• 농촌의학ㆍ지역보건
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• 제49권2호
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• pp.132-145
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• 2024

본 연구는 국내 의료기관 중심 보건의료·복지통합 서비스 활성 방안을 모색하기위하여 대구의료원 달구벌건강주치의사업, 삼척의료원 301 네트워크 사업, 부산의료원 3 for 1 사업 을 프로그램 논리모형을 적용하여 사례 비교하였다. 상황적 측면에서 세 사업 모두 보건의료·복지 서비스의 분절과 의료사각지대 문제를 해결하기 위해 고안되었으며, 투입 요소 중 인력은 모두 다학제 팀 구성 현황은 유사하였으나 구체적인 구성 분야, 채용 규모, 고용 형태, 에서는 기관별 차이가 있었다. 예산을 지원받는 재원 출처의 차이로 각 사업은 지역사회와 협력하고 지원하는 방식과 향후 방향성에서의 차별성도 확인할 수 있었다. 산출은 수혜대상자 수와 진료 건수에 차이가 있었으며, 투입인력 또는 운영비 대비실인원 수, 수혜대상 1인당 사업비 비교시 다른 결과를 확인하였다. 의료기관 중심의 보건의료·복지 통합제공체계의 설계 시 우선적으로 권고하는 상황은 안정적인 기금마련 기전을 확보하고 이에 합당한 대상자와 서비스 전달체계를 구축하라는 것이다. 또한, 의료기관 내 사례관리 전담기구로서 각 부문의 활동을 연계할 수 있도록 위탁이 아닌 전담부서 설치, 적정 규모의 채용, 안정적 고용 체계가 필요하며, 민·관 협력 및 경증부터 중증까지 제공할 수 있는 포괄적 제공체계 구축을 제안한다. 이를 통해 의료기관 중심보건의료복지 통합 서비스 제공 사업은 지역사회에서 풀리지 않는 난제였던 보건의료 서비스 강화와 촘촘한 연계를 가능하게 함으로 궁극적인 지역사회 건강안전망 역할 강화를 기대한다.

• 한국치위생학회지
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• 제14권5호
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• pp.715-721
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• 2014

Objectives : The purpose of the study is to investigate the perception of elderly oral health care in the care workers in nursing homes. Methods : A self-reported questionnaire was filled out by 200 care workers in nursing homes in Daegu and Busan. Data were analyzed by SPSS 18.0 program. Results : The oral health care was maintained by innately healthy mouth(49.5%), dentists(48.5%), public health centers including institution and dentistry(46.5%), regular visit to dentistry(44.0%), and ingestion of healthy food(38.5%). Fifty eight percent of the respondents(116 persons) agreed that regular and proper toothbrushing is the most important behavior to maintain the healthy teeth. The regular visit to dental clinics(Wald=7.076, p=0.008) and an oral care by specialist (Wald=5.210, p=0.022) influenced on elderly oral health status(p<0.05). Conclusions : The oral health care education is very important for the workers in the nursing homes that the education can improve the perception toward the elderly oral health.

• 보건행정학회지
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• 제30권4호
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

• 대한물리치료과학회지
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• 제16권3호
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• pp.43-53
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• 2009

Background: The purpose of this study was to investigate the perception of home care team's home based physical therapy in public health center Method: We surveyed 11 questionnaires for hone care team in health center from 1st to 30th, November in 2008. Results: The person who recognized the exclusion fact of home-based physical therapy in long term care insurance was 64.2% in whole 109 people. About necessity of home-based physical therapy, "absolutely necessary" as the person answer was 43.1%. Home-based physical therapy in the insurance must come to be provided with a precedence was 81.3%. About starting time of hereafter home-based physical therapy "after 1 years" the opinion which was 60.7%. Opinion about operation institution of home-based physical therapy "the pubic hospital or health center" was 52.3%. In composition form of the home-based physical therapy team "with the physical therapist and occupation therapist come together" was investigated with 37.4%. Conclusion: As long term care insurance will be developed, discussion about quality- of-service must be continuous and depth. Relates hereupon, the academic, researchers, and the persons concerned must consider the best quality of life improvement of the citizen and prepare the ground which systemic, rational, and actual on starting of home-based physical therapy in long term care insurance.

• Journal of Korean Biological Nursing Science
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• 제18권3호
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• pp.144-152
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• 2016

Purpose: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. Methods: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents' perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. Results: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. Conclusion: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.

• 보건의료산업학회지
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• 제6권4호
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• pp.219-229
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• 2012

This study aimed to explore influencing factors on the establishment of the network system between public hospitals and to make a process evaluation of it. we analyzed the case of a strategic alliance contracted by a National University Hospital(NUH) and a Community Hospital(CH). Main points of the project were regular dispatch of clinical specialists in the NUH such as gastroenterologist and running teleradiology program. The NUH considered the improvement of it's image as a public hospital as a successful element of the network program. The provincial office which have to manage the CH satisfied with these program in terms of helping CH in need of clinical specialists. Staffs in the CH pointed out the problem of discontinuity for patients who visited the CH. Three institutes argued that continuous support of central government in the relevant institution and budget could play the most important role in the advance of the network system between public hospitals.

