• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.29-36
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• 1976

Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

• Korea Journal of Hospital Management
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• v.7 no.3
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• pp.63-83
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• 2002

This study is to survey the materials purchasing and inventory management status and the characteristics and opinions of the staff in charge of purchasing and inventory of the general hospitals in Busan area in order to contribute to the rationalization of its management through the grasp of actual situation and the presentation of desirable improvement plan for the materials purchasing and inventory management. The status of medical institute had been surveyed by the purchasing/ administration managers of total 26 general hospitals, and the purchasing/ management questionnaires had been commenced with 86 staff of the 26 hospitals. Its major survey results, after the analysis of 24 medical institute statuses (return rate of 92.30%) and 60 staff questionnaires (return rate of 69.76%), are as follows. First, post-purchasing evaluation system is not used actively, orders are being placed by phone or fax, and general merchandise is being purchased through free contracts in most of the hospitals participated in the survey. Second, as per the materials supplying methods, the requisition and delivery system is currently the most popular in the hospitals surveyed, however, both the requisition and delivery system and the par level transfer system are the most desired in the hospitals of more than 500 beds, and the par level transfer system is the most desired in the hospitals under 500 beds for the materials supplying system in the future. Third, as per the inventory management system that is desired the most in the future, the SPD and JIT types are preferred in the hospitals of more than 500 beds, the stockless strategy is preferred in the hospitals under 500 beds, the senior staff above section chief grade prefer the stockless strategy, and the junior staff prefer the ABC classification and SPD types. Fourth, The necessity of purchasing staff's training for the materials management is highly recognized but the effectiveness is not so much acknowledged, which is because such a training is thought to be so superficial and formal that it is not helpful much in the actual field. When summarizing the survey results as above, the materials purchasing and management system is differed for each group of hospitals according to the size of beds, and the more scientific management system is largely required by the general hospitals in Busan city. They also hope the introduction of joint purchasing system, materials management by the bar-code system, and positive execution of the market survey and training of the relevant staff for the management of purchasing affairs. So the more systematic purchasing and inventory management is regarded to be necessary through the introduction of scientific and specialized education of materials management, market survey, and post-purchasing evaluation system also through the computerization of materials purchasing and inventory management as soon as possible.

• Electronics and Telecommunications Trends
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• v.38 no.3
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• pp.47-56
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• 2023

Physical rehabilitation consists of exercises that help individuals who have suffered injury, disease, or nervous system disorders to recover lost or impaired functions. The exercises need to be tailored to the degree and type of the patient's condition. To this end, a comprehensive rehabilitation data delivery system that connects medical institutions and local communities should be established, and an intelligent rehabilitation service technology should be developed. An intelligent rehabilitation service integrates and manages the patient's health information provided by medical institutions and the overall function evaluation information measured in the community. Based on the collected data, personalized rehabilitation services can be provided. We examine supportive policies and technological trends for rehabilitation exercise and sports. Additionally, we investigate development trends and key technologies of intelligent rehabilitation services being developed at ETRI.

• Annual Conference of KIPS
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• 2021.05a
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• pp.33-36
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• 2021

Corona 19 minimizes face-to-face contact, and online untact platforms are emerging in the medical sector. However, there are potential risks of medicine expiration, medicine misuse, and responsible materials management for secure delivery. In this paper, we investigate three key functional requirements for online pharmacy, and design the blockchain based online pharmacy to meet the requirements. To protect the patient's privacy and to ensure tamper-free traceability, we incorporate the multi-level access authentication scheme for each participant (governments, medical circles, and patients). We show that our system guarantees patient's privacy without further system modification.

• Health Policy and Management
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• v.5 no.2
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• pp.155-172
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• 1995

This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.

• Korean Journal of Veterinary Research
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• v.57 no.2
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• pp.105-111
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• 2017

Hyaluronic acid (HA) has been investigated for biomedical and pharmaceutical applications. This study was conducted to determine the distributions of HA nanoparticles (NPs; size 350-400 nm) and larger HA polymers in mice at intervals after application. $^{177}Lutetium$ (Lu)-labeled HA-NPs or HA polymers were intravenously injected (5 mg/kg) into male ICR mice, and radioactivity levels in blood and target organs were measured from 0.25 h to 28 days post-injection. In blood, the radioactivities of HA-NPs and HA polymer peaked at 0.5 h after injection but were remarkably decreased at 2 h; subsequently, they maintained a constant level until 6 days post-injection. HA-NPs and HA polymers were observed in the liver, spleen, lung, kidney, and heart (in ascending order) but were seldom observed in other organs. After 3 days, both the HA-NP and HA polymer levels showed similar steady decreases in lung, kidney, and heart. However, in liver and spleen, the HA-NP levels tended to decrease gradually after 1 day and both were very low after 14 days, whereas the HA polymer level accumulated for 28 days. The results indicate that HA-NPs, with their faster clearance pattern, may act as a better drug delivery system than HA polymers, especially in the liver and spleen.

