Background: Due to the asymmetry of information and knowledge and the power of bureaucrats and medical professionals, it is not easy for citizens to participate in health care policy making. This study analyzes the case of the insured organization participating in the Health Insurance Policy Committee (HIPC) and provides a basis for discussing methods and conditions for better public participation. Methods: Qualitative analysis was conducted using the in-depth interviews with the participants and document data such as materials for HIPC meetings. Semi-structured interviews were conducted with purposively sampled six participants from organizations representing the insured in HIPC. The meanings related to the factors affecting participation were found and categorized into major categories. Results: The main factors affecting participating in the decision making process were trust and cooperation among the participants, structure and procedure of governance, representation and expertise of participants, and contents of issues. Due to limited cooperation, participants lacked influence in important decisions. There was an imbalance in power due to unreasonable procedures and criteria for governance. As the materials for meetings were provided inappropriate manner, it was difficult for participants to understand the contents and comments on the meeting. Due to weak accountability structure, opinions from external stakeholders have not been well received. The participation was made depending on the expertise of individual members. The degree of influence was different depending on the contents of the issues. Conclusion: In order to meet the values of democracy and realize the participation that the insured can demonstrate influence, it is necessary to have a fair and reasonable procedure and a sufficient learning environment. More deliberative structure which reflects citizen's public perspective is required, rather than current negotiating structure of HIPC.
Background: This study was purposed to analyze the effect of spatial accessibility to the psychiatry department in general hospital on the outpatient visit of mental patients. Methods: Data was provided from the Statistics Korea and Statistical Geographic Information Service, National Health Insurance Service, Health Insurance Review and Assessment Service, and Korea Transport Institute in 2015. The study regions were 103 administrative regions such as Si and Gu. The 103 regions had at least one general hospitals with a psychiatry department. The number of outpatient visit of mental patients in regions was used as the dependent variable. Spatial accessibility to mental general hospital was used as the independent variable. Control variables included such as demographic, economic, and health medical factors. This study used network analysis and multi-variate regression analysis. Network analysis by ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA) was used to evaluate the average travel time and travel distance in Korea. Multi-variate regression analysis was conducted by SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA). Results: Travel distance and time had significant effects on the number of outpatient visits in mental patients in general hospital. Average travel time and travel distance had negative effects on the number of visits. Variables such as (number of total population, percentage of aged population over 65, and number of mental general hospital) had significant effects on the number of visit in mental patients. Conclusion: Health policy makers will need to consider the spatial accessibility to the mental healthcare organization in conducting regional health planning.
Thyroid cancer is one of the most common cancers in Korea, and thyroidectomy is the first-line treatment. Hypoparathyroidism is a common complication of thyroidectomy and can cause symptoms such as numbness, spasm, and anxiety, but these issues have seldom been reported in the Korean medical literature. The present case was a 53-year-old thyroid cancer patient who complained of numbness caused by hypoparathyroidism, general weakness, fatigue, and postoperative pain after total thyroidectomy. The patient was treated with Korean medicine treatment, including herbal medicine, acupuncture, cupping, and moxibustion, and her changes in clinical symptoms were measured with a numeric rating scale (NRS), the Karnofsky performance status scale (KPS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). After treatment, her clinical symptoms were improved, leading to an improvement in her quality of life. Therefore, Korean medicine may be effective in the treatment of thyroid cancer patients who experience numbness caused by hypoparathyroidism, general weakness and fatigue after total thyroidectomy.
Objectives: This study described the features of home-bound industrial accident victims and their needs for rehabilitation services. This study was also aimed to find a future direction of development of community rehabilitation programs that are suitable for their needs demands. Methods: This study is a descriptive study, were collected through two phases using structured questionnaire. In the first stage, su were performed via telephone interviews. In the se stage, surveys were performed via home visit Subjects in the first stage included 2203 indu injured victims staying at home, of whom. individuals complaining of post-traumatic complic became the subjects of the second stage. Results: This study showed that the home-bound industrial accident patients were complaining of complications from the injury even after receiving treatment by IACI. However, they were neglecting their health problems without any intervention. Even if they use health care services. the treatment is mainly focused on acute medical care, which may not effective for them. Furthermore, they had unstable employment status and suffered from financial burden for health care costs. The Labor Welfare Organization has established a plan to remove barriers of industrial accident victims in reinstatement, and has been preparing various programs in order to establish an all-embracing service system for industrial accident victims from accident occurrence to reinstatement. However, these rehabilitation services can be truly helpful only when the injured are able to obtain enough information about them. The current restrictive system is also not appropriate for solving health problems of the industrial accident victims. Therefore, it is necessary to develop a plan that can provide industrial accident victims high-quality rehabilitation services so that they can use those services in the community without being dependent on hospitals. This study proposes visit nursing services as a way to provide various health services within community for the industrial accident victims.
