• 보건의료산업학회지
• /
• 제13권4호
• /
• pp.19-31
• /
• 2019

Objectives: The purpose of this study was to analyze research trends in age-friendly research and suggest directions for future research. Methods: For this study, 112 articles related to age-friendly research were selected, from 605 published articles in The Korean Journal of Health Service Management (2007-2018). Content analysis and text network analysis were conducted using SPSS 23.0 and NetMiner 4. Results: First, 2 authors (30.4%) and 4 keywords (45.5%) were the most studied. Most of the studies used quantitative research (93.8%). Primary data (61.9%) and SPSS (77.7%) were the most used for analysis. Second, there were seven common keywords in the top 10 in all the centralities. They were Elderly, Geriatric Hospital, Depression, Care Workers, Long-Term Care Facilities, Experience, and Attitude. Conclusions: This study shows the need for diversity of research topics, subjects, research methods, and analytical tools in future age-friendly related studies. In addition, it suggests activating convergence research in this field linked to various industries and services.

• 한국병원경영학회지
• /
• 제22권3호
• /
• pp.1-17
• /
• 2017

목적: 상용치료원(usual source of care)은 아프거나 건강문제에 대한 조언이 필요할 때 주로 방문하는 특정 개인의원, 보건소, 혹은 기타 장소로, 상용치료원 보유는 예방서비스를 제공을 더 받게 되며, 보건의료에 대한 전반적인 만족도가 높고, 입원율을 감소시키며 의료급여자의 의료비를 감소시킬 수 있다. 이 연구에서는 당뇨병을 보유하고 있는 20세 이상을 대상으로 상용치료원 보유 여부에 따른 대상자의 현황을 파악하고, 의료이용 횟수 및 의료비의 차이와 이에 영향을 미치는 특성을 분석하였다. 방법: 이 연구는 제7차 한국의료패널 자료를 이용하였다. 상용치료원 보유여부에 따른 의료이용 횟수와 의료비를 비교하기 위해 분산분석을 실시하였으며, 상용치료원 유형에 따른 의료이용 횟수와 의료비용에 영향을 미치는 요인을 파악하기 위해 Tobit 분석을 수행하였다. 결과: Tobit 분석결과, 상용치료원을 보유한 경우 보유하지 않은 경우보다 외래의료비는 증가했으나 입원의료비는 감소하였다. 상용치료원을 보유한 경우 보유하지 않은 경우보다 외래이용횟수와 입원횟수가 증가했으나 통계적으로 유의하지 않았다. 함의: 지속적이고 포괄적인 의료서비스가 제공되는 상용치료원을 당뇨병 환자들이 보유하게 되면, 외래 예방서비스의 이용을 통해 장기적으로 입원의료비의 감소를 기대할 수 있을 것이다.

• 농촌의학ㆍ지역보건
• /
• 제16권2호
• /
• pp.179-194
• /
• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• 국제학술발표논문집
• /
• The 5th International Conference on Construction Engineering and Project Management
• /
• pp.344-351
• /
• 2013

Private participation on public infrastructures projects is being promoted by governments of several developing countries, among them Colombia. As a result, several advantages such as service delivery efficiency, technology application and faster execution of the projects have been recognized. Hence, the Colombian Government is looking for schemes that allow the private investment in projects like hospitals, schools, prisons and public edification. In this paper, experiences in PPP from other countries were analyzed and adjusted to the Colombian environment. As a result, a model adapted to Colombia is presented, based on a well-developed case from Spain. The awarding process is defined by economic criteria, previous compliance of minimum technical exigencies. Once the infrastructure is operating, contractual periodical payments will be done, based on the performance of the facility.

