• Title/Summary/Keyword: Private clinics

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A study on the current status of oriental medical care services in health centers and implications for its expansion (보건소장의 한방진료에 대한 태도와 관련 요인 분석)

  • 류규수;김문수
    • Korean Journal of Health Education and Promotion
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    • v.18 no.2
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    • pp.157-168
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    • 2001
  • Currently the oriental medical care services in the health centers is getting popularity because of their unique aspects which western medicine can not cover. This study was conducted to speculate the current status of oriental medical care services in health centers and possibility of how to effectively provide the oriental medical care services(or traditional medical care services) in health centers. For the study, the survey questionnaires were distributed to all 269 health centers and 138(51.3%) of them were collected. Eight of the collected were inadequate for the analysis and 130 of 269 questionnaires were finally chosen for the study. The SPSS/PC WIN 8.0 was used for the statistical analysis. The results are as follows. First, 91 out of 130 sample health centers(70%) are providing oriental medical care services. The results show that the willingness of the directors and the public awareness in community are the most important factors to provide oriental medical care services in health centers. In contrast, the lack of cooperative efforts between western and oriental medical doctors and the lack of government supports are considered as factors that intervene the oriental medical care services in health centers. About 80% of the sample health centers respond that the government supports is needed for oriental medical care services in health centers. Second, it was asked to the directors of 39 health centers which do not provide oriental medical care services regarding their future plan to include the services. About 70% of health centers respond that no plan is available now. They acknowledge that the demand on the services is the most important factor to consider the oriental services as their future medical services. Third, 69.2% of the oriental medical doctors in health centers are public health doctor. 95.6% of the sample health centers have space for the oriental medical care services in their facilities and some health centers provide the services through the private clinics nearby facilities. Finally, the surveyors consider both budgetary constraints and difficulty in recruiting doctors as barriers for the effective oriental medical care services in health centers. Finally, t-test and LSD were employed to find out the difference among several groups. The analysis shows statistically significant difference among groups about their recognition on health care policy, health care system, and effectiveness of oriental medical care services. To be conclude, the study shows the necessity of oriental medical care services in health centers. To do so, the government supports, cooperative efforts between oriental and western medical doctors, and providing job security for doctors should proceed to provide effective oriental medical care services in health centers.

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Statistics of Poison Exposure in Korea (국내중독현황)

  • Hwang Jung-Yun;Ko Jae-Ook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.1 no.1
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    • pp.59-64
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    • 2003
  • Objective: This study was conducted for the nationwide statistical survey of poison exposure to provide the rationale for establishing and developing the poison control center (PCC) in Korea. Design: Study group for Korea PCC in National Medical Center reviewed the medical literature on poison exposure of Korea from death reports of National Statistical Office (NSO), the toxic exposure statistics from the report of National Health Insurance Corporation (NHIC), and poison related data from 119 ambulance services (FD) for the purpose of obtaining the poison and its related data. We also conducted questionnaire from the expert who work in emergency medicine department at the designated 320 emergency medical centers in Korea for the preparedness and acknowledgement about necessity of PCC and their need for that. Results: We reviewed the reliable data from the death report of NSO, poison exposure data from NHIC, and running report from FD. Poisoning death occured at home ($36.7\%$) and hospital ($46.3\%$). Poisoning are more common in rural area than the city area. Patients were seen more frequently in the local clinics than in any hospital. The drugs ($45.7\%$) and pesticide ($18.1\%$) are common poison. Common place to poison exposure were residential area ($39.9\%$), industry ($9\%$). mass residential area ($7\%$). and farm ($6\%$). The education level were primary school ($33.2\%$), high school ($23.7\%$), and middle schol ($21.3\%$) in order. We have to provide the poison guideline for lay public to understand easily, and for medical experts. The medical facilities need to be invested and have more interest for toxicology. All medical staff who work in the designated emergency medical center want PCC to establish. They want to have poison information from hospital ($91.3\%$), regional poison information center ($45.0\%$), regional poison control center ($52.5\%$), nationwide poison information center ($48.8\%$), nationwide poison control center ($46.25\%$), as a role of poison control center. They also want that pcc have poison epidemiologic study and statstics, training program for the experts, registration of rare case of posion on website, reflection of policies to activities for antidote production etc., speedy consultation system for poison analysis, public education, establishment of both regional and national pee, etc. Conclusion: Poison center must be established to provide poison information for all the public and medical experitise, focusing rural area and private clinic, to detoxify, to reduce the cost, time, morbity, and mortality through the whole country.