The purpose of this study is to investigate typical ethical problems found in the technical and public services areas. The followings are the summary of the study. There are three distinct elements that govern ethical problems. One element is legal laws. The copyright law and the privacy act are exact examples. The copyright law has strong influence on the inter library loan service where the majority requests from the users are reproduction of copies. The privacy act also creates difficulties for librarians. Most requests for circulation records infringe on the privacy of library user. And advance online access systems also violates the privacy of library users. The second element is the code or rules that private organization has created. American Library Association created many statements that regulate the conduct of librarians. The bill of right, the professional code of ethics and policy on the confidentiality of library records have strong implications in the obligation of librarian. In the case of censorship at the selection of library materials, the code is a defensive tool against intellectual freedom. Yet self-censoring are prevailing practice among librarians. The thirds element is the competence of librarians. The analyzed table 3 showed that beside two elements, the rest of matters are competence required by librarians. The one aspect of it is humaneness and the other one is technical aspects. Technical aspect of competence are:(l) managerial and operational ability (2) communication skill (3) leadership (4) structure of knowledge and (5) self developing professionalism. Humanity aspect of competence are:(l) trust(fiduciary relationship) gained by diligence, objective judgement, ability, belief, rationality, integrity, kindness) (2) objectiveness (free from bias) (3) user-oriented consideration (need, interest, equal treatment, information gap) (4) caution in providing information (5) pride and (6) ability to distinguish advice and guidance specially in medical and law library.
Objective: Organization of articles have study design, make hypothesis, sample gathering, statical analysis and feasibility of conclusion and medical articles must be continuously published and be continuously monitored in order to raise the quality of research. Main characteristics of oriental pediatrics research in korea can be summarized as the increase of the number and the advances methodology in research. The purpose of this study was to analyze the trends and evaluate the level of oriental pediatrics. Methods: The subjects were 244 articles published during the from 1986 to 2002 in 'The Journal of Korean Oriental Pediatrics' In this study, all the articles pressed in this journal were divided into three classes, Iiteratural, experimental and clinical articles and these were surveyed their chronological and thematic distribution Results: Classifying the articles in the journal of the korean oriental pediatrics, there were 103(42.2%) literatural articles, 90(36.9%) clinical articles, 51(20.9%) experimental articles. Clinical articles is gradually increasing although Iiteratural articles is decreasing. About disease in oriental pediatrics, immunoactivity was 13, rhinitis and growth was 12, allergy was 11 and diarrhea was high frequent in literatural articles, statistics of chief complaints and rhinitis was high frequent in clinical articles, immunoactivity was high frequent in experimental articles. Conclusions: As can be seen from the above results, there has been many these published using various experimental methods and relating to oriental pediatrics on the symptoms and diseases and their treatments, but unfortunately they were not enough the transmission of meaning of theses and contribution of learning, because how to do theses was not unifonn and description was not evident. It is needed more careful attention and study in the method of theses works in order to further develop the specialty of oriental pediatrics.
Purpose: The purpose of this study was to investigate level of functioning in patients with stroke using Modified Bathel Index (MBI), World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and ICF core-set for stroke. Methods: Sixty-four patients with stroke were recruited for this study from nine medical institutes. The ICF core-set for stroke, WHODAS 2.0, and MBI were used to collect subjects' functional levels. ICF core-set was employed here as a standard frame to observe multi-dimension of functioning, that is physiological bodily function, activity and participation (AP) in daily life, and current environmental factors (EF) in patients with stroke. WHODAS 2.0 and MBI were also used in order to have a specific functioning level for subjects. The linkage of each item in WHODAS 2.0 and MBI into the ICF core-set for stroke was examined. Pearson correlation coefficient was used for analysis of their relationships. Results: Functioning level of participants showed moderate resulting from MBI and WHODAS 2.0 ($73.48{\pm}22.27$ and $35.55{\pm}12.53$, respectively). Strong relationship was observed between ICF core-set and WHODAS 2.0, and with MBI. Each item of disability scales was obtained its linkage into ICF in the domain of AP. However, lack of correlation between MBI and ICF in the domain of EF was found due to absence of related factors. Conclusion: MBI was found to be linked mainly into ICF in the domain of AP and to have limited linkage into EF. Therefore, it should be suggested that the ICF concept frame should be used as a multi-dimensional approach to patients with stroke.
