• Title/Summary/Keyword: Institutional arrangements

Search Result 83, Processing Time 0.028 seconds

Analysis of Status and Success Factor of Referral and Return of Patients to Clinics: Focusing on Patients with Endocrinology and Cardiology at a General Hospital in Goyang (진료회송 사업 현황 및 성공요인 분석: 고양시 소재 종합병원급 내분비내과와 심장내과 환자를 중심으로)

  • Park, Hee Sun;Choi, Jung Kyu;Tae, Eun Sook;Choi, Sang Gil;Kim, Eui Hyeok
    • Health Policy and Management
    • /
    • v.32 no.3
    • /
    • pp.323-329
    • /
    • 2022
  • Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

Analysis of the Status and Future Direction for Digital Therapeutics in Children and Adolescent Psychiatry

  • Haemi Choi;Bora Kim;Insoo Kim;Jae-Gu Kang;Yoonjae Lee;Hyowon Lee;Min-Hyeon Park
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.34 no.4
    • /
    • pp.192-203
    • /
    • 2023
  • Digital therapeutics based on software, such as artificial intelligence, virtual reality, games, and smartphone applications, are in the spotlight as new therapeutic alternatives in child and adolescent psychiatry. It draws attention to overcoming conventional therapeutics' limitations, such as toxicity, cost, and accessibility, and encourages patients to participate in the treatment attractively. The growth potential of the digital therapeutics market for psychiatric disorders in children and adolescents in Korea and abroad has been highlighted. Clinical studies and Food and Drug Administration approvals for digital therapeutics have increased, and cases approved by the Ministry of Food and Drug Safety have emerged in Korea. As seen above, digital transformation in child and adolescent psychiatry will change treatment paradigms significantly. Therefore, as this new field has just begun to emerge, it is necessary to verify the effectiveness and scope of the application of digital therapeutics and consider preparing a compensation system and institutional arrangements. Accordingly, this study analyzed the development trends and application status of digital therapeutics in children and adolescents and presented limitations and development directions from the perspective of application in healthcare. Further, the study is expected to identify the utility and limitations of digital therapeutics for children and adolescents and establish effective application measures.

A Study Consequence Management System of the Terrorism (테러리즘의 대응관리체제에 관한 고찰 - "9. 11 테러"를 중심으로 -)

  • Kim, Yi-Soo;Ahn, Byung-Soo;Han, Nam-Soo
    • Korean Security Journal
    • /
    • no.7
    • /
    • pp.95-124
    • /
    • 2004
  • It can be said that 'the September 11th Terrorist Attacks' in 2001 were not only the indiscriminate attacks on innocent people but also the whole - political, economical and military - attacks on human life. Also, 'the September 11th Terrorist Attacks' can be regarded as the significant events in the history of world, which were on the peak of the super-terrorism or new-terrorism that had emerged from the 1980s. However, if one would have analysed the developments of terrorism from the 1970s, they could have been foreknown without difficulty. The finding from this study can be summarized as the followings, First, in spite that the USA responsive system against terrorism had been assessed as perfect before 'the September 11th Terrorist Attacks', the fragilities were found in the aspects of the response on the new-terrorism or super-terrorism. The previous responsive system before 'the September 11th Terrorist Attacks' had the following defects as the followings: (1) it was impossible to establish the integrated strategy, because the organizations related to the response against terrorism had not integrated; (2) there were some weakness to collect and diffuse the informations related to terrorism; (3) the security system for the domestic airline service in USA and the responsive system of air defense against terrors on aircraft were very fragile. For these reasons, USA government established the 'Department of Homeland Security' of which the President is the head so that the many organizations related to terrorism were integrated into a single management system. And, it legislated a new act to protect security from terrors, which legalized of the wiretapping in spite of the risk of encroachment upon personal rights, increased the jail terms upon terrorists, froze the bank related to terrorist organization, and could censor e-mails. Second, it seem that Korean responsive system against terrors more fragile than that of USA. One of the reasons is that people have some perception that Korea is a safe zone from terrors, because there were little attacks from international terrorists in Korea. This can be found from the fact that the legal arrangement against terrorism is only the President's instruction No. 47. Under this responsive system against terrorism dependent on only the President's instruction, it is expected that there would be a poor response against terrors due to the lack of unified and integrated responsive agency as like the case of USA before 'the September 11th Terrorist Attacks'. And, where there is no legal countermeasure, it is impossible to expect the binding force on the outside of administrative agencies and the performances to prevent and hinder the terrorist actions can not but be limited. That is to say, the current responsive system can not counteract effectively against the new-terrorism and super-terrorism. Third, although there were some changes in Korean government's policies against terrorism. there still are problems. One of the most important problems is that the new responsive system against terrorism in Korea, different from that of USA, is not a permanent agency but a meeting body that is organized by a commission. This commission is controled by the Prime Minister and the substantial tasks are under the National Intelligence Service. Under this configuration, there can be the lack of strong leadership and control. Additionally, because there is no statute to response against terrorism, it is impossible to prevent and counteract effectively against terrorism. The above summarized suggests that, because the contemporary super-terrorism or new-terrorism makes numerous casualties of unspecified persons and enormous nationwide damages, the thorough prevention against terrorism is the most important challenge, and that the full range of legal and institutional arrangements for the ex post counteraction should be established. In order to do so, it is necessary for the government to make legal and institutional arrangements such as the permanent agency for protection from terrorism in which the related departments cooperates with together and the development of efficient anti-terror programs, and to show its willingness and ability that it can counteract upon any type of domestic and foreign terrorism so that obtain the active supports and confidence from citizens.

