• 우울조울병
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• 제16권3호
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• pp.158-162
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• 2018

Objectives : The purpose of this study was to examine psychosocial factors related to burnout of social welfare officers working in Jeonnam Province. Methods : A total of 395 social welfare officers (male 99, female 296) working in 22 areas of Jeollanam-do province, were subjects of this study. We examined socio-demographic factors, using a self-reporting questionnaire. Subjects were asked to complete the Maslach Burnout Inventory-General Survey (MBI-GS), Center for Epidemiological Studies Depression Scale (CES-D), Perceived Stress Scale (PSS), and the Generalized Self-Efficacy Scale (GSS), to assess psychosocial factors affecting to burnout of social welfare officers. Results : Among 395 subjects, 221 (55.9%) reported recent experiences of burnout. There was no significant difference in age between two groups, divided by burnout. Sex (p<0.001), rank (p=0.003), working period (p=0.034), depression (p<0.001) revealed differences between the burnout group and control group. Scores of PSS (p<0.001) were higher, while the scores of GSS (p<0.001) were lower in the burnout group, than control group. Multivariate logistic regression analysis revealed that female (OR 2.840, 95%CI 1.466-5.504, p=0.002), depressive high-risk group (OR 6.824, 95%CI 2.893-16.096, p<0.001) PSS (OR 1.247, 95%CI 1.153-1.349, p<0.001) and GSS (OR 0.950, 95%CI 0.930-0.971, p<0.001), were significantly associated with burnout. Conclusion : We found that some factors, were associated with experienced burnout in social welfare officers. Depressive symptoms were the strongest associative factor, for burnout in public servants in charge of social welfare. Sex, stress and self-efficacy also correlated with burnout, and especially self-efficacy was a protecting factor.

• 농촌의학ㆍ지역보건
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• 제30권1호
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• pp.89-100
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• 2005

의료서비스 만족도에 영향을 미치는 요인을 분석하고, 만족도가 병원의 재이용 의사에 미치는 영향을 파악하고자 지방도시 일부 종합병원 환자 600명을 대상으로 2004년 2월 1일부터 2004년 4월 30일까지 설문조사를 실시한 결과, 의료서비스 만족지수는 전체 175점 만점에 $113.54{\pm}19.23$점으로 비교적 높은 점수를 나타냈고, 국공립병원 이용자가 $120.20{\pm}18.96$점으로 대학병원 이용자 $106.46{\pm}16.49$, 사립종합병원 이용자 $107.83{\pm}18.48$점 보다 유의한 수준에서 높게 나타났다(p<0.001). 만족지수를 4개영역별로 살펴보면 진료 서비스 만족지수는 총 30점 만점에 19.57점이었고, 간호사나 의사의 친절에 대한 만족지수는 총 55점 만점에 39.10점으로 비교적 높게 나타났으나 서비스 절차 및 시설이용 만족지수는 총 60점 만점에서 36.28점을 나타났으며 환경상태에 대한 영역에서는 30점 만점에 18.59점으로 나타났다. 병원이용 만족지수에 영향을 주는 요인을 알아보기 위해 다중선형회귀분석을 적용한 결과, 이용한 병원이 국공립병원인 경우 (${\beta}=0.16$), 연령이 많을수록 (${\beta}=0.15$), 의료비에 대한 인식이 싸기 때문에 이용한다 라고 생각하는 경우(${\beta}=0.15$) 타 병원 이용경험이 있는 경우 (${\beta}=0.12$)에 만족지수가 유의하게 높았다. 병원의 재이용의사 비율은 긍적적인 비율이 전체 46.8%였고, 진료비가 비싸도 다시 이용하겠다는 비율이 전체 31.3%로 국공립병원 이용자들의 재이용의사 비율(44.7%)이 대학병원 이용자(20.0%), 사립종합병원 이용자(13.3%)의 비율보다 유의하게 높게 나타났다(p<0.001). 또한 이용한 병원의 좋은 점을 주위에 알리겠다고 한 비율이 전체 41.5%이었다. 재이용 의사에 미치는 영향을 분석한 결과, 연령(${\beta}=0.09$)과, 건강검진 여부(${\beta}=0.08$)가 유의하게 영향을 미쳤고 진료 서비스 만족지수(${\beta}=0.35$), 친절 및 대인관계 만족지수(${\beta}=0.17$)가 높은 상관성을 보였다($R^2=0.37$). 이 결과로 병원내의 인적요인에 의한 만족도가 높을수록 재이용 의사가 높아짐을 알 수 있었다. 병원의 마케팅 전략 면에서 한번 방문한 의료서비스 이용자의 재이용 의사는 매우 중요하다. 재이용 의사에는 진료서비스 만족지수가 크게 영향을 미치므로 진료서비스 만족도를 높이기 위한 전략이 중요하다고 생각된다. 특히 진료 서비스 만족도와 구성원의 대인 및 친절에 대한 만족도가 가장 많은 영향을 미치는 것으로 볼 때, 병원의 환경이나 시설보다는 인적관리가 더욱 중요한 것으로 생각된다. 그러므로 마케팅 전략에서 의료인의 질적 수준을 높이기 위한 재교육 및 병원 구성원들의 친절교육을 강화하는 것이 가장 중요하다고 생각된다.

