Financial barrier is well known as a determinant of the perceived need for and utilization of medical care in urban areas. This study aims to; a) estimate the levels of the perceived need for and utilization of medical care, b) analyze the reasons for not receiving medical care, and c) determine factors affecting the levels of need and utilization, and major reasons for not receiving medical care. The data of household interview survey in urban areas collected for a National Survey on Reorganization of Nationwide Health Care Delivery Network is used. An interview was conducted with a total of 2, 538 households in urban areas during a 28 day period of October through November, 1981, giving an overall response rate of 99 percent. The results show a factor of third-party payer is most influential to utilization (physician visits by patient), and living standard is a determinant to explain the variance of major reasons for not receiving medical care. Therefore, financial burden is still a major determent in utilization of medical care in urban areas. Improved level of living standard and expanded coverage of the third-party payer such as health insurance and public medical assistance will increase both an overall levels of utilization of and the need for medical care in urban areas in the future. The major statistics are as follows; a) rate of the need for medical care during a 15 day period per 100 persons was 33 percent: the differential rates appeared in sex, age, living standard, and third- party payer variables, b) percent of treatment employed per 100 persons who are wanting medical care was 82: the percents were high in young ages, high levels of living standard and education, and persons covered by third-party payer, and c) economic reasons for not receiving medical care per 100 persons who are wanting medical care were occupied with 60 percent: the rates are high in old ages, low levels of living standard and persons not covered by third-party payer.
Proceedings of the Korean Institute of Intelligent Systems Conference
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1995.10b
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pp.92-97
/
1995
In medical diagnostic process we are dealing with the preliminary diagnosis based on the interview chart. We will quantify the qualitative information of a patient by dual scaling and establish both prototypes of fuzzy diagnostic sets and the fuzzy linear regressions. Its utility is shown in the diagnosis of headache and CAFDDH.
The purpose of this study was to find the sociopsychological factors influencing the compliance of dietary regimen in diabetes by using focus group interviews. The data were collected from fifty three diabetes patients in eleven focus groups from September 1997 to March , 1998 in Seoul and Suwon Korea. The interviews were tape-recorded and the contents of the interviews were analysed by researchers. The subjects knew the causes, complications, and therapies of diabetes although they were incorrect at times . Patients had a wide range of outcome expectations from very optimistic to pessimistic. They recognized diabetes as a disease which needs life-time care, and they though that good care could provide a normal life. One the other hand they thought diabetes could lead to death through complications, and cause financial problems as well as social isolation. As for self-efficacy they recognized the importance of compliance to diet regimen but they thought the diet therapy was very difficult and were not very willing to follow it. They felt medical professionals, especially doctors, were influential for the therapies. However they frequently felt counselling provided by doctors was insufficient in time and content and led to attitude problems. They felt support from families and others was often insufficient and inadequate. Nutrition education fostering outcome expectation, social support, and self-efficacy is needed to increased compliance. The most influential referents were medical professional including doctors, nurses, dieticians, so their role in diet therapy should by emphasized.
Purpose: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. Method: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. Result: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. Conclusion: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.
Kim, Kyeong-Ok;Kim, Hee-Kyung;An, Hyo-Ja;Shin, Heon-Tae
Journal of Society of Preventive Korean Medicine
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v.17
no.1
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pp.163-179
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2013
Objectives : After analyzing the proficiency of medical communication of the students in College of Korean Traditional Medicine using standardized patients, we suggests ways to improve clinical practice in the future class and medical communication curriculum development. Methods : 20 students before clinical practice class (3rd grade) and 20 students after 1 year clinical practice class (4th grade) participated and did their medical interview on Standardized patient. They were evaluated on patient-physician communication skills by standardized patients and professor evaluator. In addition to be evaluated on patient-physician relationship, medical interview skills by professor evaluator. Results : As follows in the evaluation of clinical practice with standardized patients 1. More than half of the participated students regardless of their grade received poor score in their medical communication evaluated by SP(Standardized patient) and PE(Professor evaluator). 2. Greeting, History taking parts were higher in the 4th students who received 1 year clinical practice class, but verbal-nonverbal response, voice tone parts were higher in the 3rd students who do not received clinical practice lesson. 3. Pronunciation&Voice tone parts were higher in the male students but, gathering information part was higher in the female students. Conclusions : We think that the current clinical practice lessons are insufficient as a way to learn and improve medical knowledge and medical communication skills, and it is necessary a new form of clinical practice class. Participatory lesson using standardized patient could be a good alternative of that in the future class.
