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Satisfaction with Health Care in North Korea: A Study of North Korean Refugees in China (중국내 북한이탈주민을 통해 본 북한의료이용 만족도)

  • Kim, Gae-Young;Chung Woo-Jin;Lee, Yun-Hwan;Park, Chong-Yon;Robinson W. Courtland;Lee, Myung-Ken;Lee, Og-Cheol;Burnham Gilbert M.
    • Health Policy and Management
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    • v.16 no.4
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    • pp.48-67
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    • 2006
  • The aim of the study was to examine levels of satisfaction with health care in North Korea and to identify factors associated with it using a convenience sample of North Korean refugees in China. Data from the 2004 Survey of Health Seeking Behavior of North Korean Households conducted by the Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health were used. The study subjects were 273 North Korean refugees whose length of stay in China was less than 3 months. Factor analysis was used to extract factor dimensions from the 12 satisfaction items. Bivariate (t test and ANOVA) and multiple regression analyses were used in examining factors associated with satisfaction with health care use in North Korea Overall, satisfaction level was low ($2.36{\pm}0.36$, score range: 1-5). Of the three-factor dimensions, physician skills scored the highest $(2.93{\pm}0.36)$, followed by drug availability $(2.51{\pm}0.07)$ and general cleanliness $(1.66{\pm}0.55)$. In the multiple regression analysis, having a usual source of care was significantly associated with patient satisfaction. Respondents who identified primary care (section) doctors as their usual source of care tended to be less satisfied than those with the city or county hospital as their usual source of care. County residents tended to report a lower degree of satisfaction with general cleanliness than city residents. Among socioeconomic characteristics, the number of household assets positively predicted satisfaction with drug availability. North Korean residents appear to be dissatisfied with their medical care. It may reflect some inadequacies in the North's universal health care system to meet the healthcare needs of its people.

A Comparative Analysis of the Systems Related to the Production, Authorization, and Listing for Insurance of Herbal Medicine Products in South Korea and Taiwan (국내와 대만의 전통약제제 생산.허가.보험등재 관련 제도)

  • Son, Chi-Hyoung;Lim, Sabina;Lee, Eun-Kyoung;Kim, Dong-Su;Kim, Yun-Gi;Cheng, Huan-Chiang;Kim, Yong-Ho
    • The Journal of Korean Medicine
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    • v.33 no.3
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    • pp.147-159
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    • 2012
  • Objectives: Systems related to the production, authorization, and listing for insurance of herbal medicine products were compared between South Korea and Taiwan to illuminate herbal medicine products system issues in South Korea. Methods: Papers, and laws and policies related to the production, authorization, and listing for insurance of herbal medicine products in South Korea and Taiwan are analyzed to create the primary documents. The documents from South Korea were screened with the advice of a specialist, while those from Taiwan have been verified through local investigation and with the help of a related specialist. The screened documents were then compared and analyzed in the order of the systems related to the production, authorization, and listing for insurance of herbal medicine products. Results: The systems related to the production of herbal medicine products satisfy GMP requirements in both countries, while Taiwan has more specialized systems related to the production of herbal medicine products and a more strict authorization program as compared to South Korea. While South Korea has most of the herbal medicine products classified as non-prescription drugs, Taiwan has them as prescription drugs. And while South Korea does not allow new herbal medicine products to be listed for insurance, Taiwan allows for once-a-year application toward listing for insurance. Conclusions: In order to ensure the safe and effective use of herbal medicine products, systems related to the production, authorization, and listing for insurance of herbal medicine products are to be established, while the categorization of medicine products principally used by Korean medicine doctors should be prepared. Furthermore, prescription by a Korean medicine doctor for new drugs made with natural products and their listing for insurance need to be encouraged.

The Present Situation, its Controversial Points and its counterplans of Korean Students who are Studing Chinese Medicine in China (중국(中國)의 중의약대학(中醫藥大學) 한국유학생(韓國留學生) 현황(現況), 문제점(問題點) 및 대책(對策))

  • Lee, Seon-Dong;Mun, Yong
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.126-142
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    • 1997
  • For last four or five years, the number of Korean students have gone on increasing awfully. After the year 1997 when they will flow in, our field and government will be undergone a big shock and social problems. Therefore, thorough grasping and the method of provision is expeced to need. 1. The situation, According to the data published from the year 1993 to 1997, their results are great different. But recent Korean embassy in China examined the situation of the Korean students, whose result was investigated as follows: about 1500 persons, their average age is 24 to 44, the ratio of male and female students is 3 to 1, that of their academic background which is a graduate of university : that of college : that of highschool is 1.6 : 1 : 4.7, and that of their class attitude which is direct : common : indirect appears the percents 30.4 : 52.8 : 16.8. 2. The controversial points (1) A lowering of standards on Chinese medical treatment is expected by the imprudent studying abroad without qualification. And because of excessive production of herb doctors, the amount of treatment may be above people's demand. Besides owing to the impossibility of prediction on the number the counterplans of our government may fall into utler confusion. (2) The curriculum, the teaching schedule and contents are so different that the graduates seem not to be given real education of chinese medicine from the point of Korean view. (3) In the wrong national examination, the important thought of china, and the system of WTO in Korea, when China will become mighty rival above problems contain the negative sides. 3. The counterplans - what should be performed soon. (1) Illegal contents about studying abroadl in China ought to inform sidely that students might not go on increasing. Before they form nam-power, the government and the field of chinese medicine should cope with such a situation together. (2) The law of regulation about agents should be legislated and they should be surpervised. (3) The exact numbers of students, their situation, and the present condition of each university should be examined. (4) After investigating the problems of the present system of national test, its enforcement and many counterplans is requisite. (5) The cooperating confrontation with the conference of dentistry is in need. (6) Since the problems are possibility to be developed to diplomatic questions, the effort of both nations is needful. - what need middle of long time. (1) The effort that suppress the more establishment of the college of oriental medicine is necessary. (2) After comparing with the system of foreign test, the government should make the system of test in accord with the mutualism and the principle of indiscrimination among nations and cope with such a many issues thoroughly.