• 척추신경추나의학회지
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• 제11권1호
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• pp.53-64
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• 2016

Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

• 동의신경정신과학회지
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• 제25권4호
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• pp.389-400
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• 2014

Objectives: Though there are many studies about sleep disorder, no research has been performed on the utilization of oriental medicine as a treatment. Therefore, the oriental medical treatment pattern of Korean patients with sleep disorders was examined herein using the Health Insurance Review and Assessment Service (HIRAS). Methods: The medical records of patients with sleep disorders (G47) or nonorganic sleep disorders (F51) as a main diagnosis were adopted from the HIRAS database from 2011 to 2013. Analysis was performed on the number of patients and cost per patient, with comparison between oriental and western medicine in terms of gender, age, patient care service type, and hospital type. Results: 1) Regarding sleep disorders, the medical visits and insurance charges have been increasing. Western medicine was utilized 8 times more often than oriental medicine during 3 years. 2) There were 2.5 times more women than men. 3) Among all ages, the 50~59 year group had the highest representation. 4) In comparison of average portions of patient care type over 3 years, outpatients were the majority, while the number of visits of outpatients and hospitalization has been increasing. 5) Comparison of average portion of oriental hospital type over 3 years revealed oriental clinics to be used most. The use of general hospitals was higher in western medicine treatment, while public health centers used oriental medicine more. 6) Regarding average oriental medical cost per patient over 3 years, the total was 88,000 won, with 353,000 won for hospitalization and 85,000 won for outpatients. The outpatient cost has been increasing. 7) In line with 6, oriental medical hospitals cost 126,000 won, local clinics were 85,000 won, and etc. was 95,000 won. Average costs of all types have increased during 3 years, except oriental medical hospitals in 2013. Conclusions: This study provided objective information about the epidemiologic characteristic of oriental medicine used for treatment of sleep disorder. For expansion of oriental medical demand for sleep disorder, this study would be helpful in understanding the recent status.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.211-216
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• 2012

Background: Patients' demographics, presenting clinical and histopathological features for colo-rectal cancer (CRC) are important factors for patients' outcome and disease prognosis. This study aimed to describe the pattern of CRC in terms of patients' demographics, main presenting symptoms and histopathological features in Al Hassa region of Saudi Arabia. Subjects and Methods: A retrospective hospital records-based study which included reviewing of patients' records diagnosed with CRC at three general hospitals in Al Hassa region, Saudi Arabia. A compilation form was designed to collect information regarding socio-demographics, age at diagnosis; referral sites and the main presentations at CRC diagnosis. sites and the main presentations at CRC diagnosis. Histopathological reports were reviewed to delineate the main cytopathologic features, prominent cytological characteristics, the presence of predisposing pathology, and disease stage. Results: Of the 142 cases with CRC, 15.5% and 33.1% were affected before 40 and 50 years of age respectively. Emergency rooms were main referral sites for CRC cases (31.0%). Right colon was affected in 16.9% while left colonic lesions accounted for 62.7%. Intestinal obstruction was the main presentations (41.5%), and 26.1% presented with symptoms indicating distant metastastic lesions. Adenocarcinoma was the predominant pathological lesions (86.6%). Metastastic CRC was diagnosed in 62.7%. Duke's staging showed that 22.5% and 40.1% of lesions were classified into C and D categories respectively. Conclusion: Saudi patients with CRC present late with distant metastasis, and advanced disease stage. A sizeable proportion of patients developed the lesions at relatively young age. Screening recommendations should be enacted and revised in response to current change with younger age of affection.

