• 대한간호학회지
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• 제42권7호
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• pp.928-935
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• 2012

Purpose: The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling. Methods: Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis. Results: Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization. Conclusion: The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/or promotion of community awareness.

• 한국응급구조학회지
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• 제13권1호
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• pp.73-85
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• 2009

Purpose : The purpose of this study was to analyze the nursing care needs which can properly cope with patients' needs in emergency room, and grasp the patients' satisfaction level which can assess the care quality. It was aimed to check the level of today's care and provide basic data for care performance and care standard. Method : Data were collected from 192 patients in general hospitals in Daegu. The results are as followed. Results : First, the result of analysis conducted on the degree of overall patients' need for nursing care revealed that the need for nursing information (4.21+57) was the highest, followed by the order of information of patient's condition (4.05+53), emotional support (3.98+47), and nursing participation (3.65+54). Secondly, our study revealed that there was a significant negative correlat interrelation between care need and care satisfaction (r=.516, p<.01), indicating the higher the overall emergency room patients' nursing care need, treatment and nursing information, patient's condition, emotional support and nursing participation were, the lower the actual feeling of their satisfaction turned out. Conclusion : The study shows that treatment and nursing related information is the most highly needed and the patients' satisfaction level relies on actual care participation.

• 한국치위생학회지
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• 제23권2호
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• pp.125-132
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• 2023

Objectives: This study used the 2018 Korea Health Panel Survey data to analyze factors affecting employment status and income relating to unmet dental and medical care needs. Additionally it investigated measures to reduce oral health inequality among various socioeconomic classes. Methods: Descriptive statistics for the subjects' unmet dental and medical care needs were calculated through chi-square test analysis, and multivariate logistic regression analysis was applied to identify factors affecting the unmet dental and medical care needs. The odds ratio and 95% confidence interval were calculated for each level. These data were analyzed using STATA 17.0 SE (64-bit) version, and the statistical significance level was set to p<0.05. Results: As a result of unmet dental and medical care needs according to general characteristics, the lower the education level (p<0.001), the higher the age (p<0.001) and the lower the household equalization income (p<0.024) and the smoker status (p<0.003) were, respectively. Factors that have a statistically significant impact on unmet dental and medical care needs were divorce, separation and bereavement (p<0.001) in individuals than in married persons, and being smokers than non-smokers (p<0.009). The frequency of unmet dental and medical care needs were found to be lower in the cases of a high school graduate than an elementary school graduate (p<0.018), and of higher household equalization income (p<0.001) than the lowest household equalization income, respectively. Conclusions: It was found that various factors such as age, education level, household equalization income, employment status, type of working hours type, and smoking status affect unmet dental and medical care needs.

• 임상간호연구
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• 제24권1호
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• pp.34-43
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• 2018

Purpose: This study was aimed to identify the difference in satisfaction and importance of nursing care between patients in comprehensive nursing care unit (CNCU) and general nursing care unit (GNCU). It also confirms the difference between practice environment of nursing work and nurse's intention to work. Methods: Nursing care satisfaction and importance levels were measured from 202 patients. Practice environment of nursing work and nurse's intention to work were measured from 54 nurses. Results: The satisfaction level was higher in the CNCU in comparison to the GNCU (p<.001). There was no significant difference between the importance and satisfaction level of nursing care for patients at the CNCU (p=.973), whereas in the GNCU, patients' satisfaction level was lower than the importance level (p<.001). The score for practice environment for nursing work was higher in the CNCU than in the GNCU (t=3.34, p=.002). The nurse's intention to work in the CNCU was higher than that of the GNCU, but there was no statistically significant difference. Conclusion: Through the survey, the paper suggests that comprehensive nursing care is a service type that satisfies the nursing demand (importance) that patients consider important. Results from nurses showed no significant differences.

• 한국응급구조학회지
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• 제19권3호
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• pp.51-68
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• 2015

Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

• 대한예방한의학회지
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• 제1권1호
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• pp.126-136
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• 1997