Background: The purpose of this study is to elucidate the context of medical experience and the perception of unmet healthcare of elderly people with chronic diseases based on in-depth interview data. Methods: We carried out in-depth interviews with 10 elderly people with chronic diseases using semi-structured questionnaires based on literature review. The in-depth interview data were analyzed using thematic analysis; one qualitative research methodology, three core meaning categories, and four attributes associated with unmet healthcare were ultimately derived. Results: The context of the medical experience were based on the following three categories: (1) discomfort due to diseases and high medical needs, (2) the poor community medical environment and difficulties in accessing to metropolitan medical institutions, and (3) inconvenience caused by long waiting time and side effects of medicine. In addition, the elderly with chronic disease realized the unmet healthcare as (1) the availability related to the desired medical institutions at the right time, (2) the affordability related to their economic capacity, (3) the effectiveness of the medical services they experienced, and (4) the appropriateness related to receiving medical services in a pleasant environment. Conclusion: The perception of unmet healthcare among the elderly with chronic disease is the result of interaction of multi-level and multi-dimensional factors related with their medical experience.
Purpose: This study aimed to analyze the jobs of paramedics who are diversifying by deriving duties in accordance with occupational group-related laws, although they are not directly specified in the job description of paramedics or the Emergency Medical Act. Methods: This study selected four paramedics who randomly extracted participants that submitted consent to participate between March 2023 and October 2023. Their occupational groups were the Korea coast guard and air rescue, health centers, and industries; they met on September 19, 2023, and directly transcribed the recorded contents through a three-and-a-half-hour focus group interview for analysis. Results: In the results, although the job description was not directly specified in the job description or emergency medical law, five areas of work applied to practice were derived: "rescue," "administration," "education," "industry," and "tactical." Conclusion: To expand jobs according to the diversification of the occupational field of paramedics, job analysis of paramedics belonging to various occupations is required.
Objective: Using the Korean Health Panel data (KHP) of 2008 and 2009, this paper analyzed the effect of antihypertension medication adherence on the changes in medical service utilization and medical expenditure in the next year. Method: Through a face-to-face interview survey, KHP has provided an extensive data on demographic characteristics, medical utilizations behavior, medical expenditure and health behaviors of the targeted households and their members since 2008. KHP is recognized as highly accurate regarding medical expenditure in that it makes the target households to record 'Health diary' whenever they use healthcare service, which could minimize their cognitive bias or memory distortion. The 2010 KHP data was based on the interview from 6,432 households and 19,697 household members. Two part model was used to explore the effects of medication adherence on medical use (logistic regression analysis) and medical expenditures (OLS). Result: Our study result demonstrated that the 74.7% of the patients who strictly adhere to their medication in both years, in 2008 and in 2009, were likely to use inpatient service in 2010. This shows the noncompliant patients were in fact use emergency service less than the compliant patients. Conclusion: Based on our analysis, this paper concludes that the high medication adherence of hypertensive patients could contribute to reduce the emergency service use. Therefore it is highly recommendable for the Korean government and the insurer, NHIS, to actively invest in developing education and promotion program to improve medication adherence among hypertensive patients.
Objectives : Recently, the interest on medical education in flipped learning has been growing. Competency-based curriculum is also required through changes in teaching methods within the Korean medicine education. In this study, flipped learning method was applied to 'medical ethics' class to examine the perception and experience of flipped learning from the Korean medical student's perspectives. Methods : The study was conducted on 15 preparatory course freshmen students who took the 'medical ethics' course, in the second semester of the year 2017 at 'A' University. The study was proceded in two steps; 1) fill-in the questionnaire twice (before and after the class), and 2) in-depth interview with semi-structured questionnaire. The $1^{st}$ questionnaire in the first step was consisted of 'Experience on flipped learning before the class', 'Which section of the flipped learning class do participants have expectation', 'Interest and expectation on flipped learning'. In the $2^{nd}$ questionnare, the participants were asked 'Which section of the flipped learning section that the learning effect was maximized', 'Association between 'flipped learning' method and 'Medical ethics' course' with 5-point Likert scale and frequency. Results : The results showed that flipped learning method works very effectively in the 'medical ethics' course (63.6%). After the flipped learning class, the participants showed positive change in a attitude of the class (72.7%). However, this teaching method might be inappropriate for participants who had difficulties in pre-learning or a passive attitude and lecture-centered instruction (LCI) classes. Conclusions : Though applying flipped learning method to the 'Medical Ethics' was effective, to make pre-learning better, the instructors should prepare countermeasures for passive participants, help interact well among the participants, and plan a lesson thoroughly for changing LCI classes to student-centerd instruction(SCI).
Communications for Statistical Applications and Methods
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v.19
no.3
/
pp.359-365
/
2012
The fuzzy set framework has a number of properties that make it suitable to formulize uncertain information in medical diagnosis. This study introduces a fuzzy diagnostic method based on the interval-valued interview chart and the interval-valued intuitionistic fuzzy weighted arithmetic average(IIFWAA) operator. An issue in the use of the IIFWAA operator is to determine the weights. In this study, we propose the occurrence information of symptoms as the weights. An illustrative example is provided to demonstrate its practicality and effectiveness.
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