• Title/Summary/Keyword: Manpower distribution

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Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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Recognition and attitude to functional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city (대구시 개원의사와 개국약사의 의약분업에 대한 인식과 태도)

  • Lee, Moo-Sik;Yoon, Nung-Ki;Suh, Suk-Kwon;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.1 s.41
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    • pp.1-19
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    • 1993
  • Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered faliure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is sucessful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical issurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician prefered pros and 17.7 percent cons, but 38 percent of practicing pharmacist prefered pros and 45.5 percent cons. And pharmacist knew better the content of functional division between physician and pharmacist than physician. As a reason for pros of enforcing functional division between physician and pharmacist, practicing physician emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist prefered generic name (44.0%, 89%) mostly, but physician prefered brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the govermental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached ; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the goverment should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.

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The Concentration of Economic Power in Korea (경제력집중(經濟力集中) : 기본시각(基本視角)과 정책방향(政策方向))

  • Lee, Kyu-uck
    • KDI Journal of Economic Policy
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    • v.12 no.1
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    • pp.31-68
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    • 1990
  • The concentration of economic power takes the form of one or a few firms controlling a substantial portion of the economic resources and means in a certain economic area. At the same time, to the extent that these firms are owned by a few individuals, resource allocation can be manipulated by them rather than by the impersonal market mechanism. This will impair allocative efficiency, run counter to a decentralized market system and hamper the equitable distribution of wealth. Viewed from the historical evolution of Western capitalism in general, the concentration of economic power is a paradox in that it is a product of the free market system itself. The economic principle of natural discrimination works so that a few big firms preempt scarce resources and market opportunities. Prominent historical examples include trusts in America, Konzern in Germany and Zaibatsu in Japan in the early twentieth century. In other words, the concentration of economic power is the outcome as well as the antithesis of free competition. As long as judgment of the economic system at large depends upon the value systems of individuals, therefore, the issue of how to evaluate the concentration of economic power will inevitably be tinged with ideology. We have witnessed several different approaches to this problem such as communism, fascism and revised capitalism, and the last one seems to be the only surviving alternative. The concentration of economic power in Korea can be summarily represented by the "jaebol," namely, the conglomerate business group, the majority of whose member firms are monopolistic or oligopolistic in their respective markets and are owned by particular individuals. The jaebol has many dimensions in its size, but to sketch its magnitude, the share of the jaebol in the manufacturing sector reached 37.3% in shipment and 17.6% in employment as of 1989. The concentration of economic power can be ascribed to a number of causes. In the early stages of economic development, when the market system is immature, entrepreneurship must fill the gap inherent in the market in addition to performing its customary managerial function. Entrepreneurship of this sort is a scarce resource and becomes even more valuable as the target rate of economic growth gets higher. Entrepreneurship can neither be readily obtained in the market nor exhausted despite repeated use. Because of these peculiarities, economic power is bound to be concentrated in the hands of a few entrepreneurs and their business groups. It goes without saying, however, that the issue of whether the full exercise of money-making entrepreneurship is compatible with social mores is a different matter entirely. The rapidity of the concentration of economic power can also be traced to the diversification of business groups. The transplantation of advanced technology oriented toward mass production tends to saturate the small domestic market quite early and allows a firm to expand into new markets by making use of excess capacity and of monopoly profits. One of the reasons why the jaebol issue has become so acute in Korea lies in the nature of the government-business relationship. The Korean government has set economic development as its foremost national goal and, since then, has intervened profoundly in the private sector. Since most strategic industries promoted by the government required a huge capacity in technology, capital and manpower, big firms were favored over smaller firms, and the benefits of industrial policy naturally accrued to large business groups. The concentration of economic power which occured along the way was, therefore, not necessarily a product of the market system. At the same time, the concentration of ownership in business groups has been left largely intact as they have customarily met capital requirements by means of debt. The real advantage enjoyed by large business groups lies in synergy due to multiplant and multiproduct production. Even these effects, however, cannot always be considered socially optimal, as they offer disadvantages to other independent firms-for example, by foreclosing their markets. Moreover their fictitious or artificial advantages only aggravate the popular perception that most business groups have accumulated their wealth at the expense of the general public and under the behest of the government. Since Korea stands now at the threshold of establishing a full-fledged market economy along with political democracy, the phenomenon called the concentration of economic power must be correctly understood and the roles of business groups must be accordingly redefined. In doing so, we would do better to take a closer look at Japan which has experienced a demise of family-controlled Zaibatsu and a success with business groups(Kigyoshudan) whose ownership is dispersed among many firms and ultimately among the general public. The Japanese case cannot be an ideal model, but at least it gives us a good point of departure in that the issue of ownership is at the heart of the matter. In setting the basic direction of public policy aimed at controlling the concentration of economic power, one must harmonize efficiency and equity. Firm size in itself is not a problem, if it is dictated by efficiency considerations and if the firm behaves competitively in the market. As long as entrepreneurship is required for continuous economic growth and there is a discrepancy in entrepreneurial capacity among individuals, a concentration of economic power is bound to take place to some degree. Hence, the most effective way of reducing the inefficiency of business groups may be to impose competitive pressure on their activities. Concurrently, unless the concentration of ownership in business groups is scaled down, the seed of social discontent will still remain. Nevertheless, the dispersion of ownership requires a number of preconditions and, consequently, we must make consistent, long-term efforts on many fronts. We can suggest a long list of policy measures specifically designed to control the concentration of economic power. Whatever the policy may be, however, its intended effects will not be fully realized unless business groups abide by the moral code expected of socially responsible entrepreneurs. This is especially true, since the root of the problem of the excessive concentration of economic power lies outside the issue of efficiency, in problems concerning distribution, equity, and social justice.

