• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.266-278
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• 2024

Purpose: This study aimed to investigate healthcare consumers' interest in patient safety on social media using structural topic modeling (STM) and to identify changes in interest over time. Methods: Analyzing 105,727 posts from Naver news comments, blogs, internet cafés, and Twitter between 2010 and 2022, this study deployed a Python script for data collection and preprocessing. STM analysis was conducted using R, with the documents' publication years serving as metadata to trace the evolution of discussions on patient safety. Results: The analysis identified a total of 13 distinct topics, organized into three primary communities: (1) "Demand for systemic improvement of medical accidents," underscoring the need for legal and regulatory reform to enhance accountability; (2) "Efforts of the government and organizations for safety management," highlighting proactive risk mitigation strategies; and (3) "Medical accidents exposed in the media," reflecting widespread concerns over medical negligence and its repercussions. These findings indicate pervasive concerns regarding medical accountability and transparency among healthcare consumers. Conclusion: The findings emphasize the importance of transparent healthcare policies and practices that openly address patient safety incidents. There is clear advocacy for policy reforms aimed at increasing the accountability and transparency of healthcare providers. Moreover, this study highlights the significance of educational and engagement initiatives involving healthcare consumers in fostering a culture of patient safety. Integrating consumer perspectives into patient safety strategies is crucial for developing a robust safety culture in healthcare.

• Health Policy and Management
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• v.12 no.2
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• pp.23-42
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• 2002

The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

• Health Policy and Management
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• v.10 no.3
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• pp.19-49
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• 2000

This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

• Korean Journal of Soil Science and Fertilizer
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• v.42 no.1
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• pp.53-57
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• 2009

Heavy metal pollution may be one of the most serious challenges confront crop production and human health. Therefore, the selection of heavy metal tolerance cultivars which adapted to the contaminated fields will introduced a suitable solution for management this critical environmental risk. The objectives of this research is to assess human health risk using geochemical analyses and exposure assessment of heavy metals in rice cultivars. Risk for inhabitants in the closed mine area was comparatively assessed for As, Cd, Cu and Pb in 10 rice varieties as a major exposure pathway. The average daily dose (ADD) of each heavy metal was estimated by analyzing the exposure pathways to rice and soil. For the non-carcinogenic risk characterization, Hazard Quotient (HQ) and Hazard Index (HI) were calculated using toxicity indices provided by US-EPA IRIS. The different rice varieties revealed a wide range of HI values from 23.6 to 34.3, indicating that all rice varieties have a high potential toxic risk. The DA rice variety showed the lowest HI value while the TB rice variety the highest. The probabilities of cancer risk for As via rice consumption were varied with rice varieties ranging from 2.0E-03 to 3.5E-03 which exceeded the regulatory acceptable risk of 1 in 10,000 set by US-EPA. The DA rice variety also showed the lowest value while the TB rice variety gave the highest value. Our results indicate that risk assessment can be contribute to screen the pollution safe rice cultivars in paddy fields affected by the mining activity.

• Health Policy and Management
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• v.33 no.2
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• pp.185-193
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• 2023

Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.206-225
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• 2012

General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

• Health Policy and Management
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• v.20 no.1
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• pp.103-124
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• 2010

Objectives: The out-of-pocket payment (OOP) of the Industrial Accident Compensation Insurance (IACI) in Korea was investigated empirically in terms of its incidence, magnitude and factors influencing them. Methods: The subjects were sampled with stratified, randomized methods among medical institutions of which the number of monthly IACI claims exceeded its median as of May 2008. Out of 204 institutions selected, 118 institutions (57.8%) responded to this survey. A total of 24,826 episodes(2,457 inpatient and 22,369 outpatient episodes) were included in this analysis. The incidence and magnitude of OOP of IACI were calculated by characteristics of institution as well as patient. Factors that affected the incidence and magnitude of OOP were investigated through multi-level analysis. Results: The overall incidence of OOP of IACI was 9.9% (25.6% for inpatient and 8.2% for outpatient) and the percentage of OOP among total expenditures was 8.3% on average (7.6% for inpatient and 26.8% for outpatient); 25.2% at traditional oriental medicine hospitals, 9.5% at general hospitals and 2.5% at the industrial-accident-designated medical institutions. The incidence of OOP of IACI was influenced by hospital size, ownership, longer duration of designation (over 5 years) and length of stay. On the other hand, its magnitude was influenced by medium-sized hospital, public hospital, location of large city and length of stay. Extra charges for upper grade room which accommodates less than 4 patients and treatment by specialists were the leading contributors to the magnitude of OOP of IACI. Conclusion: The incidence and magnitude OOP of IACI varied in institution type and were influenced by both institutional and patient's factors. In order to achieve the goal of Industrial Accident Compensation Insurance, appropriate level of compensation, that is, no incidence of OOP, for accident and disease of workers, it is necessary to take measures to reduce incidence and magnitude of OOP.