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Models for Predicting Five Jang Biological Ages with Clinical Biomarkers (임상 생체지표를 이용한 오장생체나이 추정 모델)

  • Kim, Tae-Hee;Kim, Seok;Bae, Chul-Young;Kang, Young-Gon;Cho, Kyung-Hee;Kwon, Su-Kyung;Park, Mei-Hua
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.15 no.2
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    • pp.175-190
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    • 2011
  • Objectives: Even though there has been no consensus on the concept of viscera organ between the oriental and western medicine, we tried to investigate the correlation between clinical biomarkers of five Jang and chronological age and develop the models for predicting five Jang biological ages by statistical analysis. Methods: We obtained data from about 120,000 subjects who visited health promotion centers for health promotion and disease prevention from January 2004 to June 2009. Participants were included if they were over 20 years old, and excluded if reported to have cardiovascular disease or other serious medical illness such as cancer, malignant hypertension, uncontrolled diabetes, cardiopulmonary insufficiency, liver disease, pancreatic disease or renal disease. Among the clinical biomarkers obtained, we selected the biomarkers which were associated with the function of 5 Jang in previous studies, or showed statistically significant correlation with age. Multiple regression models were used for building prediction models of biological age after adjusting for potential confounders for men and women, respectively. Pearson correlation coefficient was calculated to examine the linear relationship between age and various biomarkers, and multiple regression analysis was used for building the prediction models of five Jang biological ages for men and women, respectively. All statistical data analysis was performed by using SPSS Version 12.0 software and statistical significance was obtained if p<0.05. Results: For males, the best models were developed using 12, 2, 8, 3, and 4 biomarkers for predicting biological ages of heart, lung, liver, pancreas, and kidney, respectively (R2 = 0.57, 0.43, 0.11, 0.24, and 0.93, respectively). Similar to males, for the females, 10, 2, 8, 3, and 4 biomarkers were selected as the models respectively (R2 = 0.76, 0.44, 0.14, 0.38, and 0.89, respectively). Conclusions: As we have developed for the first time the models for predicting five Jang biological ages with common clinical biomarkers, it is expected that these models may be used as clinical supplementary tools in the evaluation of aging status and functional decline of five Jang according to age in health promotion centers and private clinics. At the same time, it is considered that the use as objective tools to evaluate aging status and functional decline of each Jang.

Study on Institutionalized Mentally Retarded Children in Korea(Particularly Regarding Their Accommodation and Education Facilities) (한국 정신박약아의 실태 조사 연구(교육기관 및 시설을 중심으로))

  • 김초강
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.115-129
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    • 1971
  • As the result of a survey conducted by the author on the status of tile 12 educational institutions for mentally retarded children in Korea and their quartering facilities as well as on 934 children accommodated in such institutions, the following conclusion has been reached: 1) More than a half (approximately 58 percent) of the facilities for mentally retarded children are concentrated in Seoul. About eighty-three percent of these facilities are private establishments, of which 70 percent have their proprietors concurrently as their superintendents. Although these facilities were first established as many as 22 years ago, it has been only five or six years since education was actually started for mentally restarted children. 2) Out of a total of 179 employes, teachers number 99, there by constituting approximately 57.6 percent. Out of them, however, only 32 teachers or 2.8 percent have special teachers licenses. Thus, each teachers has to take care of an average of 29 children. This is excessive a number of children per teachers in view of the special nature of this education, there by indication how urgent it would be to secure more teachers lot this field. 3) Out of the mantally retarded children investigated 57.6 percent suffer from physical disorder in addition to mental retardation, 53.0 percent from mental alienation illnesses besides retardation, and 25 pent from physical, mental disorders in addition to retardation. It is therefore necessary to maintain medical and nursing facilities together with educational facilities. however, two places have no medical facilities at all, and four other places, without medical personnel, have to receive medical support from nearby hospitals or clinics. 4) The total number of children in the surveyed facilities is 934, who can be broken down into 58.7 percent boys and 41.3 percent for girls. They are classified into 12.5 percent for idiot, 37.7 percent for imbeciles, 32.7 percent for morons, and 17.3 percent for thoes children on borderline. Their average age is 13.9 years. 5) As the result of education, the illiteracy rate of mentally retarded children has decreased from 78.1 percent to 32.1 percent while the percentage of those taking the primary school course has increased for 12.2 per cent to 33.5 percent. As a result, it has been learned that education is definitely necessary for Retarded children though it may be a difficult task. 6) The children who have mentally retarded children among their brothers or sisters constitute 6.3 percent of the total number. The corresponding rate for boys is 3.5 percent while that for girls is a remarkably higher rate 10.6 percent. Through studies on the causes of their mental retardation, it has been learned that 39.6 percent of them is of the inherent type and 35.3 percent is of the environmental type. Control and improvement of health of mothers and children, early diagnosis and early treatment are believed to be very important because they could prevent or alleviant much of these conditions. 7) The storage age of teachers and employes is 35.3 years, an indication that a great proportion of them is experienced in a way or another as their major difficulty or problems in serving with these special school, 22.5 percent cited inadequate payment 24.5 gave the inadequate public understanding, and 22.5 percent pointed out the lack of understanding on the part of give parents.