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The study on outpatient-clinic practice by shift system at a hospital in Taegu (대구지역 한 중소병원의 교대제 근무에 의한 외래진료에 관한 연구)

  • Song, Jung Hup;Kim, Jing Kyun;Ha, Young Ae;Yeh, Min Hae
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.44-59
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    • 1994
  • Medical consumers(patients) want evening-clinic because of busy work. For patient's convenience and improving service, hospital should accept it. Considering payment system and patient's demand, personnel expenses, hospital can not accept. The practice of shift system to accept patient's demand and hospital's economic aspect was made. To analysis the effect of the system and probability to alternative to evening clinic this study was done. This study was composed of basal study, intervention, evaluation of effect. The basal study were composed of studying demand on evening clinic, the number of beds, doctors employee, the time table of practice and work, and the number of patients at arrival time. The intervention composed of changing of practice time, changing of working time by the number of patients at arrival time, increasing of employee. The evaluation of effect were composed of evaluating the number of patient at time, the effect of shift system, the comparison of the number of in and out patients and questionnairing the practice of shift system. In the practice time at 2 shift system First team works 7-15 hours and Second team 12-20 hours. there are no lunch and supper time. At 18-20 hours the number of patients were 25-30. The number of patient a depart were 6-7. The number of out-patient increase in 13% and inpatient increase in 10% before the system. Doctors(100%), employee(94.6%), and patients(86.4%) approved this system. The advantage of this system were utilization of surplus time, lengthen the practice time, even distribution of patients and shortening of waiting time, rapid treatment of emergent patients. The disadvantage of this system were shortage of manpower, not all depart practice, continuity of practice, no lunch and supper time, irregular rounding. At present because of small Demanding on evening clinic, this shift system was economical. To succeed this study more effectively all depart in hospital participate. But because of economical reason it is impossible for hospital to do it. If the government assist the economic loss that all depart participate in this system it is very helpful for hospital to succeed in implementing this system more early.

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A Study on Problems with the ROK's Bioterrorism Response System and Ways to Improve it (생물테러 대응체제의 문제점과 개선방안 연구)

  • Jung, Yook-Sang
    • Korean Security Journal
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    • no.22
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    • pp.113-144
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    • 2010
  • Bioterrorism is becoming more attractive to terrorist groups owing to the dramatic increase in the utility and lethality of biological weapons in line with today's cutting-edge biological science and technology. The Republic of Korea is facing both internal and external terrorist threats, as well as the possible biological warfare by North Korea. Therefore, it is essential to establish an effective bioterrorism response system in the ROK. In order to come up with the adequate response system for the ROK, an in-depth study has been conducted on the current bioterrorism response system of the U.S. whose preparedness is considered relatively adamant. As a result, the following facts have been found: (1)the legislation with regard to bioterrorism has been established or amended according to the current situation in the U.S., (2)the counter terrorism activities have been integrated with the Department of the Homeland Security as the central agency in order to maximize the national CT capacity, (3)Specific procedures and instructions to cope with bioterrorism have been made into manuals so as to enhance the working-level response capabilities. Next, the analysis on the ROK's bioterrorism response system has been performed in various categories, including the legislation system, task role distribution, cooperative relations, and resource application. It turned out that the ROK's legislation basis is relatively weak and it lacks the apparatus to integrate the bioterrorism response activities on the national level. The shortage of the adequate response facilities and resources, as well as the poor management of manpower have also emerged as problems that hinder the effective CT implementations. Through an analytical and comparative study of the U.S. and the ROK systems, this paper presents several ways to ameliorate improve the current system in the ROK as follows: (1)establish the anti-terrorism law, which would be the basic legal basis for the bioterrorism-related matters; and make revisions to the disaster-related legislation, relevant to bioterrorism response activities, (2)establish an integrated body that has a powerful authority to coordinate the relevant CT agencies; and converge the decentralized functions to maximize the overall response capacity, (3)install the laboratories with a high biosafety level and secure enough of the strategic medical stock-pile, (4)enhance the ability of the inexperienced response personnel by providing with a manual that has detailed instructions.