• Health Policy and Management
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• v.28 no.3
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• pp.315-319
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• 2018

This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial 'recovery support stage' with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are 'recovery support stage,' 'system homogenization stage,' and 'unified system stage.' Strategies at 'recovery support stage' suggested in this paper need to be pursued and followed by those at 'system homogenization stage' and 'unified system stage.'

• Health Policy and Management
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• v.27 no.3
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• pp.191-198
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• 2017

Moon Jae-in Government announced the Government's 5-Year Plan on July 19, 2017, President Moon directly announced the Government's Plan for Benefit Expansion in National Health Insurance on August 7, 2017. The main contents of the announced expansion include benefit coverage for all medically necessary services with control over non-covered service occurrence, a decrease in the cost-sharing upper limit, and monetary support for catastrophic medical costs. Although past governments have been continuously striving for benefit expansion in the last 15 years, this plan has its breakthrough aspect in that all medical services will be covered by the National Health Insurance. In alignment, there are important tasks to solve: attaining a proper fee schedule, reforming the healthcare delivery system, and improving healthcare quality. This plan is a symptom oriented action in that it is limited in reducing patients' out-of-pocket money, unlike the systematic approach of the National Health Insurance. The sustainability of the National Health Insurance is being threatened due to South Korea's low birth rate, rapidly aging society, and low economic growth, in addition to the unification issue of the Korean Peninsula, medical utilization of the elderly, management of non-communicable diseases, and so on. Therefore, the Government needs to plan the National Health Insurance system reformation including actions addressed toward medical consumers.

• Korea Journal of Hospital Management
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• v.3 no.1
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• pp.34-61
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• 1998

A study on cooperative medical treatment system between oriental and western medical practitioners was conducted from March through August 1997 in order to determine a productive model of cooperation of two medical parts for treatment of patients. Questionnaires were distributed to 195 medical doctors(M.D.) and 195 doctors of oriental medicine(O.M.D.) working in clinics and hospitals in six major cities. Statistical analysis tools used for this study were frequency, t-test and multiple regression by using SPSS/P.C package. The results are summarized as follows: 1. The respondents were composed of male docotors(78%) and female doctors(22%) and 68.2% of M.D. and 97% of O.M.D. were interested in the other medical part. The doctors of both disciplines had some limitation on treatment of patients but they were reluctant to refer their patients to other doctors in different discipline. 2. M.D assumed that oriental medicine was more effective for chronic diseases, and O.M.D. thought that western medicine was more effective for acute diseases. 92.3% of O.M.D.s responded that even though they do not utilize western medical technology for diagnosis, they believed the results of diagnoses by western medical technology. 3. 60.5% of O.M. and 93.3% of O.M.D. said that cooperative medical treatment system could be necessary for patients and it would be effective for control of diseases and 69% of western medical doctors and 99% of oriental medical doctors agreed that oriental medical practice would be more effective for cerebellar vascular accidents than other diseases. 77.4% of western medical doctors and 92.3% of oriental medical doctors responded that the students of two different disciplines have to be taught on the other disciplines. 82.6% of western medical doctors and 83.3% oriental medical doctors agreed that it would be necessary to have collaborative research between scientists in two disciplines. 81.5% of M.D.s and 93.3% of O.M.D.s believed that they had prejudice and distrust on other discipline 4.90% of the doctors were not satisfied with the government medical policies on health insurance, legal matters, and health delivery system. 5. 75.4% of M.D.s and 50.2% of O.M.D.s said that two medical disciplines should be integrated, but they were skeptical on that. 75.3% of M.D.s thought that western hospitals should employ O.M.D.s Finally this study recommended that western medical students study oriental medicine and the vice versa, and M.D.s and O.M.D.s should have seminars and workshops to exchange knowledge, and experiences. It is also recommended that medical laws be revised to allow medical doctors refer the patients whom they can not handle to oriental medical doctors and the vice versa.

• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.123-131
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• 1999

The purpose of is study deals with the physical therapy and the delivery system of public health center, as a center, in community based rehabilitation and delivery system. We hope that the system of physical therapy of public health center in community based rehabilitation spreads all over the country and contributes to the promotion of national health and social welfare. There are many public health center in the country because it can serve inhabitants with the medical benefits in the Erst line. public health center continuously provides poor inhabitants who cant pay medical expenses care of health. It has the public health center branches that take care of inhabitants who live a remote village and hiterland. Additionally, many people want to receive physical therapy. Therefore, the physical therapy of public health center becomes the central paint in community based rehabilitation so that we supply the inhabitants with superior rehabilitation service. We can approach them as a team that be constituted with physical therapist speech therapist, psychologist, nurse, social work. Also the role of physical therapist is divided into two parts, which are home visiting part that individually takes can of patients nod public health part that takes care of patient, family, home, community. We connect with both self-governing body and the government so that we may receive government subsidies. Also, we must prepare regular school education for community based rehabilitation