• Health Policy and Management
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• v.24 no.1
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• pp.100-106
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• 2014

Background: There is no consensus on the definition of primary care in South Korea. This study's objective was to define the concept of primary care using a Delphi method. Methods: Three expert panels were formed, consisting of 16 primary care policy researchers, 45 stakeholders, and 16 primary care physicians. Three rounds of voting, using 9-point appropriateness scales, were conducted. The first round involved rating the appropriateness of 20 previously established attributes of primary care. In the second round, panelists received a summary of the first-round results and were asked to once again vote on the 10 undetermined attributes and the provisional definition. The final round involved voting on the appropriateness of the revised definition. The Korean Language Society reviewed the revised definition. Results: Four core (first-contact care, comprehensiveness, coordination, and longitudinality) and three ancillary (personalized care, family and community context, and community base) attributes were selected. The Korean definition of primary care was accomplished with all three panel groups arriving at a 'very good' level of consensus. Conclusion: The Korean definition of primary care will provide a framework for evaluating performance of primary care in South Korea. It will also contribute to resolving confusion about the concept of primary care.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.47-73
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• 2017

Medical certificate is a document to demonstrate a patient's health status, made up and signed by a physician, dentist, or oriental physician who attended the patient. It serves as an evidence in many official process including civil or criminal law suit, especially for one's personal injury. The Korean legal system also acknowledges and protects the evidentiary function of medical certificate by mandating physicians etc. to issue medical certificate in good faith and only when they personally attended the patient, and by criminally punishing them when they do not comply with these legal requirements. There are some reasons, however, that medical certificates often do not reflect the true health status of the patient: When physicians attend the patient and collect information regarding the health status of the patient, their priority is and should be the most cost-effective way to meet the health needs of the patient. It does not necessarily correspond to the accurate examination of the health status of the patient. Even when the patient's report on the history of the illness or the injury seems suspicious, physicians might have to avoid disproving it because that kind of attitude might harm the rapport between the physician and the patient. All these can distort the perception of the physicians and this distortion can be reproduced in the medical certificate they made up. Some of these problems might be resolved or at least enhanced by introducing new form of medical certificate which would guide physicians to reveal the nature, factual and theoretical grounds, and the limit of their findings more accurately. Others, however, would not be able to address, because it stems from the conflict between the physician's primary duty, duty to be loyal to the patient's life and health, and his secondary duty to serve as a public or neutral witness on the health status of the patient, and when both values or duties conflict with each other, they should choose the duty to the patient sacrificing the duty to the public or the court.

• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.51-60
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• 1995

This study was to examine the awareness of health and the utilization of primary health care in rural areas. The data were obtained from self-administered questionnaire conducted 450 parents of Mi Gum md Su Dong middle school students in Nam yang Ju city, Kyung Gi-Do, Korea, from December 15 to 20 in 1993. The results were as follows : 1) Among the causes of disease, 'insufficient health care' was the highest(39.1%), and 'bad environment'(28.9%), 'complexity of life style'(17.8%) in next order. 2) In the priority between 'daily farm work' and 'primary health care', only 45.6% of respondents answered that primary health care is more important than the daily farm work. The 29.8% of respondents answered 'daily farm work', and the 23.1% answered 'the equal of the both'. 3) The 63.6% of the respondents recognized correctly, the meaning of primary health care. And the rate of information source in primary health care were 'TV and Radio'(42.2%), 'medical facilities'(23.3%), and 'newspaper and magazine'(11.3%) in order. 4) In the choice rate of medical facilities for primary health care, 'drug store' was the highest(34.9%), and 'local private clinic'(34.7%), 'health (sub)center'(15.8%), 'hospital'(10.2%) in next order. 5) The 53.5% of the respondents had experienced to visit the health (sub)center more than once. And the disfavorite reasons of health (sub)center were 'insufficient equipment'(36.7%), 'inavailable time to visit'(26.9%), and 'poor treatment'(9.1%). 6) Among the preference of the physicians for primary health care, 'specialist' was the highest rate of the respondents(54.2%), and 'general practitioner'(32.4%), and 'family doctor'(9.8%) in next order. The major obstacles in utilizing the medical facilities for primary health care were 'daily farm work'(41.6%), 'distance'(21.1%) and 'medical cost'(10.4%) in order. 7) The weakened reasons in health (sub)center function were 'insufficient medical equipment'(44.4%), 'the lack of resident's understanding for health (sub)center'(21.8%), and 'short thought of duty in health (sub)center personnel'(16.9%) in order.

