking place in Japan. Baby hotel means day care centers that renders services day and night for babies of working mothers. These baby hotels are thriving because many mothers welcome the system because of their needs. However, accidents occurred in a row recently and therefore baby hotel has suddenly become a social issue. According to the ministry of health welfare, there are 587 baby hotels in Japan accommodating about 10,000 children and they are mostly located around amusement centers. The reasons that these baby hotels thrive in spite of the fact that there are 22,000 day care centers in Japan are : (1) shortage of day care centers compared to the needs (2) most centers do not take in babies below 1 year. This study aims to describe the present status of the baby hotels and the background of the phenomena that made it possible for them to thrive with no permission from the government. This study mostly deals with the phenomena in Tokyo. 2. Day Care Policy in Japan and the Problems of Baby Hotels The present review deals with the problems from the following 6 dementions. (1) the shortage of day care centers (2) inadequate system for the care of babies (3) inadequate daily hours of day care centers (4) Unflexable enrollment system of day care centers (5) imperfect enfollment process & guidelines (6) lack of alternative institutions 3. Result The Ministry of Health & Welfare affered the following ways to cape with the problems of baby hotels : (1) restraint of the baby hotels (2) utilization of existing day care centers for the care of babies. In my opinion, these suggestions seem too superficial in solving the problems. I would rather suggest that the Japanese government review the whole system of child welfare administration. The Child welfare Law of Japan made a clear statement in its article 24 that, "if day care centers are not available, alternative institution for proper care of children must be sought for." My suggestions for the alternative care are : (1) public nursing rooms (2) family day care (3) extention of kindergarten hours (4) foster family care.

• Journal of East Asia Management
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• 제3권2호
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• pp.21-41
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• 2022

This study aims to analyze the characteristics of the management situation of the Korea Railroad Corporation(KORAIL) through the management innovation process of the KORAIL and to suggest its implications for military application. Despite stable demand, the railway passenger industry had the limitation of not being able to abolish deficit routes due to public service obligations. In addition, the launch of the Suseo High-Speed Line has introduced a competitive system, posing a threat to corporate management. KORAIL wanted to overcome this crisis by innovating its management through the utilization of big data, improvement of the freight business, decentralization of demand, the introduction of tourism railroads, and development of station influence areas. By utilizing big data, KORAIL was able to optimize the railway fare system while reducing fixed costs spent on railway maintenance. It also drastically reduced the station of cargo and created a base station to pursue economies of scale. On the other hand, the existing exclusive station system was abolished to solve the chronic saturation of the downtown area, and the railway demand was moved to Gwangmyeong Station and Suwon Station to optimize the passenger supply. In particular, it developed a new business model called the tourism railway by developing the mountain Byeokjin Line, which was a chronic deficit line, and sought to improve liquidity through the development of the station influence area. Such a process of innovation at KORAIL suggests an appropriate direction in seeking ways to innovate the military medical institutions. First of all, the necessity of improving organizational immersion through the development of a personnel structure suitable for the compulsory organization, while expanding the facilities of the division and corps, and reducing the time required for medical treatment and waiting through the establishment of a data-based medical system was suggested. Next, it was also discussed to integrate the National Health Medical College, which received accreditation as a medical facility through the designation of advanced general hospitals and is ultimately under discussion with the Medical Institution. Through this, we hope that the military medical institutions, which are facing various challenges, will overcome existing limitations and be re-lighted as innovative institution that provides comprehensive public health services.

• 가정∙방문간호학회지
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• 제6권
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Journal of Preventive Medicine and Public Health
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• 제27권1호
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• pp.117-134
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• 1994