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Time Change in Spatial Distributions of Light Interception and Photosynthetic Rate of Paprika Estimated by Ray-tracing Simulation (광 추적 시뮬레이션에 의한 시간 별 파프리카의 수광 및 광합성 속도 분포 예측)

  • Kang, Woo Hyun;Hwang, Inha;Jung, Dae Ho;Kim, Dongpil;Kim, Jaewoo;Kim, Jin Hyun;Park, Kyoung Sub;Son, Jung Eek
    • Journal of Bio-Environment Control
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    • v.28 no.4
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    • pp.279-285
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    • 2019
  • To estimate daily canopy photosynthesis, accurate estimation of canopy light interception according to a daily solar position is needed. However, this process needs a lot of cost, time, manpower, and difficulty when measuring manually. Various modeling approaches have been applied so far, but it was difficult to accurately estimate light interception by conventional methods. The objective of this study is to estimate the spatial distributions of light interception and photosynthetic rate of paprika with time by using 3D-scanned plant models and optical simulation. Structural models of greenhouse paprika were constructed with a portable 3D scanner. To investigate the change in canopy light interception by surrounding plants, the 3D paprika models were arranged at $1{\times}1$ and $9{\times}9$ isotropic forms with a distance of 60 cm between plants. The light interception was obtained by optical simulation, and the photosynthetic rate was calculated by a rectangular hyperbola model. The spatial distributions of canopy light interception of the 3D paprika model showed different patterns with solar altitude at 9:00, 12:00, and 15:00. The total canopy light interception decreased with an increase of surrounding plants like an arrangement of $9{\times}9$, and the decreasing rate was lowest at 12:00. The canopy photosynthetic rate showed a similar tendency with the canopy light interception, but its decreasing rate was lower than that of the light interception due to the saturation of photosynthetic rate of upper leaves of the plants. In this study, by using the 3D-scanned plant model and optical simulation, it was possible to analyze the light interception and photosynthesis of plant canopy under various conditions, and it can be an effective way to estimate accurate light interception and photosynthesis of plants.

A Study on the Introduction of Performance Certification System of Inspection and Diagnostic Equipment for Infrastructure (시설물 진단장비의 성능인증제 도입에 관한 연구)

  • Hong, Sung-Ho;Kim, Jung-Gon;Cho, Jae-Young;Kim, Do-Hyoung;Kim, Jung-Yeol;Kim, Young-Min
    • Journal of the Society of Disaster Information
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    • v.18 no.1
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    • pp.104-115
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    • 2022
  • Purpose: Infrastructure inspection and its diagnostics technique have been rapidly developing recently. Therefore, it is important to secure the reliability of diagnostic equipment, and this paper deals with inspection of diagnostic equipment, introduction to a certification system and development plans for infrastructure. Method: Several certification systems are established and introduction plans are reviewed through experts by synthesizing the contents of certification research for existing infrastructure diagnosis equipment. In addition, the revision of the law for introduction of the system is reviewed, detailed operation regulations are prepared and phased development plans are reviewed, which are based on the operation scenario. Result: Inspection and certification plans were constructed through four routes in order to consider infrastructure inspection and diagnostic equipment in use, and new diagnostic equipment using state-of-the-art technology. Furthermore, market confusion depending on the introduction of a new certification system is minimized and reliability is secured by transforming a simple inspection system in the short term into a formal certification system in the long term. The law amendments according to the introduction of the system were reviewed and detailed operation regulations were developed. Also, phased development plans, which are based on the long-term development scenario including manpower, infrastructure and specifications, were presented. Conclusion: It is important to secure reliability through the distribution and certification of diagnostic equipment using 4th industrial technology to strengthen the safety management of infrastructure at the national level since the infrastructure is various in type and increasingly large in size. It is also essential to train human resources who can use new technology with inspection and diagnosis system in order to enhance the safety management of all infrastructures. Moreover, it is necessary to introduce a regular inspection system for infrastructure that combines loT technology in the long-term point of view and to promote the introduction by giving active incentives to institutions that actively accept it.