  • PDF

A Study on the Improvement Plan through Current Status of Historical Park in Seoul (서울시 역사공원의 현황 고찰을 통한 개선 방안 도출)

  • Ko, Young-Kwon;So, Hyun-Su
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.34 no.1
    • /
    • pp.107-117
    • /
    • 2016
  • In this study, six historical parks in Seoul is analyzed. Based on the analysis, the representative values of the historical parks in Seoul draw three criteria such as historicity, educational attributes, and sociality, and also the type of historic and cultural resources, spatial functions and arrangements, circulation and accessibility, and the type and usage of introduced facilities. Consequently the current status and improvement plan is suggested as follows. First, cultural assets oriented historical parks such as Sayuksin Bongeun and Seonnongdan historical Park focus on the management based on the preservation of historic and cultural resources. Non designated cultural heritages oriented historic parks such as Shingye Yanghwajin Itaewon-bugundang historic park should focus on the usages the symbolize and commemorate historic and cultural resources. Second, Careful attitudes on the historicity of the park are needed in the mixed type of historic and cultural resources that determine the identity such as Yanghwajin Itaewon-bugundang historic park. Third, the rate of facilities in Bongeun and Shingye historical park is increased due to the renovation of religion facilities, rather than the neighborhood parks. The autonomy of regulations that does not have the limits of the area of park facilities weaken the publicity of the historical parks. Fourth, Shingye historical park suggest changing its name into Danggogae martyrs' shrine historical park. because its historic and cultural resources are included as the historic park is named. Fifth, the current problems such as numerous uncontrolled entrances, mixed uses in circulation, and accessible failure due to the closure are recognized. Therefore, the entrances and circulations should be articulated clearly in order to increase opportunities of experience for visitors in the historic and cultural resources, and also neighborhood facility should be suitably divided. Sixth, the park facilities in the neighborhood parks are introduced equally in Seoul historical parks. The uses and arrangements that considered the circumstance of the historical parks should be determined in the cultural facilities such as outdoor music hall and sporting facilities. Seventh, historic facilities that named historic hall, culture hall, memorial hall, and promotion hall in the historic parks are utilized for convenience and religion facilities. Institutional framework should be examined to keep publicity in the historic parks by spatial privatization of the specific group.

Nutritional status of Korean elderly by oral health level - based on 2009 national health and nutrition survey data (한국 노인의 구강건강수준에 따른 영양섭취 상태 - 2009년 국민건강영양조사 자료에 근거하여 -)