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A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea (자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구)

  • Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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A Qualitative Study on Traditional Korean Medicine Treatment for Child Patients with Night Crying - With a Focus on Descriptions by Main Fosterers - (야제 환아의 한의치료에 대한 질적 연구 - 주양육자의 서술을 중심으로 -)

  • Kim, Hyejin;Jeon, Chaeheun;Kim, Eunji;Kim, Hyunho;Leem, Jungtae;Ryu, Suhyang
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.1
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    • pp.44-53
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    • 2018
  • Objectives This study sets out to examine treatment experiences of child patients with night crying based on the traditional Korean medicine. Also, the study traces the process in which clients chose traditional Korean medicine treatment, and proposes a possible future direction of Korean medicine treatment. Methods The investigator conducted a semi-standardized open-ended question interview with two main fosterers of a child who received traditional Korean medicine treatment for night crying, and examined two fosterers' experiences of a child with the traditional Korean medicine treatment. Their interviews were recorded with their facial expressions and acts for analysis. Collected data was analyzed based on the Grounded theory. Results The participants felt a sense of responsibility, worry, and fear for their children with night crying. They had easy access to traditional Korean medicine doctors who were in the community and had positive experiences with traditional Korean medicine treatment. They reported that some people had been forced to use traditional Korean medicine, had misunderstandings about traditional Korean medicine, and had prejudice that night crying is not a disease. They felt there was a room for improvement in terms of the high medical expenses and the absence of a cooperative system between Oriental and Western medicine. Conclusions As the first qualitative study on night crying based on the traditional Korean medicine treatment, this study proposed a future direction for traditional Korean medicine treatment for night crying in the shoes of fosterers. The findings showed that the fosterers chose traditional Korean medicine treatment for night crying child based on their feelings, accessibility and experiences with traditional Korean medicine. Fosterers felt a need for improvement of the general public's perceptions about Korean medicine treatment on night crying, and a cooperative system between Oriental and Western medicine.

Design and Implementation of a Robot Analyzing Mental Disorder Risks for a Single-person Household Worker through Facial Expression-Detecting System (표정 감지 시스템을 통한 직장 생활을 하는 1인 가구의 정신질환 발병 위험도 분석 로봇 설계 및 구현)

  • Lee, Seong-Ung;Lee, Kang-Hee
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.1
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    • pp.489-494
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    • 2020
  • We propose to designs and to implements a robot analyzing the risk of occurrence of mental disorder of single-person households' workers through the facial expression-detecting system. Due to complex social factors, the number and proportion of single-person households continues to increase. In addition, contrast to the household of many family members, the prevalence of mental disorder among single-person household varies greatly. Since most patients with mental can not detect the disease on their own, counseling and treatment with doctors are often ignored. In this study, we design and implement a robot analyzing the risk of mental disorder of single-person households workers by constructing a system with Q.bo One, a social robot created by Thecorpora. Q.bo One is consisted of Arduino, ar raspberry pie, and other sensors designed to detect and respond to sensors in the direction users want to implement. Based on the DSM-5 provided by the American Psychiatric Association, the risk of mental disorder occurrence was specified based on mental disorder. Q.bo One analyzed the facial expressions of the subjects for a week or two to evaluate depressive disorder, anxiety disorder. If the mental disorder occurrence risk is high, Q.bo One is designd to inform the subject to counsel and have medical treatment with a specialist.