• Safety and Health at Work
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• v.9 no.3
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• pp.339-346
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• 2018

Background: Workplace bulling is a pervasive phenomenon with negative consequences for the health of victims and the productivity of organizations. The aim of this study was to measure the prevalence and forms of workplace bullying among employees working at the public health-care sector of Cyprus using the Greek version of Leymann Inventory of Psychological Terror (LIPT) instrument. Methods: A translation process was followed from the French to the Greek version of LIPT questionnaire. Test-retest reliability expressed by Pearson's correlation coefficient was 0.98 indicating excellent reproducibility. Internal consistency reliability assessed by Cronbach ${\alpha}$ coefficient was 0.87 suggesting high reliability. LIPT instrument was distributed among 403 employees working at the primary health-care setting and at the largest public hospital of Cyprus with response rate of 73.4%. Results: Women comprised the majority of participants (71.4%). Mean age was 43.3 years. Prevalence of workplace bulling according to Leymann's definition was 5.9%. Most common forms of bullying were "Being continuously interrupted" (17.2%) and "continuously being given new work assignments" (13.5%). Women were significantly more often exposed to at least one mobbing behavior than men within the previous year (49% vs. 35.7%, p = 0.038), whereas nurses were significantly exposed to at least one mobbing behavior as compared to physicians (53.3% vs. 31.4%, p = 0.004). Conclusion: This was the first study that examined the prevalence of workplace bullying in the public health-care sector by elaborating the Greek version of LIPT instrument. Results showed that workplace bullying is a common and complex phenomenon among health-care organizations.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.221-225
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• 2017

Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.

• Journal of Korean Academy of Rural Health Nursing
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• v.12 no.2
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• pp.29-44
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• 2017

Purpose: The purpose of this study was to identify community health practitioners' (CHP) perception of barriers to research utilization, current status and competence in evidence-based practice (EBP). Methods: From all over the country, 126 CHP completed an e-mail survey. Results: The items with the highest barrier scores were that it is difficult to understand articles written in English and physicians will not cooperate with implementation. There were statistically significant differences in the scores for attitude toward EBP and knowledge in EBP by education level and nursing academic society membership status. When faced with a problem, the nurses usually use related regulations or asked a colleague for advice. Conclusion: Results indicate an awareness of the necessity of applying EBP, need to improve readiness to use EBP voluntarily and actively, and need to search for various factors that are barriers to research utilization. There is a need to develop and apply EBP training/education programs to find new evidence that might actually support previous practice for which nurses lack confidence. Guidelines that consider CHP task characteristics and barrier factors to research utilization should be developed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.3
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• pp.207-216
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• 2019

Functional gastrointestinal disorders (FGIDs) such as infantile colic, constipation and colic occur in almost half of the infants. The aim of this paper is to provide a critical and updated review on the management of FGIDs and their impact on the health of the infant and family to health care physicians. Guidelines and expert recommendations were reviewed. FGIDs are a frequent cause of parental concern, impairment in quality of life of infants and relatives, and impose a financial burden to families, health care, and insurance. Therefore, primary management of the FGIDs should be focused on improving the infants' symptoms and quality of life of the family. If more than parental reassurance is needed, available evidence recommends nutritional advice as it is an effective strategy and most of the time devoid of adverse effects. The role of healthcare providers in reassuring parents and proposing the correct behavior and nutritional intervention by avoiding inappropriate use of medication, is essential in the management of FGIDs.