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Reasons for Extraction of Permanent Teeth in Private Dental Clinics (치과의원 내원환자의 영구치 발거원인에 관한 조사연구)

  • Lee, Byung-Ho
    • Journal of dental hygiene science
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    • v.8 no.1
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    • pp.1-6
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    • 2008
  • The purpose of this study was to analyze the reasons and mean age for tooth extraction among patients living in Busan city. The researcher observed 1,119 patients' teeth extracted due to dental caries, periodontal disease and other reasons. This study examined the reasons for tooth extraction by age, sex, and tooth-kind. The reasons for tooth extraction were dental caries, periodontal disease, eruption problems and others. The obtained results were as follows; 1. Among the reasons for tooth extraction, dental caries accounted for 25.9%, periodontal disease 56.5%. 2. Periodontal disease was the main reason for tooth extraction and continued throughout life irrespective of sex. However dental caries was remarkably increasing in those aged 30 years old and under. 3. In the extraction of permanent teeth, males outnumbered females while upper teeth did lower teeth. 4. Although the third molars were most extracted in all kinds of teeth, the main reasons for the extraction were eruption problem. 5. The mean age of the tooth extracted was 47.9 years in both sexes for the mandibular first molars and the mandibular first molars had the shortest life except third molars of total teeth. The mandibular canines had the longest life of total teeth. Because dental caries and periodontal disease are the main causes of tooth extraction in Korea, the dental health policy should be focused on the prevention and treatment of these two diseases in the government level.

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Introducing the Insurance Health Care Delivery System and Its Impact on Patients Distribution of Medical Service Organizations (보험진료체계 개편이 의료기관 종별 환자분포에 미친 영향 분석 -3차 의료기관, 종합병원, 병원, 의원을 중심으로-)

  • 공방환;한동운;장원기;강선희;문옥륜
    • Health Policy and Management
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    • v.5 no.1
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    • pp.31-58
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    • 1995
  • The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

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The Conflict over the Separation of Prescribing and Dispensing Practice (SPDP) in Korea: A Bargaining Perspective (의약분업을 둘러싼 갈등 : 협상론의 관점에서)

  • Lee, Kyung-Won;Kim, Joung-Hwa;T. K. Ahn
    • Health Policy and Management
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    • v.12 no.4
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    • pp.91-113
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    • 2002
  • We report and analyze the Korean physicians' recent general strike over the implementation of the Separation of Prescribing and Dispensing Practice (SPDP) in which more than 18,000 private clinics and 280 hospitals participated. Utilizing game-theoretic models of bargaining we explain why the Korean physicians were so successful in organizing intense collective action against the government and securing very favorable policy outcomes. In particular, we highlight the role of distributional conflict among social actors in shaping the details of institutional reform. The introduction of the SPDP was a necessary first step in the overall reform of health care system in Korea. However, the SPDP was perceived to be a serious threat to the economic viability of their profession by the vast majority of Korean physicians who had long been relied on the profits from selling medicines to compensate for the loss of income due to the low service fee under the previous health care system. The strong political coalition among heterogeneous physicians enabled them to organize an intense form of collective action, the general strike. Thus, physicians were successful not only in dragging the government to a bargaining table, but also winning in the bargaining and securing an outcome vastly favorable to them. On the other hand, the lack of an overall reform plan in the health care policy area, especially the finance of the National Health Insurance and the need for maintaining an image as a successful reform initiator, motivated the government to reach a quick resolution with the striking physicians.