MAXILLARY FLOATING TEETH IN A CHIARI MALFORMATION PATIENT (Chiari malformation 환아에서 상악 구치부의 부유치)

  • Shin, Eun-Young;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.649-653
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    • 2001
  • The Chiari malformation is a deformation within the central nervous system which the lower brain stem and the cerebellum migrate into the foramen magnum causing herniation. In 1891, Arnold Chiari classified such symptoms into 3 categories. This case report is of a 8-year-old female with the complaint of a slight facial swelling and pain on the upper right molar during tooth brushing since 10 days before. Clinical examination showed gingival pocket formation on distal of the upper right first molar with pain and mobility of the tooth. Radiographic examination showed generalized low bone density in the upper molar area, and especially no bone support above the upper right and left first molars were noted. With a temporary diagnosis of Early-onset periodontitis, consultations with medical doctors for the possibility of an underlying systemic disease were made during periodontal treatment. 3D CT was taken with after a final diagnosis of Chiari malformation. Generalized thinning and defect of the cranial bone was noted and the foramen magnum was slightly enlarged. The occipital and maxillary bone was low in density, and the alveolar bone of maxillary posterior teeth was especially almost non-existing causing the upper right and left first molar to be floating. For this, the patient went under consultation with the department of neurosurgery and is still under observation. Periodontitis in childreren is very rare. When symptoms of periodontitis appear in a child, due to the possibility of an underlying systemic disease such as leukemia, histiocytosis X, and hypophosphatasia, proper examinations should be carried out so that the primary factor the symptoms can be treated.

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An Index of Visual Function in Patients with Cataract - Pilot study - (백내장 환자의 시기능지표 - 사전 연구를 중심으로 -)

  • Kang, Hyung-Gon;Park, Eun-Cheol;Choi, Yoon Jung;Kim, Han Joong;Hong, Young Jai;Cho, Woo Hyun;Sohn, Myongsei;Lim, Seung Jeong
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.128-138
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    • 1998
  • Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity(VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ${\geq}$ 0.86). The better visual acuity(operated eye, better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest $R^2$. Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to be used for analysis.

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Relationship among Patient Outcomes in Cataract Surgical Patient - Pilot study - (백내장 수술환자 진료결과들간의 관계 - 사전 연구를 중심으로 -)

  • Park, Eun-Cheol;Kim, Han Joong;Hong, Young-Jae;Cho, Woo Hyun;Sohn, Myongsei;Lim, Seung Jeong;Kang, Hyung-Gon;Choi, Yoon Jung
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.106-118
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    • 1998
  • Background : This study was done to assess the relationship among multiple patient outcomes of cataract surgery perioperatively, 3-4 months and 12 months after surgery. The patient outcomes include changes in visual acuity(operated eye, better eye), visual function(VF-14), patient satisfaction, subjective satisfaction with vision, and subjective overall health status. Methods : For the assessment of relationship, prospective study was performed with 92 patients who had undergone either one or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 4 stages : preoperatively, perioperatively, postoperative 3-4 months, and postoperative 12 months. Results : The correlations within patient outcomes at 4 stages - the visual acuity of operated eye and that of better eye, patient satisfaction and VF-14, subjective overall health status and relative health status as against others - were found to be positively correlated. The change in the visual acuity of operated eye and better eye was correlated with VF-14 as well as with patient satisfaction. The change was also correlated with overall health status. However, the correlations between variables were decreased as the postoperative period got longer. Conclusion : As for the postoperative clinical patient outcomes, VF-14 is acted to linker between visual acuity - clinical outcomes and overall health status - endpoint outcomes. Therefore. VF-14 is the index of patient-sided and disease-specific outcome for cataract surgery.

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Determinants on Korean Medicine Use among Breast Cancer Patients (유방암환자의 한의약의료서비스이용 결정요인)

  • Han, Dong-Woon;Kim, Yoon-Yong;Choi, Soo-Jeong;Hwang, Jung-Hye
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.3
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    • pp.37-51
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    • 2012
  • Objectives : The objective of this study is to determine the present state of patients with breast cancer use of Korean medicine(KM) and predictive factors for the use. Through this, the present study is intended to present reasonable treatment approaches for patients with breast cancer as well as communicating correct information on KM to healthcare providers and presenting objective alternatives for patients with breast cancer management based on the subjects' experience in health benefits obtained from their use of KM. Methods : To collect data for the present study, questionnaire surveys were conducted on outpatients who visited four hospitals located in Seoul, Korea during around three weeks from May 31, 2012. Although the total number of the questionnaire sheet distributed in the form of directly asking questionnaire questions was 300, 12 incomplete questionnaire sheets were excluded. Therefore, the number of questionnaire sheets actually used in analyses was 288 and thus the collect rate was 96%. Results : Major results of this study are as follows. First, the number of subjects who responded to the questionnaire was 288 in total. Forty-six percent of the patients reported KM usage and the most commonly used ginseng and qigong/exercise. KM use was found to be associated with age, experiencing side effects of cancer treamnent. Factors that affect the use of KM were analyzed by Linear Logistic Regression and the results showed that age, experiencing side effects of cancer treatment, effectiveness of cancer treatment, and satisfaction of the treatment were factors that were related with relatively more frequent use of KM. Conclusions : Comparing the previous studies, it could be seen that patients with breast cancer were highly interested in and used KM in which conventional medicine and KM are used simultaneously. Knowledge on the integrative use of KM and conventional therapies is necessary for cancer physicians and traditional Korean medical doctors to help patients make informed choices. KM use may play a role in the positive benefits associated with process of breast center treatment. Healthcare providers should communicate correct information on the KM use that has been scientifically verified and talk with each other openly. The fact that the significant correlation between predictive factors for the use of KM was identified trough the present study is quite meaningful.