• 한국학교ㆍ지역보건교육학회지
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• 제14권3호
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• pp.67-76
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• 2013

Objectives: This study was intended to provide the base of developing countries' Health Partnership Strategy by investigating the Paraguay's awareness level of health and analyzing the actual state. Methods: The data was collected from 11 government employees, 20 hospital staffs, 26 local residents on Asunci$\acute{o} $n, Paraguay in February, 2012. The method of the study was the questionnaires consisting of 62 questions including 7 questions of general features, 3 questions of awareness on maternal health care, child health care, planned parenthood program, 52 questions of awareness on health. The questionnaires was translated into Spanish which is local language in Paraguay. Results: The results of this study are summarized as follows; 1) The most important awareness on maternal healthcare, child healthcare, planned parenthood program was providing child health care. 2) The most important awareness to prevent non-health behavior was sufficient nutrition. The most important awareness to reduce the rate of chronic disease was diabetes. The most important awareness to eradicate communicable disease was HIV/AIDS. 3) The most important awareness to provide healthcare service was vaccination. 4) The most important awareness on healthcare delivery system was policy. The most important awareness on health education was student's health education. 5) The most important awareness to strength healthcare capacity was developing domestic economy. Conclusion: The results of this study suggest that awareness levels on health are high against low health behavior status in Paraguay. But awareness on health can lead to health behavior by healthcare system. Therefore, it has to induce the healthcare network and system by injecting public health funds, infrastructure, human resources on prevention of disease and healthcare management.

• Journal of Preventive Medicine and Public Health
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• 제56권6호
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• pp.563-572
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• 2023

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

• 대한안전경영과학회지
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• 제16권3호
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• pp.295-304
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• 2014

The purpuse of this study is to find factors on the recognition by people involved in occupational safety and health of KOSHA 18001, the need of KOSHA 18001 certification, and the compliance by each medical institution with KOSHA 18001 review standards to help medical institutions introduce and use OSHMS. There was a survey of people involved in occupational safety and health at 300 local general hospitals with 100 or more beds that were registered with the Korean Hospital Association in 2012. The survey included the recognition of KOSHA 18001, the need of certification and the compliance by medical institutions of the occupational safety and health. A total of 132 people responded, of which an analysis of 126 cases was conducted except 6 cases poor in information.

• 한국정보통신학회논문지
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• 제4권1호
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• pp.27-33
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• 2000

현재 사회는 고령화와 생활의 질적 향상으로 인해 재택 의료 기술이 필요하게 되었다. 재택 의료가 가능하게 되려면 재택 의료기의 가격이 저렴해야 하며, LAM이나 공중망에 의료기가 직접 접속을 하여 어디서든지 의사가 있는 병원으로 접속이 가능해야 한다. 본 논문에서는 심전도 전처리 과정중 기저선 제거만을 하고 디스플레이 영역을 생략하며, 전력선 잡음 제거를 위해 연산량이 적은 디지털 필터를 적용함으로써 CPU의 부담을 줄일 뿐 아니라 크기를 줄이고 가격을 낮출 수 있고, 남는 CPU의 능력을 LAN(Local Area Network)을 이용한 심전도 데이터 전송에 사용하여 직접 TCP/IP망에 접속할 수 있는 심전도 단말기를 구현하였다.

• Journal of Preventive Medicine and Public Health
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• 제24권3호
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• pp.328-338
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• 1991

To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows : 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons ; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benifits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (p<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6% ; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs : the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet ; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in th health centers or subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (p<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.