대구직할시 남구 1 개동 주민을 대상으로 도시 지역의료보험 실시 전후(이하 실시 전후)의 의료 이용양상을 파악하기 위하여 실시 6개월 전인 1989년 1월에 1차조사를 하였고, 실시 1년 6개월 후인 1991년 1월에 2차조사를 하였다. 1차조사의 대상자는 1,230가구 4,939명이 었으나, 2차추적조사가 가능했던 인구는 519가구 2,277명 (추적률:46.1%)이었다. 2차조사까지 추적이 가능했던 2,277명 중 1차 조사시 보험에 가입되지 않았던 240가구 1,033명을 코호트 I군(이하 I군)으로 하였고, 1차조사시 보험에 가입되었던 279가구 1,244명을 코흐트 II군(이하 II군)으로 구분하여 조사자료를 분석하였다. 인구 1,000명당 급성이환으로 인한 의사방문율의 변화는 실시 후에 I군에서 16.5 증가한 반면, II에서는 2.4만 증가하였으며, 만성이환에서도 I군이 13.5 증가하였으나 II군은 7.2만 증가하였다. 이환 및 활동제한 의료필요 충족률도 I군에서 실시 후 뚜렷히 증가하였다. 월가구소득별 급성이환에 의한 의료필요충족률은 I군에서 40만원미만군이 1.6으로 $40{\sim}99$만원군의 4.0과 100만원이상군의 49.3에 비해 월등히 낮았다. 이러한 소견은 나머지 조사대상군과 만성이환에서도 동일하였다. 급성과 만성이환자의 병원이용 이유는 유용성, 의원의 경우는 지리적 접근성이 실시전후모두에서 가장 많았고 약국이용 이유 중 실시 전에는 접근성과 의료비지불성이 중요하였으나, 실시 후에는 의료비지불성의 중요성은 상대적으로 감소하였다. 최근 15일간 의사방문여부를 종속변수로한 multiple logistic regression analysis에서 급성이환(+), 만성이환(+) 그리고 월가구소득(+)이 실시전후 모두에서 유의한 변수였다. 실시 후 부과된 보험료에 대한 불만족률이 두군 모두 지역의료보험 가입자에서 각각 81.0%와 74.1%로 타 의료보험가입자에 비해 월등히 높았다. 실시 후 병원과 의원의 의료비와 서어비스에 불만족스럽다고 응답한 사람이 I군에 비해 II군에서 더 많았다. 이상의 소견으로 의료보험이 실시됨으로 미충족의료수요를 감소시키는 효과를 가져왔으나 실시 후에도 저소득층의 의료이용률이 고소득층에 비해 여전히 낮아 의료보험실시로 경제적 장애가 감소하였음에도 불구하고 본인부담금 등으로 인한 경제적 장애와 의료기관을 방문하는데 소요되는 시간, 대기시간 등 의료이용을 저해하는 요인이 남아있어 의료이용의 형평이 사회계층들간에 완전히 이루어지지는 않았다. 특히 만성이환의 경우, 불균형이 심하였다. 또한, 부과된보험료에 대한 불만족도가 높아 현행 보험료선정기준의 재평가 및 공정성을 향상시킬 필요성이 제기되었다.

• 농촌의학ㆍ지역보건
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• 제28권1호
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• pp.53-66
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• 2003

본 연구는 2002년 2월 한 달 동안 전국 보건지소에 근무하는 공중보건의사 1,036명을 대상으로, 보건지소의 전반적인 의료서비스 제공여건과 지역사회를 기반으로 이루어지고 있는 보건사업의 수행 현황을 조사하고, 보건사업의 기획, 수행, 평가의 각 단계별 참여 현황과 지역보건사업에 대한 견해 및 관련특성 등을 파악하고자 하였다. 보건지소의 전반적인 의료여건으로는 근무하는 의사수가 1명 내지 2명인 경우가 98.7%였고, 의사 이외의 직원수는 3명 이내인 경우가 89.7%였다. 보건지소 관할 구역인 읍 면단위에서 보건지소 이외에 다른 의료기관이 있는 경우가 45.9%였고, 이 경우 해당 의료기관까지의 소요시간은 도보로 평균 5분정도였다. 보건지소의 33.5%가 의약분업제도 시행지역에 위치하고 있었고, 보건지소 이외에 타 의료기관이 있는 지역 중 의약분업을 시행하는 곳은 68.8%였다. 평균 1일 진료건수는 2000년 5월 18.0${\pm}$15.6건에서 2001년 11월 14.8${\pm}$14.8건으로 점차 감소하는 추세였으며, 특히 의약분업 실시 지역인 경우 감소정도가 크게 나타났다. 보건지소에서 이루어지고 있는 보건사업은 예방접종사업이 96.7%로 가장 높았고 보건교육이 76.5%로 가장 낮았으며, 각 사업의 기획 및 평가단계에 관여하는 경우는 예방접종사업과 방문보건사업이 각각 49.5%, 49.1%로 높게 나타난 반면 전혀 관여하고 있지 않은 경우가 29.6%였다. 보건사업의 세부 항목별 참여에서는 예방접종예진, 방문보건사업대상자 방문, 근무지역내 학교 수 인지도가 각각 94.2%, 81.5%, 75.5%로 높게 나타났으며, 보건사업의 기획, 수행, 평가의 각 단계별 참여는 평균적으로 수행 단계가 61.8%로 높게 나타났고, 기획 단계가 34.8%, 평가 단계가 22.6%로 나타났다. 보건지소에서 이루어지는 지역보건사업이 주민 보건향상에 긍정적인 효과를 나타낼 것이라고 보는 견해가 55.8%, 지역보건향상에 공중보건의사의 역할을 긍정적으로 보는 경우가 37.6%, 지역보건사업에 참여 의사가 있는 경우가 58.7%로 나타났다. 현재 농어촌 지역에서 보건지소의 단순진료실적이 감소하고 있는 상황인 반면 보건지소의 지역보건사업 중추기관으로서의 요구가 증가되고 있다. 주로 진료 위주의 역할에 국한되었던 공중보건의사를 보건사업 인력으로 활용하여 지역보건사업 인력 확충 및 전문화 등 지역보건사업의 양적 질적 향상을 도모할 수 있을 것이다. 아울러 공중보건의사에 대한 지속적인 보건사업 관련 교육 및 보건사업 참여에 대한 동기부여를 통해 지역보건사업의 수행단계에 수동적으로 참여하는 단계에서 기획 및 평가 단계에까지 능동적으로 참여하게끔 유도하는 정책적인 지원이 필요할 것으로 사료된다.

