• Journal of Digital Convergence
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• v.18 no.12
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• pp.445-457
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• 2020

The purpose of this study is to analyze various issues that may arise from the recent deregulation of telemedicine implemented by the government, propose initiative preparations for the implementation of telemedicine policies, and suggest implications for the basic conditions and direction of the deregulation of telemedicine. Recently, deregulation policy cases in telemedicine include that designation of a special zone for regulatory freedom in Gangwon Province, allowing physician-patient telemedicine and telephone counseling and prescription cases in the COVID-19 crisis. There are four main issues that could arise with the deregulation of telemedicine: safety, effectiveness, differences in access to health care and the economic industry, and legal responsibility. As a initiative preparation, this study proposed a pilot project for telemedicine and enhanced support for face-to-face care complementary tools, vitalizing remote co-operation, policy model that do not disrupt the medical delivery system, and legal maintenance. In conclusion, as a suggestion of basic premise and direction in the implementation of telemedicine deregulation, the implementation of initiative measures to address issues concerning telemedicine, the review and regulation of conditions to be considered in the implementation of telemedicine, and the establishment of a close communication and cooperative sturcture with medical providers.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.85-93
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• 2014

Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

• Molecular & Cellular Toxicology
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• v.3 no.3
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• pp.195-197
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• 2007

Currently praziquantel is used for treatment of not only clonorchiasis but also other trematodes and cestodes. But cure rate of praziquantel is just 60-80% for most trematodes. It needs for the treatment-failed patients to have more drugs. The cause of failure of treatment is not studied. We just know that the blood level of praziquantel is severely different among the people. We guess that this factor may influence the results of treatment. In an endemic area of human clonorchiasis in Heilongjiang Providence, China, 78 subjects were selected for the study. Three doses of 25 mg/kg (total 75 mg/kg) of praziquantel were administered to 78 clonorchiasis patients. After three weeks of treatment, stool examination was undertaken once again to confirm the cured and uncured subjects. To analyze SNP (single nucleotide polymorphism) of CYP3A5 PS2-1, CYP3A5 PS2-2, and CYP3A5*6, PCR method was done with specifically designed primers. The mutation rates of all sites were not significant statistically. The number of subjects was too small, so we need more subjects and other delivery proteins of bile ducts (ex. MRP etc.) were also considered for effects of praziquantel. We analyzed, for the first time, the entire CYP3A5 gene in a French population, using a polymerase chain reaction- single strand conformational polymorphism (PCR-SSCP) strategy.

• Health Policy and Management
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• v.28 no.1
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• pp.48-52
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• 2018

Background: The current study evaluated the hospital utilization and characteristics of patients who received health care services for acute cerebral infarction outside their own residential area. Methods: Using the 2014 national patient survey data, information on 2,982 patients diagnosed with acute cerebral infarction through emergency department were retrieved for the analyses. Multiple logistic regression was performed to investigate the characteristics associated with using hospitals outside residential area among patients diagnosed with acute cerebral infarction. Results: Fifteen point nine percent of patients admitted for acute cerebral infarction utilized hospitals outside their residential area. Patients residing in a province were 7.7 times more likely to utilize hospitals located outside their residential areas compared to those living in Seoul metropolitan city. Patients living in Gangwon and Jeolla were 0.26 times and 0.48 times more likely to go to hospitals in different geographical areas. Also, patients within the age group of 80 years and over were 0.65 times less likely to be admitted to hospitals outside their residential area compared to those in their 40s-50s. Conclusion: The use of hospitals outside patient's residential area is shown to be substantial, given that the acute cerebral infarction requires immediate recognition and treatment. The findings on the geographical differences in the hospital utilization suggest further investigation.

• Journal of Preventive Medicine and Public Health
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• v.52 no.5
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• pp.323-332
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• 2019

Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.

• Health Policy and Management
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• v.31 no.1
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• pp.91-99
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• 2021

Background: The Korean government introduced National Cancer Control Program and strengthening national health insurance coverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancer management such as patient concentration or time-to-treatment. Thus, we investigated the association between the time-to-treatment and survival of cancer patients, and compared regional differences by time trend. Methods: The data used in this study were national health insurance claims data that included patients diagnosed with lung cancer and received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for the association between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences for time-to-treatment by time trend. Results: A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30 days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30 days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, but it was generally reduced after 2010. Conclusion: Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improve cancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity and types of cancer.