A Study on the Influence of Filmmaking Factors and Promotions on the Intention of Watching Movies (영화제작요소와 프로모션이 영화 인지 및 관람의도에 미치는 영향에 관한 연구)

  • Lee, Ji-Hun;Kim, Hee-Goon
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.87-98
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    • 2019
  • This study sought to identify the impact of scenarios, capital, manpower (directors, actors), media promotion, oral communication, and recognition on the intention of watching movies, and to present marketing and policy implications to film producers for ways to revitalize their films. Therefore, the implications of this study are as follows: First, if you watch a movie with a friend or introduce a movie, you should set up a marketing strategy to promote the movie as a oral message to the people around you through double points and free admission at the 10th movie. It will also require the promotion of the scenario to be strengthened so that people around them can recognize it naturally. Second, film production companies will have to improve the quality of their movies by readjusting the distribution of capital in the event of capital investment. In addition, the movie should be encouraged by the oral publicity that the huge amount of capital has enhanced the quality of the movie, as well as pre-experience events to help the audience recognize it. Third, filmmakers will have to choose directors and actors who can digest novel and experimental material over the director's or actor's reputation. Fourth, the movie promotion company should set up strategies to cater to visitors through a contest for ideas for promoting visitors, which can arouse interest among visitors. Fifth, movie promoters will have to set a sufficient promotional period for visitors to be aware of the film in advance. Finally, movie writers will have to create scenarios with a variety of materials that meet the needs of visitors. Also, movie officials will have to develop or create a mechanism for those who watch the movie to practice oral and cognitive skills.

A Study on the Policy Directions of Sports Welfare in Gangwon Province for Improving Quality of Life (삶의 질 향상을 위한 강원도 스포츠복지 정책방향 연구)

  • Kim, Heung-Tae;Kim, Tae-Dong
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.8
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    • pp.411-424
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    • 2019
  • The purpose of this study is to explore the feasible policy directions for sports welfare that can not only improve the standard of living through health but also ensure a happy and enjoyable life for the people of Gangwon Province. For this purpose, I have conducted studies such as the analysis on the sports class voucher project being implemented by the South Korean government and the case analysis in sports welfare, and present policy directions as follows. First of all, it is about upgrading the sports class voucher project. And as its implementation plans, I suggest ① increased publicity, ② the earmarking of the province's own budget for the sports class voucher project, ③ the establishment of a system for cooperation for work implementation between the related organizations and their staff in charge with a view to activating the sports class voucher project, and ④ the upgraded services for the sports class voucher project and the upgraded access to the life cycle-based universal welfare. Second, it is about using public sports facilities and developing various programs. I suggest the active utilization of the public sports facilities that enable people to learn the skills for such sports disciplines as baseball, badminton, ice sports, and golf and the development and distribution of distinctive educational programs for dance for media entertainment shows for female youths, climbing, cheer leading, fencing, surfing and horseback riding. Third, it is about nurturing the human resources and networking. For this, I suggest the creation of 'Sports Welfare Specialist Training Program' and the training of the college students majoring in sports science with the aim of creating a number of jobs. Fourth, it is about refurbishing the system and establishing the support system. I suggest the dismantling of the partitions in the welfare policy related to sports activities and the formation of (tentatively named) 'Gangwon Province Sports Welfare Implementation Committee', and the creation of (tentatively named) 'Sports Welfare Project Support Team' in Health, Welfare & Women's Affairs Bureau or Culture, Tourism and Sports Bureau in the short term and then its long-term expansion into (tentatively named) 'Gangwon Province Sports Welfare Support Center' in responding to the needs that reflect the provincial demographics, with a view to establishing a single lineup for the administrative support system. Furthermore, as budget and manpower are needed to realize customized sports welfare that suits the characteristics of the province and in which all the provincial residents can collect benefits, I suggest that the province provide the legal basis through creating 'Ordinance Promoting Sports Welfare in Gangwon Province' and pushing forward with (tentatively named) 'Gangwon Province Sports Welfare Competition' as what revises the sports class voucher project for the purpose of broadening the basis for sports welfare promotion.