• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.90-114
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• 2004

This study was conducted to examine the influence and effect of muscle enforcement program on Activity of daily living(ADL) improvement and posture balance of the old, and to provide more effective muscle enforcement program and educational data. The muscle enforcement exercise program was performed on the old(institution, 16 men, 10 women) for 8 weeks from April 22, 2002 through June 17,2002. Programed Exercise 1 - Exercise 10 were practised 8 times per program for 3 days a week. The load of exercise was increased per two weeks. The methods of measurement were questionnaire, Indiana 47903(action-response analysis machine) and Sample exercise protocol for KAT 2000(balance training device). SAS/PC statistic analysis was used for data analysis. T-test was used for analysis of change before and after exercise in this study. The summary and conclusions are as follows. 1. On subjectively recognized health states, the healthy were $42.3\%$. On the satisfaction with health states, the satisfied were $50.0\%$. On the factors of effects on daily-life behavior performance, the group who had troubles was $50\%$ and the group who was so and so was $34.6\%$ compared with the old of the same age. On prospect about health states in the future, the group who would be better was $38.\%$. On effective methods for problem solving, exercise was $42.3\%.\;88.5\%$ of respondents answered the need of health care. The participation intention in health program was $92.3\%$. 2. On the change of psychological emotion and behavior aspects, the group who had repeated complaints or anxieties and reduced activities or interests was effective(P<0.01). 3. On the improvement effects of IADL difficulties, the group who had difficulties in doing daily-life indoors was improved effectively compared with before and after exercise(P<0.01). On medication management, the effects of improvement after exercise were high compared with before exercise(P<0.01), the effects of improvement was high on the whole. 4. On the effects of ADL function improvement, putting on upper clothing and lower clothing was improved effectively(P<0.05), toilet use and individual sanitation was improved effectively(P<0.05). 5. On the effects of action-response, the results of 8weeks regular exercise program were not different significantly compared with before and after exercise. The behavior quickness of the old by muscle enforcement program was not increased. This means that the old needs much time for exercise sense training because of the regression of cognition sense. 6. In the effect of posture balance, the whole grades were effective from 1272.69 before excercise to 476.92 after exercise(P<0.01). Especially right balance 657.65 was lowered to 208.57 after exercise most effectively(P<0.01). Rear balance 776.34 before exercise was lowered to 136.65 after exercise. The results of measurement were significant(P<0.05).

• Journal of Korea Entertainment Industry Association
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• v.14 no.7
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• pp.559-570
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• 2020

The purpose of this study was to classify the internal members of nursing hospitals and Western hospitals that received the certification system of medical institutions, and to examine the effect of certification on member satisfaction, job stress, hospital operation effect, and improvement of medical services. In nursing hospitals, the certification system was higher in member satisfaction, hospital operation effect, and medical service effect than in Western hospitals, and members of Western hospitals were higher in job stress. In both nursing hospitals and Western hospitals, the satisfaction of members, hospital operation effect, and medical service effect according to certification showed positive (+) results. It is believed that the effect of the certification system has been empirically high in nursing hospitals as mandatory certification from 2013. Therefore, this study aims to contribute to the efficiency of hospital management and improvement of patient satisfaction through continuous quality management of medical care by analyzing the effect of certification system on medical service improvement.

• Journal of Preventive Medicine and Public Health
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• v.46 no.2
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• pp.74-81
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• 2013

Objectives: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. Methods: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. Results: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. Conclusions: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.

• Korean Journal of Childcare and Education
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• v.9 no.5
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• pp.513-538
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• 2013

