• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.455-464
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• 2020

Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments' regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions: The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.236-244
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• 2020

Objectives: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. Methods: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. Results: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. Conclusions: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.

• 한국융합학회논문지
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• 제8권4호
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• pp.149-157
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• 2017

한국의 메르스 유행발생은 역학적으로 의료기관과 관련된 감염을 보였다. 이 당시 메르스로 인한 의료인 감염자 수는 39명이었고 그 중 간호사는 15명 이었다. 미래의 간호사로서 이러한 감염환자를 돌보게 될 간호대학생들에게 메르스에 대한 지식과 태도 및 감염예방행위 수행도에 대하여 조사하여 감염예방에 기여하고자 하였다. 본 연구는 서술적 조사연구로, 연구 시기는 2016년 4월부터 5월까지이며 연구대상자는 간호대학생 350명이다. 연구결과 메르스를 예방하려는 태도(p<.001)와 감염예방행위 수행도가 통계적으로 유의미한 정(+)의 상관관계가 나타났다. 메르스 감염예방행위 수행도에 대한 지식과 태도의 영향은 회귀모형의 설명력이 15.2%이었고 통계적으로 유의미하였다(F=31.081, p<.001). 즉, 메르스를 예방하려는 태도(${\beta}=.383$, p<.001)가 높을수록 감염예방행위를 더욱 준수하려는 것을 알 수 있었다. 향후 간호대학생에게 메르스와 같은 감염질환에 대한 융합적 교육프로그램을 실시하여, 감염질환의 전파를 막으려는 태도를 강화하고 감염예방행위를 실천하게 하는 연구가 필요하다고 제언한다.

• 보건행정학회지
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• 제22권4호
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• pp.696-702
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• 2012

The purpose of this study was to evaluate the improvement of disabled access to healthcare institution located in Jongno-gu, Seoul in 2011 compared to 2003 since disabled access has been mandatory in healthcare institutions located in new buildings by the amended law in 2004. We had investigated 10 assessment items for disabled access in 166 healthcare institutions located in Jongno-gu, Seoul and the results were compared with those of 2003 survey. On average, 74.1% of the healthcare organizations has equipped with items for disabled access. However the adequately equipped rate for those items was only 39.2%. Compared with the results of 2003 survey, these rates showed a little increase by 4.1% and 8.0%, respectively. There were only 10 healthcare institutions located in new buildings which were constructed after July, 2005. Their average equipped rate(84.4%) and adequately equipped rate(46.8%) were higher than those of the other organizations because the Korean government ruled that healthcare institutions in new buildings must have facilities for the disabled. In conclusion, we confirmed that the accessibility of the disabled to healthcare institution slightly increased. In particular, the healthcare institutions in newly constructed building showed the significant increase of accessibility of the disabled. However, it is founded that disabled access is still not enough for the disabled.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2001년도 제53차 추계 학술대회 연제집
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• pp.371-372
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• 2001

• 대한예방한의학회지
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• 제14권2호
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• pp.43-56
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• 2010

Objectives : This study aimed to investigate the attitude of healthcare consumers toward the East-West Collaborative Medical Practices(hereafter EWCMP). Method : The participants were 245 healthcare consumers who visited outpatient clinic of an university hospital, and attended at an emergency rescue educational program held by an emergency medical center, Busan. Data were collected by interviewing or self-reporting with questionnaires and analyzed with descriptive statistics and $X^2$ test with SPSS win 14.0. Results : 53.1 percent of 245 participants has heard, 13.9 percent has ever used, and 82.4 percent wanted to use EWCMP in the future. For participants who has used EWCMP, the decision to use it was made by themselves(58.8%), 26.5% of them was satisfied with EWCMP, and 79.4% showed the intention to introduce EWCMP to others. The use of EWCMP was significantly different by gender($X^2$=4.702, p=0.030) and having job or not($X^2$=14.305, p<0.001). Preferred type of EWCMP was to use both medical and Korean medical treatment at the same time(42.4%). Musculoskeletal disease(51.0%) and circulatory disease(51.0%) were expected to be the most effective when the EWCMP applied to them. Utilization of EWCMP was expected to be effective in disease treatment(88.2%), diagnosis(83.3%), and prevention(75.1%), and to increase medical cost(66.1%). Intention to use of EWCMP was not significantly different by demographic characteristics. Conclusion : Considering low proportion of utilization of and positive attitude toward the EWCMP among general populations, it is needed to introduce or advertise EWCMP to them.

• Safety and Health at Work
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• 제13권1호
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• pp.59-65
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• 2022

Background: Healthcare workers' attitudes toward vaccination have been widely described in the literature, but a restricted amount of studies assessed healthcare students' knowledge, attitudes, and opinions on this issue. This study aimed to estimate the influence of a degree course on knowledge and immunization behavior among healthcare students and to compare medical students with students from other health profession degree programs to identify possible differences. Methods: A multicenter, cross-sectional study was performed in 2018 in 14 Italian Universities (3,131 students were interviewed). A validated questionnaire was used to assess knowledge, attitudes, and opinions toward vaccinations, with a specific focus on influenza vaccine and attitudes toward mandatory vaccination policies. Statistical software STATA® 14 was used. Results: Significant differences were recorded between medical students and other healthcare students. The intention to get vaccinated against influenza during the next season and having been vaccinated in the previous season was higher in the medical group (p < 0.001). In the group of students of other health professions, we registered a lower probability of identifying themselves as a high-risk group for contracting infectious diseases as a consequence of their profession and health status (aOR 0.49; CI95%: 0.40-0.60) and an increased likelihood of defining their level of knowledge on vaccine-preventable diseases and related vaccinations as "insufficient/sufficient/fair" (aOR 1.31; CI95%: 1.11-1.56). Conclusions: Results show several differences between medical students and students of other health professions when it comes to vaccination knowledge, attitudes, and perceptions, as well as a general low tendency to be vaccinated against influenza.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.539-548
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• 2022

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

• Journal of Preventive Medicine and Public Health
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• 제55권1호
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• pp.49-59
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• 2022

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

• 대한예방한의학회지
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• 제28권2호
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• pp.99-111
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• 2024

Objectives : Anxiety is an important mental health symptom associated with healthcare utilization. This research aims to identify the demographic, socio-economic, and health-related factors associated with the use of Korean medicine (KM) treatments in adults experiencing anxiety. Methods : We conducted a cross-sectional analysis using the Korea Health Panel Annual Data 2019. Logistic regression models were employed to examine the relationships between KM utilization and various factors such as economic activity, perceived stress levels, and presence of physical discomfort. The study sample included 552 adults experiencing anxiety. Results : Among the subjects, 19.20% were using both conventional treatment and KM treatment. The analysis revealed that individuals engaged in economic activities were more likely to use KM treatments compared to those who were not (odds ratio [OR] = 2.207, 95% confidential interval [CI] = 1.316 to 3.699). Additionally, individuals reporting high levels of pain or discomfort showed a significantly higher likelihood of using both KM and conventional medical services (OR = 2.933, 95% CI = 1.645 to 5.231). Musculoskeletal conditions were the most common reason for KM utilization among the study participants. Conclusion : The findings suggest that economic activity and the severity of physical discomfort significantly influence the use of KM treatments among adults with anxiety. These insights could inform healthcare policy and the integration of KM services into broader health management strategies for anxiety.