• Journal of Korean Public Health Nursing
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• v.15 no.1
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• pp.27-41
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• 2001

The purpose of this study was to discern the level of satisfaction of postpartum care in hospitals. the level of importance of traditional postpartum care and the need for home health care for postpartum women. The study's design was to obtain data needed to develop a community-based postpartum care program and to improve the quality of nursing for postpartum care recipients. Data for the study was collected from 1 March to 31 June 2000 from 116 postpartum care recipients treated in Chung-Buk, Korea. Data analysis consisted of frequency, percentage, t-test, and ANOVA. using SPSS win program. The results the of analysis were as follows: 1) The level of satisfaction of postpartum care in the hospital (mean 1.31) was very low. The most laudable items of nursing care by category were: moderate satisfaction with 'perineal wound care' (2.04) and 'afterpain observation'(2.09). The overall level of satisfaction of postpartum care in the hospital. however, was very low. 2) Among other items of postpartum care in the hospital, 'postpartum exercise' $(25.9\%)$. 'assessment and support for postpartum depression' $(25.9\%)$, 'operation wound care for women who underwent Caesarean sections' $(24.5\%)$. and 'contraception and family planning' $(20.4\%)$ showed a need for home health care for postpartum care recipients above $20\%$. 3) The level of importance of traditional postpartum care (Sanhujori) was relatively high (mean 2.72). The importance of Sanhujori by category was as followed: 'the fourth principle: protecting the body from harmful strains' was the highest (2.88), 'the third principle: eating well', 'the first principle: invigorating the body by augmenting heat and avoiding cold', 'the second principle: resting without working', 'the fifth principle: keeping clean' and 'the sixth principle: handling with the whole heart' showed 2.85, 2.80, 2.70, 2.51 and 2.46 respectively. 4) The need for home health care with Sanhujori was very low. 5) The relationship between demographic factors and the level of satisfaction with postpartum care in the hospital was as follows: the satisfaction levels were significantly different among' delivery frequency' and 'health status' alteration after delivery'. 6) The relationship between demographic factors and the importance of the Sanhujori category was as follows: There were no significant differences in the level of importance of the first and the forth principle of Sanhujori. The level of importance of the second principle of Sanhujori was significantly different among 'income' and 'family type'. The level of importance of the third principle of Sanhujori was significantly different among 'having a boy'. The level of importance of the fifth principle of Sanhujori was significantly different among 'income' and 'feeding type'. The level of importance of the sixth principle of Sanhujori was significantly different among 'education background' and 'feeding type'. In conclusion. the findings of this study illustrate the nursing needs of postpartum care recipients. It provides a challenge to caregivers in the healthcare industry to develop a continuous postpartum care program and integrative postpartum care system that embodies the oriental and western paradigm for the promotion of women's health.

• Health Policy and Management
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• v.12 no.3
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• pp.1-22
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• 2002

Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

• Journal of Hospice and Palliative Care
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• v.22 no.3
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• pp.105-116
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• 2019

Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.

• Therapeutic Science for Rehabilitation
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• v.11 no.3
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• pp.93-106
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• 2022

Objective : The COVID-19 pandemic has brought non-face-to-face healthcare service delivery system. Research into telehealth system and its efficacy remains unclear. Methods : Seven healthy adults participated in this study to investigate effects of tele-monitoring with the speech-to-text (STT) application to induce changes in occupational activities on occupational balance in healthy adults. Subjects were requested to choose occupational activities they wanted to have researched and then register them to the STT application. The STT application provided an alarm to check whether the pre-registered activities were performed on time, and whether the subjects performed it by their voice. The subjects were followed for 1 week, with assessments at baseline, and after 1-week's tele-monitoring. Results : Our findings showed that the subjects were willing to participate in tele-monitoring with the STT application with high adherence and satisfaction. In addition, there was a significant improvement in occupational activities related to health (p<.05). Specifically, adherence, satisfaction, and efficacy of the tele-monitoring with the STT application could successfully bring occupational balance in short-term periods. Conclusion : These findings highlight that tele-monitoring with a smartphone could be considered as one promising way to restore occupational balance in lockdown after the COVID-19 outbreak.