• 치위생과학회지
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• 제20권4호
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• pp.200-205
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• 2020

The purpose of this study was to determine the status of dental hygienists in Japan. The study explicated the history, core curriculum, National Examination for Dental Hygienists, work roles of dental hygienists, and workplaces of dental hygienists. This study was based on the government policy report on dental hygienists and the information published by each public institution. The latest statistics presented by the institutions were collected through official websites. The employment information of graduates from Hiroshima University was analyzed based on actual field study. The results of the study revealed that social demand for dental hygienists has steadily increased and policies and education have been revised accordingly. The work roles of dental hygienists have expanded to meet the needs of the treatment and those of public health fields. In line with major policy changes, the educational period has been extended from 1 year to 3 or 4 years, while the mandatory credits for graduation have been established. Licensing examinations were being performed by the local governments since 1948 due to the different situations of dental hygienists in different areas. In 1992, they were converted into a single national examination. The work roles have expanded from assisting dental treatments to health guidance, home care, and perioperative care. Consequently, the number of dental hygienists has increased, especially in healthcare facilities for the elderly. Dental hygienists perform various roles. However, the most essential role is to provide the best oral care services to the patient. The expected role of dental hygienists has expanded in alignment with public healthcare needs and support for the elderly. The government and universities are expected to bring about improvements such as diversifying the channels of education and establishing policies to respond to growing patient needs by cultivating excellent dental hygiene professionals.

• 한국병원경영학회지
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• 제8권1호
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• pp.95-111
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• 2003

The purpose of this study was to evaluate the information searching behavior of consumer by type of medical institution. A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling in nationwide level, excluding Jeju-Do. Personal survey was conducted through door-to door survey from 27 July to 10 August 1999. The main results of this research was as following; 1. The proportion of information searching of respondents ranged from 91.5-95.2%. Even though the proportion of user in university hospital was slightly high, there was not significant statistically by type of medical institution. In terms of information source, personal informer was most common information source in all type of medical institution. Public informers were more frequently used in university hospital visitors and professional informer in general and university hospital visitors. 2. Comparing to searching intensity, user informer and professional informer's influences were more powerful, but not statistically significant. In analysis of unit influence for information source, written informer or public informer was more powerful in clinic visitor, professional informer and written informer in university hospital visitor. 3. Information which consumer want to know mostly were about on special potential and career of physician. The clinic visitor wanted to know about institutional location and kindness of medical personnel. The university hospital visitor also wanted to know about facilities and convenience of process. Comparing to institution selection criteria of consumers at 1991, quality related criteria were recognized more importantly in outpatient and dental services. But in case of inpatient services, convenience factor was recognized more importantly. In conclusion, the effort for specific marketing plan by type of medical institution should be needed. And more concern on information searching behavior of consumer will be needed.

• Journal of Yeungnam Medical Science
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• 제40권1호
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• pp.58-64
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• 2023

Background: A group health service is a system that delegates workplace health management to an entrusted institution. There have been various studies on group health services to date, but recent changes, such as an increase in foreign workers, are rapidly changing industry characteristics. Methods: Satisfaction was assessed using a 27-question survey distributed among 203 workplaces employing health professionals. The survey items consisted of general characteristics, comprehensive satisfaction, requirements for health professionals' work, and satisfaction with work environment management, ergonomic management, and healthcare management. Multiple regression and frequency analyses were performed. Results: The comprehensive satisfaction was 4.08 points on average, out of 5. The comprehensive satisfaction of health professionals in the industry was positively correlated with each factor. Hazardous materials and chemical management (material safety data sheets, MSDSs) were the most common requirements. Conclusion: A low level of satisfaction with work environment management indicates high demand for healthcare management. The working environment should be improved by identifying characteristics of the workplace, examining harmful substances, inspecting equipment, and enhancing worker methods. The shorter the work experience of health professionals, the more dependent they are on group health services. The variables affecting comprehensive satisfaction were the period of work, healthcare management satisfaction, and work environment management satisfaction. Most of the requirements of health professionals in the workplace were practical improvement case presentations, MSDSs, and legal document management.

• 보건행정학회지
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• 제16권3호
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• pp.19-36
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• 2006

The purpose of this study was to assess adequately equipped with convenience facilities for the disabled in 160 healthcare institutions in Jongno district, Seoul. Healthcare institutions were equipped an average of 3.7 facilities out of 10. General hospitals had an average of 5.0 facilities, which was higher than an average of 3.6 facilities for private clinics (p<0.05). Of 160 healthcare institutions, only 13 (8.1%) offered easy access to the outpatient setting from the entrance for wheelchair users, highlighting difficult wheelchair access within hospitals. To provide easy access to medical service for the disabled, more accessible designs need to be adopted as part of the effort to improve public facilities for the disabled. Also, universal designs could be applied for newly constructed roads, structures and transportation vehicles to maximize accessibility for the disabled. Increased accessibility for the disabled in the community will eventually increase the use of healthcare institutions.