• 농촌의학ㆍ지역보건
• /
• 제15권1호
• /
• pp.41-48
• /
• 1990

In order to find out the status of health care of the old aged people (age of 65 and over) in a rural area, a study was carried out, through analyzing the data of health care clinic for 207 old aged people with geriatric diseases, and of questionnired survey for 84 old aged people with geriatric diseases in a rural community. Su Dong-Myun. Nam Yang Zu-Gun, Kyung Gi-Do, Korea, during the year of 1989. The following results were obtained. 1) The composition rate of population of age of 65 and over was 9.8% in total, and sex-specific composition rate was 9.3% in male and 10.4% in female. 2) Utilization rate of health care clinic for old aged people with geriatric diseases was the highest rate with 37.9%, through individual letters at the first time, and showed gradually decreasing tendency afterward. 3) In the means of utilization advices to health care clinic for the old aged people. the individual letters(37.9%) at the first time were more effective than public information of the old aged hall or/and Myun office(18.4%). 4) In opinion on utilization of health subcenter-health care clinic for the old aged people "will utilize"(59.5%) was the highest and "do not know"(26.2%) "be difficult to utilize" (9.5%) and "will not utilize"(4.8%) were in the next order. 5) Out of 84 respondents, the old aged people With geriatric diseases, 73.8%(about three-fourths) of them answered "their diseases to the aggravated" (29.8%) "not to be changed"(25.0%) and "to be unknown"(19.0%), and the others(26.2% of them) "to be changed for the better". 6) Out of 62 respondents(the old aged people), answered their geriatric diseases not to be changed for the better, "no curative effect" was the highest with 43.5% of them. "could not know" (33.9%), "would not treat"(19.4%) and "could not be treated"(4.8%) were in decreasing order. 7) The old aged people, responded their diseases to be changed for the better, answered that they(patients) should make themselves(68.2%) responsible for basic effort of health care. However the old aged people responded their diseases not to be changed for the better answered that they should impute the responsibility of basic effort for health care to medical facilities or other conditions(63.0%). 8) In the reason of failure that the old aged people responded their geriatric diseases not to have curative effect, mis-control of regular habits of daily life was the highest(57.1%), and failure of taking selected medicine steadily(28.6%), and abuse of medicines(14.3%) were in decreasing order. 9) The reason order of being changed for the better that the old aged people responded their diseases to have curative effect, was keeping and control of regular habits of daily life (46.7%), taking selected medicines steadily(33.3%) and others (20.2%) respectively. 10) The courses of geriatric diseases itself are so chronic, duplicate and uncertain, and the old aged people activities for disease control are so slow, various and uncertain that continuous health education in home or/and community unit must be essential factors for effective geriatric health care.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권1호
• /
• pp.413-417
• /
• 2014

Background: Prisoners represent a population group that is disadvantaged, socially deprived and underprivileged, needing particular attention with regard to provision of necessary oral health care, health promotion and motivation and tobacco cessation. Considering the situation in prisons, smoking and tobacco chewing are burning issues related to health deterioration and economic loss that seem to be overlooked by the public health sectors. Aim: To assess prisoners' perception of tobacco use and cessation in Chhatisgarh, India. Materials and Methods: A pre-tested, close ended questionnaire was administered in the form of extensive face to face interviews, to assess perceptions regarding tobacco use and cessation in the central jail of Durg District of Chhattisgarh state, India. Results: Prevalence of tobacco usage amongst the prisoners was found to be 61%. Some 27% reported smoking, 44% used tobacco in the chewable form and 29% indulged in consuming tobacco in both forms i.e. smoked as well as chewed. Results suggest several recommendations for policy relevance such as provision of a prison dentist, a tobacco cessation counseling program and targeted eradication of oral cancer by educating the prisoners. Conclusions: Health is a fundamental human "right of everyone to the enjoyment of the highest attainable standard of physical and mental well-being". This applies to prisoners just as it does to every other human being. The alarming findings in the study suggest the need for dental treatment facilities and tobacco cessation counseling in prisons.

• Asian Journal of Atmospheric Environment
• /
• 제8권1호
• /
• pp.35-47
• /
• 2014

The purpose of the study is to evaluate the pollution level (gaseous and particle phase) in the public facilities for the PAHs, non-regulated materials, forecast the risk level by the health risk assessment (HRA) and propose the guideline level. PAH assessments through sampling of particulate matter of diameter < 2.5 ${\mu}m$ ($PM_{2.5}$). The user and worker exposure scenario for the PAHs consists of 24-hour exposure scenario (WIES) assuming the worst case and the normal exposure scenario (MIES) based on the survey. This study investigated 20 PAH substances selected out of 32 substances known to be carcinogenic or potentially carcinogenic. The risk assessment applies major toxic equivalency factor (TEF) proposed from existing studies and estaimates individual Excess Cancer Risk (ECR). The study assesses the fine dusts ($PM_{2.5}$) and the exposure levels of the gaseous and particle PAH materials for 6 spots in each 8 facility, e.g. underground subway stations, child-care facilities, elderly care facilities, super market, indoor parking lot, terminal waiting room, internet caf$\acute{e}$ (PC-rooms), movie theater. For internet caf$\acute{e}$ (PC-rooms) in particular, that marks the highest $PM_{2.5}$ concentration and the average concentration of 10 spots (2 spots for each cafe) is 73.3 ${\mu}g/m^3$ (range: 6.8-185.2 ${\mu}g/m^3$). The high level of $PM_{2.5}$ seen in internet cafes was likely due to indoor smoking in most cases. For the gaseous PAHs, the detection frequency for 4-5 rings shows high and the elements with 6 rings shows low frequency. For the particle PAHs, the detection frequency for 2-3 rings shows low and the elements with 6 rings show high frequency. As a result, it is investigated that the most important PAHs are the naphthalene, acenaphthene and phenanthrene from the study of Kim et al. (2013) and this annual study. The health risk assessment demonstrates that each facility shows the level of $10^{-6}-10^{-4}$. Considering standards and local source of pollution levels, it is judged that the management standard of the benzo (a)pyrene, one of the PAHs, shall be managed with the range of 0.5-1.2 $ng/m^3$. Smoking and ventilation were considered as the most important PAHs exposure associated with public facility $PM_{2.5}$. This study only estimated for inhalation health risk of PAHs and focused on the associated cancer risk, while multiple measurements would be necessary for public health and policy.

