• The Journal of Korean Medicine
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• v.20 no.2
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• pp.3-11
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• 1999

The Korean system of health and medical care has been organized with both Oriental and Western medical sciences. To get complete clinical treatment results is not possible with only one-sided medical care, therefore we need to formulate an interdisciplinary plan for better health care, that is to say our ultimate purpose is the cooperative medical care for the promotion of social welfare and health. Hereupon, I made a searching inquiry into the present condition of cooperative medical care and its problems and also took a consideration into the medical state of other countries like China. Japan and North Korea where the Oriental medical care is used. The results of this investigation are as follows. There are some problems in both Oriental and Western(general) medical care, such as a lack of mutual confidence, a severance of interdisciplinary study, a shortage of professional human resources and so on. There also used to be problems of the system such as, the responsibility of medical care, the double charge for medical treatment, the governmental passive participation and policy, the private-oriented study system and so on. The solutions of these problems are that the mutual understanding and coexistence between both Oriental and Western medical sciences should be preceded and the interdisciplinary study, identified terminology and cooperative medical specialists would be necessary. Furthermore, the government has to seek some policies and legislation for the cooperative medical system and needs to support the public research institutes and centers of the cooperative medical care. After all, we have to train the cooperative medical specialists for the mutual aid of both Oriental and Western medical sciences and the government also has to support it with some policies and legislation for the better medical care system.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.301-309
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• 2015

Objectives: To investigate trends in the prevalence of allergic disease over a 9-year period. Methods: Using National Health Insurance Service (NHIS) data, the annual number of patients with allergic disease was obtained for each regional subdivisions (small cities, counties, and districts) from 2003 to 2011. Annual populations for each sub-region were obtained and used to calculate the standardized prevalence. To compare prevalence within the study period, data was standardized spatially and temporally. For standardization, demographic data was used to obtain the registered population and demographic structure for 2010, which was used to perform direct standardization of previous years. In addition, a geographic information system (GIS) was used to visualize prevalence for individual sub-regions, and allergic diseases were categorized into five groups according to prevalence. Results: The nationwide outpatient prevalence of allergic rhinitis increased approximately 2.3-fold, from 1.27% in 2003 to 2.97% in 2013, while inpatient prevalence also increased approximately 2.4-fold,. The outpatient prevalence of asthma increased 1.2-fold, and inpatient prevalence increased 1.3-fold. The outpatient prevalence of atopic dermatitis decreased approximately 12%, and inpatient prevalence decreased 5%. Conclusions: There was a large difference between prevalence estimated from actual treatment data and prevalence based on patients' self-reported data, particularly for allergic rhinitis. Prevalence must continually be calculated and trends should be analyzed for the efficient management of allergic diseases. To this end, prevalence studies using NHIS claims data may be useful.

• Clinical and Experimental Pediatrics
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• v.63 no.9
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• pp.361-367
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• 2020

Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.

• Journal of Home Health Care Nursing
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• v.13 no.1
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• pp.5-15
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• 2006

Purpose : This study was done to examine the home care service provided by home care nurses and the level of client satisfaction in community. Method : Data were collected from 120 clients who received the home care service at the community home care service center in Pusan from 2th May. 2003 to 31th May 2003. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale by Kim. Data were analyzed by using SPSS/WIN 10.5 program. Result: 1) 67.5% among 120 clients was over sixty years old and 30.6% of clients received home visits 20 times by home care nurse. 2) The total number of home care services was 15,783. And most of the clients received therapeutic nursing care. 3) The mean score of satisfaction on provided home care services was 3.31, among 16 items, "The home care nurses kept up the secret of patients and family" was the highest($3.67{\pm}0.48$). the total level of satisfaction of home care services was very high, with mean score $3.31{\pm}0.32$. Conclusion : The satisfaction level of home care services was very high. so we can expect that the prospect of home care services is very challengeable. Therefore we should try to expand the service recipients with promotional education to assure close ties with the public health centers for the continuous home care service linking and make more efforts to improve the quality of the service.

• Journal of Preventive Medicine and Public Health
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• v.43 no.3
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• pp.222-234
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• 2010

Objectives: Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. Methods: The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects(2661 patients who gave written informed consent to particiate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. Results: When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. Conclusions: This study showed that needs on patient with cancer was significantly influenced by female, higher educagion, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.

• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.182-189
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• 2021

Objectives: This study investigated the relationship between sleep quality during pregnancy and preterm birth. Methods: This longitudinal study was conducted between August 2018 and May 2019. The participants were 150 pregnant women who had been referred to 7 healthcare centers in the city of Qazvin, Iran and met the inclusion criteria. The Petersburg Sleep Quality Index, the Epworth Sleepiness Scale, and 2 questions about daytime sleep status and a demographic questionnaire were administered at 14-18 weeks and 28-32 weeks of gestation. Data were analyzed using the Mann-Whitney test, the Fisher exact test, and univariate and multivariable logistic regression. Results: In the present study, poor sleep quality affected 84.7% of the participants at 14-18 weeks and 93.3% at 28-32 weeks of gestation. The final model for preterm birth prediction incorporated age and the Petersburg Sleep Quality Index score in the second and third trimesters. Preterm birth increased by 14% with each unit increase in age. With each unit increase in the Petersburg Sleep Quality Index score in the second and third trimesters, preterm birth increased by 42% and 28%, respectively, but the p-values of these factors were not significant. Conclusions: Although a significant percentage of pregnant women had poor sleep quality, no significant relationship was found between sleep quality during pregnancy and preterm birth.

• Health Policy and Management
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• v.32 no.2
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• pp.125-136
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• 2022

The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Journal of Agricultural Extension & Community Development
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• v.21 no.4
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• pp.1007-1028
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• 2014

This study aimed to explore the direction of development of agricultural safety and health system in Korea based on experience on Farmers' Occupational Health Services (FOHS) of Finland. In Finland additional and specialized Occupational Health Services (OHS) for self-employed farmers were developed and have been conducted by municipal primary health care centers with cooperation of National Centre for Agricultural Health (NCAH) of Finnish Institute of Occupational Health, Social Insurance Institute (SII) and Farmers' Social Insurance Institution (FSII). Based on the study, in order to activate the FOHS in Korea, the analysis results could suggest the development of four prerequisites. Firstly, center for farmers' safety and health like NCAH, which conducts surveillance on health and safety status, standardization of intervention contents and epidemiological research is needed in national institution. Secondly, development of evaluation tools with lower cost and difficulty like walk-through survey for checking status of systems of safety in the farms is needed. Thirdly, farmers' occupational health insurance which will be initiated on near future should be connected to preventive intervention programs like FOHS. Lastly, training and qualification of more local occupational health experts and units is needed.

• Journal of agricultural medicine and community health
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• v.41 no.3
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• pp.129-139
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• 2016

Objective: The purpose of this study was to identify the predictors and frailty level in the frail elderly receiving home visiting health care services. Methods: The subjects were 177 frail elders aged over 65 registered in the home visiting health care services of three public health centers in Daegu. The data collection was performed from June 9 to June 24, 2015. This study used descriptive statistics, t-test, ANOVA, scheffe test and stepwise multiple regression by SPSS Win 18.0 program. Results: The mean of the frailty score was 10.05 (${\pm}4.52$). Age and life satisfaction were the significant factors related to the frailty score in frail elderly. Health promotion behavior, empowerment, social participation and perceived health status had a negative correlation with the frailty score. Thirty seven point four percent of the variance in the frailty score can be explained by perceived health status (${\beta}=-0.398$, p<0.001), health promotion behavior (${\beta}=-0.251$, p<0.001) and age (${\beta}=0.232$, p<0.001)(Cum $R^2=0.374$, F=25.744, p<0.001). Perceived health status was the most important factor related to the frailty score in our study. Conclusions: An integrative care program which includes these significant variables of subjects is essential to prevent the deterioration of frailty in frail elderly.

• Journal of the Korea Convergence Society
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• v.7 no.6
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• pp.105-113
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• 2016

This study was conducted to identify the Convergence influence of job satisfaction of care service providers on their psycho-social well-being status. A study subjects were 308 care service providers employed in local self-support centers for Social Service in Gwangju, Jeonam Jeonbuk province, from whom data was collected using self-administrated structured questionnaire after regular holiday education. In consequence hierarchical multiple regression analysis, research findings; adjusting general and occupational characteristics, the higher they perceived sub-dimensions of job satisfaction such as relationship with job demands(${\beta}=0.393$, p=.063), clients(${\beta}=0.669$, p=.000), relationship with peers and supervisors(${\beta}=0.229$, p=.068) the better their psychosocial well-being status was. And psychosocial well-being status of those who held certificate of care provider(${\beta}=4.815$, p=.003), helpers for neonate and mother(${\beta}=4.348$, p=.011) were higher than that of those who did not, which reflexed difference in their clients. As a results, promote mental health of care providers, it would be necessary to provide them training programs for facilitating human relationships with clients, peers and supervisors.