• Korea Journal of Hospital Management
• /
• v.7 no.1
• /
• pp.105-120
• /
• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• Korean Public Health Research
• /
• v.44 no.4
• /
• pp.1-13
• /
• 2018

Purpose : The purpose of this study was to explore the subjective experiences of problem drinkers participating in the early intervention program for moderate alcohol drinking. Methods : A qualitative descriptive study design was used. Data were collected through individual interviews with thirteen problem drinkers and analyzed using qualitative content analysis. Results : The experiences of the problem drinkers participating in the early intervention program were derived from four themes and nine sub-themes in terms of awareness, alcohol expectancies, perceived self-efficacy and behavioral change. They participated in programs offered in the workplace, and there were differences in motivation level among individuals, but generally accepted the necessity of the program. Participants who had trust with the program provider were more likely to change drinking behavior. Conclusion : Problem drinkers who participated in the early intervention program showed that it is a useful approach to change the problem drinking behavior by promoting awareness of alcohol-related knowledge, motivation for change through acquiring enough information and acquisition of self-efficacy as a behavior skill. These findings can be used as basic information for implementing and adapting early intervention for prevention of alcoholism in primary health care setting including workplace.

• Journal of Korean Public Health Nursing
• /
• v.8 no.2
• /
• pp.101-113
• /
• 1994

Maternity means all the women who are capable to conceive. In the aspect of health and medical care. however. it means the women who are now in pregnancy or have already given birth to a baby or are in a period of being recoverd from physiological changes occurred by pregnancy. According to the rapidly changing social structure. both the Quality and Quantity of the capacity of childbirth experienced by women are changing. Our society. having established a great economical growth by virtue of the highly developing and growing industrialization and urbanization. stimulates the women's advance into society and thereby increasing the number of employed women. When the women's participation in society is increased. their age of marriage is also affected. Which means there are a decrease of the capacity of childbirth in terms of quantity and a trend for women to have less children and to deliver a baby in their old age in terms of quality. On the contrary. since the number of multipara who want to have a baby in their old age is increasing. as a counter functional effect to the political project of decrease of a birth rate. concern has been focussed on childbirth in old age in the present study. And also such kind of the childbirth may be danger to the health of both mother and baby. Therefore the present study intended to provide some basic data of health education in the part of the health management of both mother and baby in the general hospital. based on understanding the realities of childbirth in. old age and things related to them. To achieve such a purpose of the present study. an analytical study by means of SPSS. was done using the data of 269 clinical records on both the newborn .babies and their mothers who had been supported by public general hospitals located in Seoul for 3 years from Jan. 1. 1991 to Dec. 31. 1993. Some significant results from the analytic study are as follows: 1. It appeared that the average age of normal. natural delivery was 33.8 years old and the average age of delivery through the cesarean operation was 35.4 years old. 2. It appeared that danger factors to childbirth women were types of the delivery and placental extrusion and danger factors to newborn babies are not so outstanding. 3. It appeared that the variables of the childbirth capacity which showed a significant difference according to each age group of women were the number of pregnancy. number of still birth, and number of existing children. That is. the age group of 'more than 35 years' had more frequency of experience In all 3 variables than the age group of 'less than 35 years'. 4. It appeared that the variables of the childbrith capacity which showed a significant difference a according to the sex of a newborn baby were number of pregnancy, number of still birth, and number of existing children. That is, the age group of 'more than 35 years' had more frequency of experience in all 3 variables than the age group of 'less than 35 years'. 5. It appeared that the health index of newborn babies which showed a significant difference was only 5 minute APGAR. That is, the health index 9.46 in the age group of 'more than 35 years' was less than an index of 9.72 in the age group of 'less than 35 years'. 6. Since a counter correlation of -0.10, as Pearson Correlation Coefficient, was showed between the age of childbirth mothers and the weight of newborn babies, it indicated that the higher age of childbirth woman, the lesser the weight of newborn baby. 7. It appeared that the number of women who had confirmed the sex of their baby before their delivery were 45 women, $67.2\%$ of total 67 women who had delivered a baby. and the expected sex by women in childbed was male with $73.1\%$ of total childbirth women expecting male birth and with their expression of feeling of female delivery. very regretful' by $39.3\%$ of total childbirth women. The results as shown above may indicate that instead of the possibility of danger to both the mother delivering a baby in old age and the baby delivered, the expectation of getting a son motivates childbirth in old age. As a conclusion, in a dimension of general hospital as well as national reform. it is required that a program of health education for childbirth in late maternal age have to be developed in the part of the health management of both mother and baby in the near future.