Usefulness of Vibration Response Imaging (VRI) for Pneumonia Patients (폐렴환자에서 진동 공명 영상 검사(VRI)의 유용성)

  • Park, Eu-Gene;Park, Jung-Hee;Hong, Mi-Jin;Kim, Won-Dong;Lee, Kye-Young;Kim, Sun-Jong;Kim, Hee-Joung;Ha, Kyoung-Won;Chon, Gyu-Rak;Kim, Hyun-Ai;Yoo, Kwang-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.30-36
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    • 2011
  • Background: Pneumonia is commonly seen in outpatient clinics. it is widely known as the most common cause of death from infectious disease. Pneumonia has been diagnosed by its typical symptoms, chest X-ray and blood tests. However, both chest X-rays and blood tests have limitations in diagnosis. Thus primary care clinicians usually have been constrained due to a lack of adequate diagnostic tools. Vibration response imaging (VRI) is a newly emerging diagnostic modality, and its procedure is non-invasive, radiation-free, and easy to handle. This study was designed to evaluate the diagnostic usefulness of the VRI test among pneumonia patients and to consider its correlation with other conventional tests such as Chest X-ray, laboratory tests and clinical symptoms. Methods: VRI was performed in 46 patients diagnosed with pneumonia in Konkuk University Medical Center. VRI was assessed in a private and quiet room twice: before and after the treatment. Sensors for VRI were placed on a patient's back at regular intervals; they detected pulmonary vibration energy produced when respiration occurred and presented as specific images. Any modifications either in chest X-ray, C-reactive protein (CRP), white blood cell count (WBC) or body temperature were compared with changes in VRI image during a given time course. Results: VRI, chest X-ray and CRP scores were significantly improved after treatment. Correlation between VRI and other tests was not clearly indicated among all patients. But relatively severe pneumonia patients showed correlations between VRI and chest X-ray, as well as between VRI and CRP. Conclusion: This study demonstrates that VRI can be safely applied to patients with pneumonia.

Short-term Evaluation of a Comprehensive Education Program Including Inhaler Training and Disease Management on Chronic Obstructive Pulmonary Disease

  • Yoo, Kwang Ha;Chung, Wou Young;Park, Joo Hun;Hwang, Sung Chul;Kim, Tae-Eun;Oh, Min Jung;Kang, Dae Ryong;Rhee, Chin Kook;Yoon, Hyoung Kyu;Kim, Tae-Hyung;Kim, Deog Kyeom;Park, Yong Bum;Kim, Sang-Ha;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.377-384
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    • 2017
  • Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

Comparative Evaluation of the Survival Rates of Zirconia Crown and Stainless Steel Crown for Proximal Caries in Primary Molars: a Retrospective Study (유구치 인접면 우식증 수복 시 지르코니아 전장관과 기성금속관의 생존율 비교 평가: 후향적 연구)

  • Gahui Jeong;Nanyoung Lee;Hyewon Shin;Suhyun Park;Myeongkwan Jih
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.3
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    • pp.307-317
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    • 2023
  • Due to increasing demand for aesthetics, zirconia crowns have become a popular choice for treating primary molars. However, there is limited literature available comparing the survival rates of zirconia crowns with those of other restorative materials. The objective of this study was to compare the 36-month survival rates of zirconia crowns and stainless steel crowns for proximal caries, as well as to analyze failure types associated with each crown type. Electronic medical records and radiographs of 1,061 primary molars from 498 patients treated with 2 types of prefabricated crowns at Chosun University Dental Hospital and 2 private dental clinics between 2017 and 2019 were collected and analyzed. The survival rate of zirconia crowns was found to be lower compared to that of stainless steel crowns. Regarding the groups without pulp treatment, the survival rate of stainless steel crowns was significantly higher than that of zirconia crowns. However, in the groups that received pulp therapy, no significant difference in the survival rates was observed between the two preformed crowns. Notably, abnormal root resorption or periapical lesions were identified as the primary cause of restorative failure in stainless steel crowns, whereas loss of restoration was the predominant cause in zirconia crowns. This study holds valuable implications for clinicians when selecting preformed crowns for primary molars.