• 한국보건간호학회지
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• 제33권1호
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• pp.98-108
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• 2019

Purpose: The purpose of this study was to identify factors influencing care workers' patient safety behaviors (PSB), we hoped to provide baseline data for its activation. Methods: The subjects of this study were chosen by convenience sampling, which included 114 care workers at long term care facilities. Data were collected from August 22 to October 10, 2018. The gathered data were analyzed using the SPSS program, which was used to Cronbach's alpha, descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise regression. Results: The care workers' average PSB was at 7.81 points, patient safety culture (PSC) 3.86 points and safety of long-term care facilities 7.07. PSB positively correlated with safety of facilities(r=.802, p<.001) and PSC(r=.558, p<.001). Work attitude and satisfaction of job were explained 35.1% of the PSB. Conclusion: Administrators of long term care facilities should be interested in patient safety culture and improving job satisfaction of care workers in order to improve patient safety behaviors.

• 한국보건간호학회지
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• 제33권2호
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• pp.163-174
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• 2019

Purpose: The purpose of this study was to identify the effects of job stress, depression and fatigue on sleep quality of care workers employed in long-term care facilities. Methods: The participants were 213 care workers who worked in 11 long-term care facilities. The collected data was analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple linear regression with using the SPSS 23.0 program. Results: We found that patient-related job stress was the greatest stressor among care workers' job stresses. A significant difference in sleep quality was observed according to the self-perceived health status of the care workers. The care workers' sleep quality was negatively correlated with job stress (r=-.16, p=.018), depression (r=-.31, p<.001) and fatigue (r=-.29, p<.001). The influencing factors of sleep quality were depression (${\beta}=-0.22$, p=.001) and fatigue (${\beta}=-0.15$, p=.047). Conclusion: It is necessary to improve the health status and sleep quality of care workers by developing and applying health promotion programs to reduce the depression and fatigue of the care worker. This will ultimately improve the quality of service care for the patients.

• 지역사회간호학회지
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• 제10권1호
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• pp.44-52
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• 1999

This investigation & study has been made in oder to revitalilize the health care for the elderly in public health centers. The date subject, including 88 persons in charge health services in public heal centers, were from Chejudo. These were largely female, the average age was 38.4 at the health center. Their responsibilities included home visitation, nutrition management for the early, health education, and physical therapy. The most important problem were personal management and a lack of facilities, especially in home visitation, health education, physical therapy. Systematic networks of various activities are needed to encourage not only the patient but also volunteer who will also take part in these services. The numbers of members in charge of the elderly are not only to be increased and educate with facilities and equipment but also better provided with proper facilities and equipment. This is the best way to conduct health services the elderly.

• Journal of Preventive Medicine and Public Health
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• 제44권1호
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• pp.48-55
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• 2011

Objectives: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. Methods: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. Results: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. Conclusions: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.

• Journal of Preventive Medicine and Public Health
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• 제25권1호
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• pp.53-63
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• 1992

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows ; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on quality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.

• 지역사회간호학회지
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• 제15권4호
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• pp.551-565
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• 2004

Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

• 한국환경보건학회지
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• 제32권1호
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• pp.36-45
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• 2006

The aim of this study is to examine size-based concentration and genera of airborne fungi distributed in public facilities such as hospital, kindergarten, day-care center and postpartum nurse center and to provide fundamental data in order to prevent respiratory diseases caused by exposure to airborne fungi. Culturable total and respirable concentrations of airborne fungi averaged to $382\;cfu/m^3\;and\;292\;cfu/m^3$ in hospital, $536\;cfu/m^3\;and\;347\;cfu/m^3$ in kindergarten, $334\;cfu/m^3\;and\;266\;cfu/m^3$ in day-care center, and $371\;cfu/m^3\;and\;289\;cfu/m^3$ in postpartum nurse center, respectively. The ratio of respirable to total concentration of airborne fungi in the investigated public facilities was ranged from $55\%\;to\;70\%$ but there was no significant difference among them (p>0.05). The mean I/O ratio of culturable total and respirable concentrations were 0.56 and 0.64 in hospital, 0.72 and 0.91 in kindergarten, 0.33 and 0.45 in day-care center, and 0.63 and 0.73 in postpartum nurse center, respectively. Indoor concentration of airborne fungi did not correlated significantly with indoor temperature and relative humidity (p>0.05) but had a significant positive correlation with $CO_2$ concentration (p<0.01) and surrounding condition (p<0.05). Penicillium spp., Cladosporium spp., and Aspergillus spp. were estimated to over $95\%$ of total airborne fungi identified in the investigated public facilities.

• Safety and Health at Work
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• 제11권1호
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• pp.10-18
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• 2020

Background: The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit. Methods: The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011-2012 were compared with follow-up internal audits in 2014-2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability. Results: At baseline, 25% of 60 facilities were "noncompliant" (audit score<50%), 48% "conditionally compliant" (score >50 < 80%), and only 27% "compliant" (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate). Conclusion: Low baseline compliance with OHS-IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.

• 한국환경보건학회지
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• 제44권4호
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• pp.397-407
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• 2018

Objectives: The purpose of this study is to investigate human health risk assessment of indoor air pollutants at small-sized public-use facilities (e.g., daycare centers, hospital and elderly care facilities) that the susceptible population is mainly used. Methods: To assess indoor air quality (IAQ), the concentrations of indoor air contaminants such as HCHO, benzene, toluene, ethylbenzene, xylene, styrene, PM-10, CO, $NO_2$ and $O_3$ in air samples were measured according to the Indoor Air Quality Standard Method. By conducting the questionnaire survey, the major factors influencing IAQ were identified. Human health risk assessment was carried out in the consideration of type of use (user and worker) at 75 daycare centers, 34 hospitals and 40 elderly care facilities. Results: As a result of measurement of indoor air contaminants, the average concentration of HCHO and TVOCs in hospitals was higher than daycare centers and elderly care facilities, about 8.8 and 23.5% of hospitals were exceeded by IAQ standard. In human health risk assessment, for the user of daycare centers and elderly care facilities, the mean carcinogenic risk of HCHO inhalation was higher than acceptable value. Except for HCHO, other values were determined under acceptable risk. Similarly, for the worker of hospitals, the mean carcinogenic risk of HCHO inhalation was higher than acceptable value and other values were evaluated under acceptable risk. In contrast, the risk levels of other contaminants measured in elderly care facilities were acceptable. In the determination of factors influencing IAQ, the construction year, building type, ventilation time, and the use of air cleaner were identified. Conclusions: This study provides the information for establishing the plans of public health management of IAQ at small-sized public-use facilities that have not yet been placed under the regulation. The findings suggest the consideration of human health risk assessment results for the IAQ standards.

• 보건행정학회지
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• 제10권3호
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• pp.1-18
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• 2000

This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.