As a childcare program of TaeHwa Christian Women's Institution in 1921, the childcare system in Korea was incepted. Since then, the political foothold of childcare system has steadily been advancing to provide high quality services to young children. In almost a hundred-year-history of public childcare in Korea, depending on the changes enforced on the related laws and regulations and varying perspectives over time, the administration office accountable for childcare policies has been authorized to the Ministries of Health, Social Affairs, Education, Labor, Home Affairs, Rural Development Administration, and/or others. But as of 1991, under the enactment of Infant and Child Care Act, it was changed to be administered by the unified authority of the Health and Social Welfare Ministry. Then, in 2004 and 2007, its statutory authority, respectively, transferred to the Ministry of Gender Equality and Family and back to the Ministry of Health and Social Welfare. Staring of the Infant and Child Care Act in 1991, Korean childcare policies have been managed by the dual systems of the Education Ministry and the Health and Social Welfare Ministry each holding jurisdiction over kindergartens and childcare centers, respectively. Faced with the recent marked decline of birth rate, diverse childcare policies are currently implemented in the pursuit of finding means to enhance the quality of childcare and to develop policies for the restoration of the low birth rate. This study presented distinct features of current childcare policies and discussed about future directions and challenges of these policies.

• Journal of Convergence for Information Technology
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• v.10 no.9
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• pp.206-214
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• 2020

This study analyzed the impact of direct and indirect subsidies on profitability in general hospitals in Korea. The data were collected from medical institution accounting information disclosure system of 270 general hospitals from 2016 to 2018. The analysis index used the ratio of net profit to business revenue for profitability, and Subsidies index the ratio of subsidies to business revenue(state subsidies for facility investment purposes, Fund related to essential business, research revenue and contribution revenue). According to the study, the ratio of state subsidies, which are direct subsidies, was very high at 57.30 percent for public institution hospitals. ratio of Fund related to essential business, which is a tax reduction effect with indirect subsidies, had the highest at 6.69 percent for Private University Hospitals. which are Indirect subsidies for deficit or operational assistance, research revenue ratio had the highest 2.8 percent for National University Hospitals, contribution revenue ratio had the highest 36.4 percent for public institutions. As a result of looking at the impact of subsidies on profitability, Nation University Hospitals had the lower the ratio of Fund related to essential business and the ratio of research revenue, the higher the net profit ratio of Business revenue. Medical Corporation Hospitals and Foundation Hospitals had the higher the ratio of Fund related to essential business to business revenues, the higher the net profit ratio of business revenue. These results mean that profitability may fluctuate depending on the utilization of funds related to essential business.

• Health Policy and Management
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• v.12 no.3
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• pp.1-22
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• 2002

Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.93-114
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• 2005

The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.651-659
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• 2020

The objective of this study is to provide high-quality medical service, by understanding the characteristics and death risk factors of patients at V long-term care hospital, that has established and operated the cooperative treatment system in connection with a public institution, the S veterans hospital. A follow-up survey targeting a total of 850 discharged patients was conducted for the year 2017. Average age of patients was 79.2 years, with 86.4% belonging to the 70 years or over group. The men of national merit were 75.4%, which was more than three times higher than general patients. Hospitalization for 180 days or more was 46.4%, which was higher than general long-term care hospitals (37%). The major death risk factors were age and the number of hospitalized days. Our data indicate that transfer to S veterans hospital results in providing quicker treatment and higher effectiveness of the numerous recovery therapies. We therefore propose that the cooperative treatment system should be expansively operated to increase the quality of happy life, by alleviating the health of patients with chronic diseases in a long-term care hospital.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.26-36
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• 1998

This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2)to survey whether there exists a Hospital Ethics Committee(HEC), 3)to research what consideration are formally taken in selecting recipients, and 4)to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with an HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time. and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second. we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least. there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.192-201
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• 2000

The purpose of study was to investigate the oral health care status in institutions and special schools for the disabled in Korea. Nurses in 123 institutions and nurse-teachers in 102 special schools were asked to fill questionnaires regarding periodic oral examination, preventive dental programs. and dental treatment. The results of this study were as follow. 1. 56.8% of institutions implemented regular oral examinations and all of special schools did it twice a year. 2. Preventive programs for dental caries were done in 69.1% of the institutions and 86.3% of the special schools. Programs included regular toothbrushing and dental health education. 3. Dental treatment was done in 84.2% of the institutions and 39.2% of the special schools. Institutions utilized private dental clinics(60.2%), public health centers(16.8%), volunteers(15.3%), and dental hospitals. 4. 17.7% of the institutions experienced the refusal to treat the disabled by private dental clinics.