• Journal of the Korean Society of School Health
• /
• v.12 no.2
• /
• pp.207-215
• /
• 1999

The objectives of this study are to explain the use of media materials in school health education with other related factors in elementary, middle, and high schools in Korea. The data were collected by questionnaires from June to September in 1998. The number of subjects were 294 school nurses. The PC-SAS program was used for statistical analysis such as percent distribution, chi-squared test, spearman correlation test, and logistic regression. The use of media materials in health education has become extremely common. Unfortunately, much of the early materials were of poor production quality, reflected low levels of interest, and generally did little to enhance health education programming. A recent trend in media materials is a move away from the fact filled production to a more affective, process-oriented approach. There is an obvious need for health educators to use high-quality, polished productions in order to counteract the same levels of quality used by commercial agencies that often promote "unhealthy" lifestyles. Health educators need to be aware of the advantages and disadvantages of the various forms of media. Selecting media materials should be based on more than cost, availability, and personal preference. Selection should be based on the goal of achieving behavioral objectives formulated before the review process begins. The decision to use no media materials rather than something of dubious quality usually be the right decision. Poor-quality, outdated, or boring materials will usually have a detrimental effect on the presentation. Media materials should be viewed as vehicles to enhance learning, not products that will stand in isolation. Process of materials is an essential part of the educational process. The major results were as follows : 1. The elementary schools used the materials more frequently. But the production rate of media materials was not enough. The budget was too small for a wide use of media materials in school health education. These findings suggest that all schools have to increase the budget of health education programs. 2. Computers offer an incredibly diverse set of possibilities for use in health education, ranging from complicated statistical analysis to elementary-school-level health education games. But the use rate of this material was not high. The development of related software is essential. Health educators would be well advised to develop a basic operating knowledge of media equipment. 3. In this study, the most effective materials were films in elementary school and videotapes in middle and high school. Film tends to be a more emotive medium than videotape. The difficulties of media selection involved the small amount of extant educational materials. Media selection is a multifaceted process and should be based on a combination of sound principles. 4. The review of material use following student levels showed that the more the contents were various, the more the use rate was high. 5. Health education videotapes and overhead projectors proved the most plentiful and widest media tools. The information depicted was more likely to be current. As a means to display both text and graphic information, this instructional medium has proven to be both effective and enduring. 6. An analysis of how effective the quality of school nurse and school use of media materials shows a result that is not complete (p=0.1113). But, the budget of health education is a significant variable. The increase of the budget therefore is essential to effective use of media materials. From these results it is recommended that various media materials be developed and be wide used.

• Health Policy and Management
• /
• v.25 no.3
• /
• pp.162-173
• /
• 2015

Background: The aim of the current study was to investigate the factors related to the non-practice of cancer screening in cancer survivors, who are at high risk of developing second cancers. Methods: This study is a cross-sectional analysis of 1,125 cancer survivors ${\geq}19$ years old who participated in the Korean National Health and Nutrition Examination Surveys IV and V (2007-2012). A Rao-scott chi-square test and a survey logistic regression analysis were employed respectively to analyze the difference of cancer survivors in cancer screening by each characteristic and the factors related to the non-practice of cancer screening in cancer survivors. Results: Among total subjects, 33.5% did not participate in cancer screening in the last two years. Results from a fully adjusted logistic model showed that the non-practice of cancer screening in cancer survivors was significantly associated with variables such as sex, age, marital status, education level, monthly income, and drinking a alcoholic beverage Specifically, the odds ratio of non-practice of cancer screening was higher in males than in females, in the younger group than in older group, in the group with no spouse than in the group with a spouse; in a group with a low level of education than in a group with a high level of education; in a group with the lowest income level than in a group with the other levels of income; or in non-drinkers than in drinkers. Conclusion: Health policies to reduce the non-practice rate of cancer screening in cancer survivors should be designed and implemented with close attention to cancer survivors' socio-economic characteristics such as sex, age, marital status, education, and income, along with a health behavioral characteristic as drinking.