• Korean Journal of Family Social Work
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• no.55
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• pp.265-297
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• 2017

This study aims to provide basic information about the policy and system improvements relevant to single elderly men, through an investigation concerning the use and needs of activity spaces near their housing environments. Eighteen single elderly men over 60-years-old living in Gunsan city of Jeonbuk province in Korea participated in in-depth interview, and the data were qualitatively analyzed. The results of the study are as follows: The social networks of the participants were focused on friends or colleagues, while mutual exchanges with their children were intermittently undertaken. Natural networks of the elderly were formed mainly in third places, such as parks, restaurants, or community facilities, and about a half of the elderly participants had no spatial needs, and the rest required spaces for meal services, the elderly living community, jobs, leisure/hobby activities, or facility improvements. The elements influencing use of activity spaces were access from the residence, health, social networks, and economic conditions. The results suggest the following: Exercise or leisure facilities supporting elderly mobility should be set up close to their residential environments. Senior facilities centered on systematic supports and shuttle buses circulating around the places that the elderly visit frequently should be considered. On the other hand, regular maintenance and education on residents' proper use of the facilities, and sufficient information and fee discounts for the general programs are needed so that the elderly could interact with the younger generation. From a public perspective, a rational system and policy based on understanding single elderly men's needs should be prepared for provision and management of the activity space.

• Health Policy and Management
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• v.34 no.2
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• pp.120-128
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• 2024

From February to now 2024, there continues to be controversy over the expansion of admission number to medical school. Some of the controversy arises from a mix of present and future time points. In the present time point, the controversy over whether physicians are some shortages or not has various aspects. Some aspects are presented as evidence of the physician shortage and others as non-shortage. Also, the presenting evidence of shortage is being disputed, and so is the evidence of the contrary. This controversy over whether there is a shortage or not in the present time point makes it difficult to reach a consensus. In 10 years, the shortage of doctors will increase due to the rapid increase in the elderly population, so the admission number of medical schools will need to be increased. However, the increase must be such that there is minimal deterioration in the quality of medical education. More admission numbers should be allocated to medical schools with a high quality of medical education. This study suggests that large-scale medical schools increase the admission number by 20%-30%, and small-scale medical schools increase the admission number by 40%-50%, if so, the total increasing number is 760 to 1,066. If the 2,000-person increase is enforced, the quality of medical education must be carefully evaluated and the results should be reflected in adjusting the admission number of medical schools. In 20 years later, the admission number of medical schools will have to be reduced. This is because the physician supply is changing to a linear function and the physician demand (medical care demand) is changing to a quadratic function. Even if the current number is maintained, there will be an excess of doctors from 2048, so the medical school admission number must be reduced and its size will be reduced to about 2,000, a 30% reduction from the current number. Because the same reduction rate for all medical schools will result in many small-scale medical schools, the M&A (mergers and acquisitions) strategy should be considered with 40 medical schools and 12 Korean medical schools. In Korea, the main contributor to estimating physician demand is the change in population structure. Due to the rapid decrease in the total fertility rate, future population projections are uncertain. The recent rapid increase in healthcare utilization should be reexamined in the forecasting of physician demand. Since the various factors that affect the estimate of doctor supply and demand are unclear, the estimate of physician supply and demand must be continuously conducted every five years, and the Health Care Workforce Committee must be established and operated. The effects of increasing the admission number of medical schools should be evaluated and adjusted annually.

• Health Policy and Management
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• v.15 no.1
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• pp.97-117
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• 2005

This study was designed to compare the differences m results of supervisor and subordinate rating. Data was collected from personnel evaluation and subordinate rating results for middle managers(n=68) in hospital from 3rd January to 20th March in 2004. Supervisor rating consisted of performance, ability and attitude evaluation. Subordinate rating consisted of leadership, ability and attitude evaluation. Collected data included sociodemographic characteristics, work department, work level, years of work, years at present level and whether working in a patient serving department. The difference of standardized supervisor and subordinate rating score was used to define groups as 'higher in supervisor rating group'. Groups were defined in total score, ability score and attitude score. Main results were as follows: 1. In total score, sectional chiefs were apt to be 'higher in subordinate rating group' while chief clerks were apt to be 'similar group' or 'higher in supervisor rating group'. Staffs in patient serving department were likely to be 'higher in supervisor rating group' and staffs in non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 2. In ability score, there were no statistically significant differences in age, sex, years of education, work department, work level, years of work and whether working in a patient serving department among 'higher in supervisor rating group', 'similar group' and 'higher in subordinate rating group'. 3. In attitude score, staffs in the department of medical affairs and the department of administration were apt to be 'higher in subordinate rating group'. Staffs in the department of nursing were apt to be 'higher in supervisor rating group'. Staffs in a patient serving department were likely to be 'higher in supervisor rating group' and staffs in a non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 4. Logistic analysis about total score showed that sectional chiefs had higher Odds Ratio(OR) to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. Both these results were statistically significant. 5. Logistic analysis about ability score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. These results were not statistically significant. 6. Logistic analysis about total score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group', but the difference was not statistically significant. Staffs in a non-patient serving department had significantly higher OR to be in 'higher in subordinate rating group'. In conclusion, there is no clear superiority between supervisor and subordinate rating in personnel evaluation. It would be better to use a mixed model. It's also suggested to use an intervening rate of application or scores considering work levels and work department in personnel evaluation. These results would be helpful for hospitals planning a supervisor and subordinate rating system for personnel evaluation.