To procide basic data for improvement of oriental medical care system, the questionnaire interview was carried out with community peoples, over 20 years old, selected randomly in Seoul, Pusan, Taegu and Taejon err. from 10th Mar. to 20th Apr. 1996. The result were summarized as follows: 1. In the general characteristics of subjects, the highest portion of each part was 52.4% of male, 22.4% of thirties, 37.1% of college graduates, 19.1% of married, 30.6% of town dwellers, 63.3% of muddle social class, 26.6% of housewife, 19.3% of student, 16.6% officer and 11.6% of professional technician. 2. The portion of subjects agree to open oriental clinic in western medicine hospital was 60.0%, that of disagreement was 20.1%, Among 60.0% of agreement group, the high rate was showed in female, fifties, middle school graduates, unemployed, middle social level. 3. The rate of positive responses in system of a herb specialist was 64.7%, that of negative responses was 11.6%. Among positive responses, the groups of high rate were male. twenties, above college graduates, student, middle-high social level and city dwellers. 4. In the question whether a pack of herb medicine should be included in medical insurance or not, the rate of agreement was 74.3%, that of disagreement was 4.1%. Amount agreement subjects, the high rate was showed in male, young age, high educated, city dwellers, professional technician middle social class. 5. In the cost of oriental medical care, the portion was divided by 70.3% of expensiveness,25.6% of moderate, 4.1% of low price. among 70.3% of high price, the high rate was in female, forties, agrolivestock-fishery, and town dwellers. 6. In the question what the herb doctor should do for the improvement of oriental medicine, the highest rate was 54.2% in further study. The next was 23.0% in need of western medical and 9.1% in no complain in present situation. Among 54.2% of further study, the high rate was showed in male, forties, high school graduate, profession technician, high social level, christian, married and city dwellers. 7. About institution of oriental care, 86.8% of subjects answered to need of improvement, 8.0% of them replied no problem as present. Amount 86.8% of subjects, the high rate was showed in male, twenties, above college graduate, sales, singles, high social level and city dwellers. 8. About necessity of western medical care instrument in oriental medical hospital, the rate of sightly need was 47.5%, inevitably need was 37.7%, no need was 6.3%, the Positive subjects were showed high rate in male, officer, singer, the younger age, the higher educated, better social level and city dwellers. These results might be useful information for establishing of oriental medical care policies, which open oriental medical clinic in western medical hospital, equip western medical care instrument in oriental medical hospital, improve oriental medical care instrument carry out a herb specialist system, balance the resonable medical care cost and effort for further study & research on oriental medicine to satisfy increasing need of oriental medicine.

• 의학교육논단
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• 제24권1호
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• pp.3-9
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• 2022

The concept of "public health care (public health and medical services)" as discussed in South Korea is used in an unclear sense, with a meaning unlike the terminology used worldwide. The terms "public health care (public health and medical services)" and "health care (health and medical services)" have the same legal definition in Korea. Globally, "public health care (public health and medical services)" refers to medical services provided to the public that are operated as publicly funded resources, but in Korea, this term is confined to limited medical services prescribed by the government. The following considerations regarding "public health care (public health and medical services)" in Korea are proposed: All medical services performed by the state, regional governments, health care institutions, or health care workers to protect and promote the health of the people should be clearly established as "public health care (public health and medical services)" by definition. The financial burden borne by the state through national health insurance should be increased to an appropriate level to clarify the state's responsibility. Improving public health is an urgent priority in Korea, and this goal can be achieved by improving regional public health through systematic relationships between the state and regional governments, establishing a Ministry of Health, and efficiently allocating public health doctors who are important for providing regional medical care in rural and remote areas. It will be possible to actively deal with infectious diseases at the national level through establishment of a Ministry of Disease Control and Prevention.

• 보건교육건강증진학회지
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• 제16권1호
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• pp.149-166
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• 1999

Self-care and the performance of their own role might be important for the prevention of complications and improvement of quality of life in hemodialysis patients with chronic renal failure(CRF). To improve well-being and quality of life for the patients, the author estimated the level of self-care and associating factors through a questionnaire. The information was composed of the knowledge for hemodialysis and renal disease, the level of self-care, health belief, supports from the family, disease-related stresses, personal characteristics, medical history, relationships with medical personnel, etc. The data was gathered from 126 hemodialysis patients who were undergoing hemodialysis in one university hospital and five hospitals in Kyungsangnam-Do area from December 1997 to January 1998, and was analyzed by PC SAS program(version 6.12) with the level of significance($\alpha$=0.05). The mean age of subjects was 47.0$\pm$13.5years with no significant difference in gender distribution. The mean duration of hemodialysis was 39.0 months, and their frequencies of hemodialysis were more than three times per week(77.0%). Only 21.4% had the specific education on hemodialysis and CRF. In the level which was expressed as the score out of 100, the mean of knowledge was 90.7$\pm$9.1 and the mean of self-care was 73.9$\pm$12.7, that means, they only partially carried their knowledge into practice. They showed a significant correlation between knowledge and health belief($\gamma$=0.282); self-care and health belief($\gamma$=0.357), family supports and knowledge($\gamma$=0.221), self-care($\gamma$=0.402), health belief($\gamma$=0.431); and health belief and stress($\gamma$=-0.361). Age, religion, marrital status, education, and relationships with medical personnel showed positive correlations, and smoking showed negative correlation with self-care. In the multiple regression with the level of self-care as dependent variable, and each of the characeristics as independent variables, supports from the family($\beta$=6.615=0.158), the experience of disease specific education($\beta$=4.959), relationships with medical personnel($\beta$=6.615), current smoking($\beta$=-6.986), and current drinking ($\beta$=-7.095) were detected as significant factors. The value of R-square was 34%. In summary, to promote the level self-care and to improve the well beings and Quality of life for the hemodialysis patients, it would be emphasized that they terminate smoking and drinking, and it would be recommended that the education programs and supports from the family be strengthened. And, because there was a considerable difference between the level of knowledge and self-care, it would also be emphasized to propose the education programs which focused on execution. In addition to that, there is a need to improve relationships between the patients and medical personnel through positive changes in the attitudes of the medical personnel.

• 한국응급구조학회지
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• 제15권2호
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• pp.67-84
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• 2011

Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.661-671
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• 1993

In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.