• The Korean Journal of Health Service Management
• /
• v.6 no.3
• /
• pp.141-155
• /
• 2012

The purpose of this study is to analyze the effects of job stress on job attitude among nurse practitioners, determine moderating effects of perceived organizational support in this process, and provide preliminary data to devise a scheme for managing job attitude effectively in nursing manpower. The research model was composed of 7 sub-variables of job stress, which was a independent variable; job attitude, which was a dependent variable, was divided into job satisfaction and organizational commitment; and variables of moderating effects included perceived organizational support. The data for empirical analysis of the model were collected from 300 nurses working in one university hospital and two general hospitals in Busan by using structured self-administered questionnaires. The main results of empirical analysis were as follows: Perceived organizational support was effective in preventing job stress from worsening job attitude. Moderating effects of perceived organizational support were found to exist in relations between job stress and organizational commitment. These results imply that a sense of organizational support has both direct and moderating effects on job attitude and can be a good means of managing job attitude.

• Journal of muscle and joint health
• /
• v.13 no.1
• /
• pp.31-42
• /
• 2006

Purpose: The purpose of this study was to identify the effects of aquatic exercise program on physical fitness, pain and physiological function in patients with osteoarthritis. Method: The subjects of the study were thirty women(age: forty-seventy five) who have an osteoarthritis. Aquatic exercise program consist of approximately two hours of exercise in water, two days per week, for six weeks. Data were gathered from April 19 2005 to May 27 using a questionnaire and measuring physical fitness and physiological index. Data were analyzed with the SPSS Win 12.0 using frequency and paired t-test for difference between pre-exercise and post-exercise. Results: The results of this study were as follows: There were significantly increased on left shoulder (t=3.848, p=.001) and waist flexibility(t=-5.622, p=.001) scores. There were significantly decreased on pain score(t=5.288. p=.000), body weight(t=5.072, p=.001), systolic B.P(t=18.362, p=.001), diastolic B.P(t=32.558, p=.001), blood sugar(t=1.805, p=.041), total cholesterol(t=2.032, p=.026) scores. Conclusion: From these results, it is concluded that the aquatic exercise program can be effective in increasing physical fitness, physiological function and decreasing pain in patients with osteoarthritis.

• Journal of Preventive Medicine and Public Health
• /
• v.51 no.3
• /
• pp.121-129
• /
• 2018

Objectives: To assess the nurses' hand hygiene (HH) knowledge, perception, attitude, and self-reported performance in small- and medium-sized hospitals after Middle East Respiratory Syndrome outbreak. Methods: The structured questionnaire was adapted from the World Health Organization's survey. Data were collected between June 26 and July 14, 2017. Results: Nurses showed scores on knowledge ($17.6{\pm}2.5$), perception ($69.3{\pm}0.8$), self-reported HH performance of non-self ($86.0{\pm}11.0$), self-reported performance of self ($88.2{\pm}11.0$), and attitude ($50.5{\pm}5.5$). HH performance rate of non-self was $Y_1=36.678+0.555X_1$ (HH performance rate of self) (adjusted $R^2=0.280$, p<0.001). The regression model for performance was $Y_4=18.302+0.247X_{41}(peception)+0.232X_{42}(attitude)+0.875X_{42}(role model)$; coefficients were significant statistically except attitude, and this model significant statistically (adjusted $R^2=0.191$, p<0.001). Conclusions: Advanced HH education program would be developed and operated continuously. Perception, attitude, role model was found to be a significant predictors of HH performance of self. So these findings could be used in future HH promotion strategies for nurses.

• Quality Improvement in Health Care
• /
• v.22 no.2
• /
• pp.27-40
• /
• 2016

Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.

• The Korean Journal of Health Service Management
• /
• v.14 no.2
• /
• pp.29-40
• /
• 2020

Objectives: To investigate the effect of authentic leadership and servant leadership on job engagement among hospital employees, focusing on the mediating effect of job crafting and moderated mediating effect of positive psychological capital. Methods : Data were collected from 329 employees working at hospitals through a self-administered questionnaire-based survey. Results : Job crafting had a direct positive effect on job engagement and a mediating effect between the servant leadership and job engagement. Self-efficacy among positive psychological capital had a moderating effect on the relationship between job crafting and job engagement and a moderated mediating effect on the relationship among servant leadership, job crafting, and job engagement. Conclusions : Results imply that manager's authentic leadership and servant leadership is required to instill enthusiasm among hospital employees regarding their job crafting and job engagement. Additionally, development of self-efficacy among employees would lead to the improvement of job engagement.