Purpose: The purpose of this study was to investigate the characteristics of patients with Chronic Low Back Pain (CLBP) in disability, pain, and cognition, and to compare those characteristics to the ICF concept analyzing the association between World Health Organization Disability Assessment Schedule 2.0: 12 item-interviewer version (WHODAS 2.0) and those of scales i.e. Oswestry Disability Index (ODI), the Short-Form McGill Pain Questionnaire (SFMPQ), and the Fear avoidance & belief questionnaire (FABQ). Methods: A total of 91 patients with CLBP were invited to participate in the study. Physical therapists interviewed all participants using SFMPQ, FABQ, ODI, and WHODAS 2.0 for collection of information on pain, cognition, and functional level data. Subjects scored their disability, pain, and cognition related to LBP using WHODAS 2.0, ODI, SFMPQ, and FABQ. Data analysis was performed using the Spearman correlation coefficient. Results: A positive relationship was observed between WHODAS 2.0 and each scale indicating that lower back specific disability components could be related to the ICF concept in ODI (r=0.77). Pain intensity and pain oriented movement were found to be related to general functioning in patients with CLBP (r=0.52, r=0.55, respectively). Conclusion: It can be suggested that the specific disability scale for LBP, ODI can be related to the ICF concept, WHODAS 2.0, and it may be a useful measure for patients with CLBP.
Contemporary hospital has more and more extension because the growth and change of hospital has to respond the various needs. For expanding, the sky bridge(sky walk) becomes one of the method to interconnect two or more buildings on the air. Sometimes the designers don't know exactly how the sky bridge works after construction. Beyond the role of interconnecting two buildings, the role of sky bridge is transformed the main axis of pedestrian in the whole hospital organization. This scope of analysis is about the sky bridge of Hanyang University hospital. The first method is the investigation of the utilization in this time. The second is the analysis of design drawings got form the designing of the past(1994-1998). From this analysis, the conclusions are followings.;The designer who wants to apply the sky bridge should more consider about, 1) how the sky bridge impacts the whole spatial system such as the pedestrian, patients, physicians, service's facilities etc. 2) what the inside of sky bridge has something such as natural light, ventilation, and the height, depth, width of aisle, the sign for seeking orientation. etc. In future the research relating sky bridge should be studied some hospital as well as one hospital for comparing the characteristics of the concepts and organizations
Sanchez-Ramirez, Diana C.;Franklin, Richard;Voaklander, Donald
Journal of Preventive Medicine and Public Health
/
제50권5호
/
pp.311-319
/
2017
Objectives: This article aimed to compare alcohol consumption between the populations of Queensland in Australia and Alberta in Canada. Furthermore, the associations between greater alcohol consumption and socio-demographic characteristics were explored in each population. Methods: Data from 2500 participants of the 2013 Alberta Survey and the 2013 Queensland Social Survey were analyzed. Regression analyses were used to explore the associations between alcohol risk and socio-demographic characteristics. Results: A higher rate of hazardous alcohol use was found in Queenslanders than in Albertans. In both Albertans and Queenslanders, hazardous alcohol use was associated with being between 18 and 24 years of age. Higher income, having no religion, living alone, and being born in Canada were also associated with alcohol risk in Albertans; while in Queenslanders, hazardous alcohol use was also associated with common-law marital status. In addition, hazardous alcohol use was lower among respondents with a non-Catholic or Protestant religious affiliation. Conclusions: Younger age was associated with greater hazardous alcohol use in both populations. In addition, different socio-demographic factors were associated with hazardous alcohol use in each of the populations studied. Our results allowed us to identify the socio-demographic profiles associated with hazardous alcohol use in Alberta and Queensland. These profiles constitute valuable sources of information for local health authorities and policymakers when designing suitable preventive strategies targeting hazardous alcohol use. Overall, the present study highlights the importance of analyzing the socio-demographic factors associated with alcohol consumption in population-specific contexts.
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