  • Kim, Cheoul-Sin;Shin, Bo-Mi;Bae, Soo-Myoung
    • Journal of Korean society of Dental Hygiene
    • /
    • v.11 no.6
    • /
    • pp.833-841
    • /
    • 2011
  • Objectives : The purpose of this study was investigation of quality and quantity of nutritional intake related oral health status among Korean elders. Methods : The nutrient intake and the dietary quality was evaluated on the basis of the Dietary Reference Intakes For Koreans(KDRIs). Chi-square test for Complex Samples was used to determine the relationship between oral health and inadequate nutrient intake in Korean elders. The complex samples general linear model was used to test difference of average value difference of nutrient intake percentage compared to dietary reference intake(DRI), energy intake rate from three major nutrients, average mean adequacy ratio(MAR) and index of nutritional quality(INQ) related oral health status. Age, sex and total energy intake was compensated for this analysis. PASW 18 was used for statistical analysis. Results : We could found the difference of the nutrient intake and the dietary quality related oral health status among Korean elders. Especially, Nutrient intake percentage and component ratio of protein among energy intake rate from three major nutrient was lower as oral health status became worse. The percentage of subjects with nutritional intakes under showed highest level in worst oral health status. As oral health status became worse, average mean adequacy ratio(MAR) was lower and the number of nutrient of which index of nutritional quality(INQ) was under 1 was more. Conclusions : From the result above, this study clearly shows the level of oral health affecting the inequalities of eating and the food for the people. And the various propose of oral health policies is needed for vulnerable groups who needs solution to solve the problem of inequality of food distribution where intensive distribution of nutrition problem occurred. Sufficient, safe, and a variety of healthy food intake is a fundamental right of our people. And also, to apply this policy in reality, institutional arrangements and organizations, and specific performing system will be needed.

Nonresident Fathers' Informal Support to Children -Focusing on the Effects of Family Structures- (자녀를 양육하지 않는 아버지의 비공식 양육비 제공 - 가족구조의 영향을 중심으로 -)

  • Choi, You-Seok
    • Korean Journal of Social Welfare
    • /
    • v.62 no.2
    • /
    • pp.57-85
    • /
    • 2010
  • Using the Survey of Wisconsin Works Families, the survey of the Child Support Demonstration Evaluation (CSDE) project in Wisconsin, this study examines whether the family structures of nonresident fathers and resident mothers are associated with nonresident fathers' economic contributions, measured by the level of informal support provided to their children living in the mothers' households. Findings show that the level of informal support is associated with not only individual and economic characteristics of nonresident fathers and resident mothers, but also family structures and institutional factors such as child support arrangements and the CSDE experiment. Both mothers' repartnering with another man and fathers' repartnering with another woman are negatively associated with the level of informal support. Fathers who lived together with mothers when their children were born provide more informal support than do fathers who did not. Fathers' multiple partner fertility is not associated with the level of informal support provided. Among fathers who have children with multiple partners, fathers provide more informal support to their children born by their first partner. Fathers who have multiple children with the mother of the focal child provide more informal support. Fathers who have other biological children living elsewhere provide less informal support. Fathers who pay higher levels of formal child support also provide higher levels of informal support. Fathers associated mothers assigned to the CSDE experiment group provide more informal support. The findings suggest that child support programs may increase informal support, thereby improving the well-being of resident mothers and their children living in poverty.

  • PDF

Review of Communal Housing for the Elderly in the UK (영국의 노인공동생활주택에 대한 검토)

  • 홍형옥
    • Journal of Families and Better Life
    • /
    • v.19 no.4
    • /
    • pp.49-68
    • /
    • 2001
  • The purpose of this study was 1) to review communal housing in the UK, 2) to consider the policy implications for elderly communal housing in Korea. The research methods used were 1) literature review about communal housing and related policy in the UK 2) field survey in the UK 3) interpretative suggestion for the proper policy implication to develope communal housing for the elderly in Korea. Sheltered housing in the UK had been developed as communal housing for the elderly with special needs since the 1970s. The type of sheltered housing were category 1 and category 2. Very sheltered housing with more facilities and meal services was added in 1980s. Sheltered housing was evaluated as the most humanistic solution for older people in the UK in 1980s. Because of the policy of moving institutional care to community care, sheltered housing became less in demand because of more options for older people including being able to stay in their own home. So new completion of sheltered housing by registered social landlords reduced saliently. Sheltered housing already totalled over half million units in which 5% of all elderly over 65 still lived and a small quantity of private sector for sale schemes emerged in the 1990s. The reason why the residents moved to sheltered housing was for sociable, secure, and manageable living arrangements. In general the residents were satisfied with these characteristics but dissatisfied with the service charge and quality of meals, especially in category 2.5 schemes. The degree of utilisation of communal spaces and facilities depended on the wardens ability and enthusiasm. Evaluation of sheltered housing indicated several problems such as wardens duty as a \"good neighbour\" ; difficult-to-let problems with poor location or individual units of bedsittiing type with shared bathroom ; and the under use of communal spaces and facilities. Some ideas to solve these problems were suggested by researchers through expanding wardens duty as a professional, opening the scheme to the public, improving interior standards, and accepting non-elderly applicants who need support. Some researchers insisted continuing development of sheltered housing, but higher standards must be considered for the minority who want to live in communal living arrangement. Recently, enhanced sheltered housing with greater involvement of relatives and with tied up policy in registration and funding suggested as an alternative for residential care. In conclusion, the rights of choice for older people should be policy support for special needs housing. Elderly communal housing, especially a model similar to sheltered housing category 2 with at least 1 meal a day might be recommended for a Korean Model. For special needs housing development either for rent or for sale, participation of the public sector and long term and low interest financial support for the private sector must be developed in Korea. Providing a system for scheme managers to train and retrain must be encouraged. The professional ability of the scheme manager to plan and to deliver services might be the most important factor for the success of elderly communal housing projects in Korea. In addition the expansion of a public health care service, the development of leisure programs in Senior Citizens Centre, home helper both for the elderly in communal housing and the elderly in mainstream housing of the community as well. Providing of elderly communal housing through the modified general Construction Act rather than the present Elderly Welfare Act might be more helpful to encourage the access of general people in Korea. in Korea.