• Quality Improvement in Health Care
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• v.10 no.1
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• pp.58-76
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• 2003

Background : Aim of this study is focused on the analysis of the needed abilities of medical representatives resulting in building up the market and increasing sales. It is to propose methods to increase this ability ensuring continuous growth in market share and profit. Methods : A survey was conducted between January 6 and May 31, 2003. Using SPSS(Version 10.0), the collected data was analyzed by Hotelling T2, factor analysis. Some hypotheses were selected to include the conclusion. Some questionnaires for physicians working in hospitals or clinics and the medical representatives working in a pharmaceutical company were created and asked to them to either prove or reject those hypotheses. The results were analyzed to find the primary factors that effect the interactions between physician and the medical representatives. These factors were also studied along with the theoretical research based on published references. Results : The results were as follows. The main reasons for the physician to meet with a medical representatives were collection of product informations needed for patient treatment and collection of informations on current medical issue and as well as personal interests. The main parameters by which physicians evaluate the medical representatives are human relationship including sincerity and manners and supply of accurate and unbiased information on products. Overall, the medical representatives' perception on the importance of medical knowledge and ability to deliver it are lower than that expected by physicians. Conclusion : Medical and pharmaceutical companies' environment are changed rapidly. And those changes forced medical representatives to set new roles and competency. In order to drive away from the past 'rule of thumb' and 'adaptation to circumstance', optimal method and systemic development to train and support the medical representatives should be quipped. They will help medical representatives to be specialists in medical knowledge and to understand the exact need of health care professions. Product competitiveness will be increased and eventually successful business can be achieved through it.

• Journal of Genetic Medicine
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• v.15 no.2
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• pp.72-78
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• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• Research in Community and Public Health Nursing
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• v.11 no.2
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• pp.499-512
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• 2000

The number of deliveries by cesarean section has increased internationally. However, The cesarean section rate is different by country to country. It is because each country has different social and cultural background and. practices its unique delivery policies. Hence, it is very important to understand the uniqueness that one country faces related with the cesarean section. In Korea, there have been many researches on the clinical. maternal. hospital and community factors and so on. However, few studies have attempted to reveal the physician factors in Korea because it is difficult to approach hospital records. So, in this study, the physician factors that influence the increase of cesarean section rate in Korea was investigated, and preliminary research agenda for policy establishment to keep the cesarean section rate from excessive increase was provided. In this study, all 2744 cesarean section deliveries performed by 36 physicians at the hospital was considered. and detailed delivery records of 12 months selected randomly from January 1996 to August 1998 was reviewed retrospectively. Chi-square analysis is used to examine the homogeneity of distribution of maternal, fetal, and clinical factors. In addition, multiple regression analysis is used to examine the effect of physician characteristics on the cesarean section rate. Physician characteristics as independent variable and the cesarean section rate as dependent variable was put in this analysis. Follows are the results of this study. 1) Total cesarean section rate is 34.8%. primary cesarean section rate is 12.5 % and repeated cesarean section rate is 22.3 %. Among the indications for the primary cesarean section, 15.6 % is for breech presentation. 40.2 % is for dystocia. 7.6 % is for fetal distress. and 36.6 % is for others. 2) There is positive correlation between physician's age and the cesarean section rate (p<0.001). And statistically significant correlation is found between the physician's educational attainment and the cesarean section rate (p<0.001). A physician with Ph.D degree has lower cesarean section rate than a physician with B.A only and M.A. degree (p<0.001). However. physician's gender, location of graduated university. position at the hospital, and the religious belief were not shown statistically significant relations with the cesarean section rate. 3) Among all cesarean sections in this study, only 15.4 % is performed during weekend. While 18.2 % is performed on monday only. This suggests that physicians may not prefer weekend operation of cesarean section. In addition, 86.1 % among all cesarean section operations is performed from 6 a.m. to 6 p.m. So the cesarean section rate could be related with a day of the week and a time of the day. From this results. there is a possibility that the physicians' personal comfort may influence the cesarean section rate.