• 한국콘텐츠학회논문지
• /
• 제19권8호
• /
• pp.525-534
• /
• 2019

우리나라는 경제발전과 보건의료의 발달로 인한 평균수명의 연장과 저출산 등으로 세계에서 가장 급속도로 인구구조의 고령화 문제에 직면하고 있다. 정부는 이러한 사회적 구조 및 노인문제를 해결하기 위하여 장기요양대상 노인의 삶의 질 향상과 가족부양 부담의 완화 등을 목적으로 노인장기요양보험법을 제정 시행 중에 있다. 하지만, 노인장기요양보험제도의 시행결과, 시설의 민영화와 난립으로 서비스의 공적 책임과 시설의 질 제고에 대한 요청이 확산되고 있다. 이 밖에, 저임금 요양인력의 양산, 질 개선에 관한 과제, 재원조달 방식에 관한 문제, 등의 대비가 다각도로 필요하다. 이에 노인장기요양보험제도가 장기 지속적으로 유지 발전하기 위해서는 시대적인 사회환경의 변화에 따라 법 제도적 측면의 개선방안의 모색과 더불어 노인복지서비스가 신체적 건강뿐만 아니라 노후 생활의 안정을 위한 정신적 심리적 조치를 강구하는 방안을 검토한다.

• Journal of Preventive Medicine and Public Health
• /
• 제14권1호
• /
• pp.3-12
• /
• 1981

To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

• 가정과삶의질연구
• /
• 제19권4호
• /
• pp.49-68
• /
• 2001

The purpose of this study was 1) to review communal housing in the UK, 2) to consider the policy implications for elderly communal housing in Korea. The research methods used were 1) literature review about communal housing and related policy in the UK 2) field survey in the UK 3) interpretative suggestion for the proper policy implication to develope communal housing for the elderly in Korea. Sheltered housing in the UK had been developed as communal housing for the elderly with special needs since the 1970s. The type of sheltered housing were category 1 and category 2. Very sheltered housing with more facilities and meal services was added in 1980s. Sheltered housing was evaluated as the most humanistic solution for older people in the UK in 1980s. Because of the policy of moving institutional care to community care, sheltered housing became less in demand because of more options for older people including being able to stay in their own home. So new completion of sheltered housing by registered social landlords reduced saliently. Sheltered housing already totalled over half million units in which 5% of all elderly over 65 still lived and a small quantity of private sector for sale schemes emerged in the 1990s. The reason why the residents moved to sheltered housing was for sociable, secure, and manageable living arrangements. In general the residents were satisfied with these characteristics but dissatisfied with the service charge and quality of meals, especially in category 2.5 schemes. The degree of utilisation of communal spaces and facilities depended on the wardens ability and enthusiasm. Evaluation of sheltered housing indicated several problems such as wardens duty as a \"good neighbour\" ; difficult-to-let problems with poor location or individual units of bedsittiing type with shared bathroom ; and the under use of communal spaces and facilities. Some ideas to solve these problems were suggested by researchers through expanding wardens duty as a professional, opening the scheme to the public, improving interior standards, and accepting non-elderly applicants who need support. Some researchers insisted continuing development of sheltered housing, but higher standards must be considered for the minority who want to live in communal living arrangement. Recently, enhanced sheltered housing with greater involvement of relatives and with tied up policy in registration and funding suggested as an alternative for residential care. In conclusion, the rights of choice for older people should be policy support for special needs housing. Elderly communal housing, especially a model similar to sheltered housing category 2 with at least 1 meal a day might be recommended for a Korean Model. For special needs housing development either for rent or for sale, participation of the public sector and long term and low interest financial support for the private sector must be developed in Korea. Providing a system for scheme managers to train and retrain must be encouraged. The professional ability of the scheme manager to plan and to deliver services might be the most important factor for the success of elderly communal housing projects in Korea. In addition the expansion of a public health care service, the development of leisure programs in Senior Citizens Centre, home helper both for the elderly in communal housing and the elderly in mainstream housing of the community as well. Providing of elderly communal housing through the modified general Construction Act rather than the present Elderly Welfare Act might be more helpful to encourage the access of general people in Korea. in Korea.