  • PDF

The Development Policy of Major Port City considering Port-Port City Relationship - The Case of Gwangyang Port, Korea - (항만과 배후도시 관계를 고려한 항만중심도시의 발전방향 - 광양항을 중심으로 -)

  • Jeong, Bonghyun
    • Journal of Korea Port Economic Association
    • /
    • v.29 no.1
    • /
    • pp.77-97
    • /
    • 2013
  • This paper focuses upon the relationship between port and port city. The purpose of this study is to theoretically review the relationship between port and its city, and to identify crucial policy directions for mutual development of port and the backward city in the case of Gwangyang Port (GP), Korea. The contents of this paper consist of five main sections: introduction; a concept of port-port city relationship; an analysis of the relationship between GP and its city; policy directions for GP city; conclusion. This study was mainly conducted by a literature review of the papers/reports and the analysis of secondary data. Significant policy strategies are associated with development of value-added logistics, expansion of additional port business, vitalization of port hinterlands, and establishment of port logistics clusters in terms of port economic function. Green port operation, improvements of coastal environment, establishment of port waterfronts, and conceptual port redevelopment master plan are included in the major port city development strategies in terms of sustainable development. Another major port city development strategies contain major port city master plan, institutional arrangements for port city development, specialized port city development policy, and formation of free trade port city in relation to integrated port-port city planning and management.

Present and Future Agricultural Extension System and International Agricultural Technology Cooperation of Sudan (수단 농촌지도사업의 현재와 미래)

  • Geberaldar, Sumaya Ahmed Hamid;Park, Duk-Byeong;Cho, Gyoung-Rae
    • Journal of Agricultural Extension & Community Development
    • /
    • v.21 no.4
    • /
    • pp.1227-1259
    • /
    • 2014
  • This paper explores agricultural extension systems, extension challenges, research and extension models, governance structures of agricultural extension and advisory services in Sudan. Agricultural extension services in Sudan are provided by a variety of governmental department and corporation. The Technology Transfer and Extension Administration under the Ministry of Agriculture and Irrigation, had been launched during mid 2000's aims at making extension systems farmer driven and farmer accountable by way of new institutional arrangements for technology dissemination in the form of community participation approach at the state level, to make the extension reforms have the active participation of farmers/farmer groups. The main problem facing agricultural extension services in developing countries is poor link between extension organization and research. Both extension administration and Agricultural Research Corporation (ARC) are operating as departments of ministry of Agricultural and irrigation for very long time. There are three recommendations to achieve the effectiveness of the Agricultural Research Corporations (ARC) in reaching farmers. Firstly, extension staff members should be assigned to every ARC station. Secondly, the ARC might increase positions for Agricultural development specialist or Farming System Research (FSR) specialist. Their role would be to reflect the needed of farmer and translate them to the researchable topics. Thirdly, researcher should conduct more research on farmer's fields.

Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
    • /
    • v.5 no.1
    • /
    • pp.133-145
    • /
    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

  • PDF