• 한국인구학
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• 제11권2호
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• pp.33-53
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• 1988

This study aimed at developing a desirable family planning policy and strategy by examining the current status of family planning practice in rural Korea and by indentifying the crucial factors which affect fertility control behavior. For this purpose, an analytical study was conducted, using the survey data collected in July 1985, on an interview basis, on 1, 440 married women living in the Soyi, Wonnam and Maingdong townships of Eumseong County(in North Chungcheong Province). This study population has the typical characteristics of rural areas, and the results of the analysis can be summarized as follows: 1. In regard to the demographic characteristics of the study population : their average age at marriage was 23.7, they had an average of 2.6 children( 1.3 boys, 1.3 girls) :10% experienced the death of their child (ren) :14% had spontaneous abortion(s) :4% weathered stillbirth(s) :35% went through induced abortion (s) : and 5.5% were currently pregnant. The average of their ideal numbers of children was 2.2, while 44% felt that they must have a son. 2. Looking at the contact rate with medical & health institutions, over the past 1 year, the visit rate to health subcenters was 43.7%, while 26.9% visited the (county) health center :59.6% had been to private clinics : and 41.5% went to the Soonchunhyang - Eumsung hospital : thus showing a relatively high rate of accessibility. 3. The utilization rate of family planning services was 76.5%, with tubectomy being the most prominent method at 52.3%, while the informants were health workers in 54.2% of the acceptors. Of the 8.4% who discontinued the use of contraceptive methods, only 26% did so due to want for pregnancy, natural infertility (meno - pause), or other reasons, while the remaining 74% stopped usage on account of side effects, failure in the methods themselves, and inconvenience of use, thus pointing to a situation where the proper choice of family planning methods have not yet been made. It can be noted that there is a strong motivation for early birth stopping as 35.3% practice family planning even with only one child, of which 38.3% have had sterilization operations. According to results of a multiple regression analysis, among the variables affecting contraception usage the most significant variable was the number of sons. 4. 34.8% experienced induced abortions. It was shown as a result of multiple regression analysis that the number of children and attitudes toward induced abortions extensively affected their frequency of abortions conducted. 5. In the regard to the relation between family planning and induced abortions, 33.7% of the women used both, while 52.0% of them used only the former(family planning), with only 1.4 % utilizing solely the latter(abortion), and 12.9% totally abstaining from fertility regulation : again, the discriminant analysis indicated that the choice of family planning and/or induced abortion was determined by the number of children and attitudes toward induced abortion. In view of the above mentioned results, the following are some comments and suggestions concerning problems related to the current family planning policies, in Korea : 1. It is difficult to expect a further quantitative expansion in family planning program operations, as there has been an excessive supply of target-oriented sterilization operations on women. From a maternal and child health care point of view, it will be desirable to have a diversification of service points in the future where family planning methods may be properly chosen, so that choices of methods which suit the mothers' characteristics and tastes may be made by the individuals themselves by strengthening their quality of family planning information services. 2. Along with the strengthening of the qualitative improvement of family planning services policies must be implemented to effectively promote the moral (ethical) deterrents to induced abortions and to preference for sons. From a maternal care standpoint, the social permissive norm toward induced abortion must be modified, and the bias towards son must be analyzed as the women with more daughters have a lower rate of family planning acceptance. Such changes in attitudes, however, can not be hoped to be accomplished with ad hoc policies, but will only be possible when an enhancement of the women's status(within the society) is brought about in a long - term perspective.