• Title/Summary/Keyword: Public health doctors

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Association between the Use of Humidifier Disinfectants and Bronchiolitis and Allergic Rhinitis Diagnoses in Korean Children (가습기살균제 사용과 모세기관지염 및 알레르기성 비염 진단과의 관계에 관한 연구)

  • Cho, Jun Ho
    • Journal of Environmental Health Sciences
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    • v.45 no.4
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    • pp.381-393
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    • 2019
  • Objectives: The purpose of this study was to assess the association between the use of humidifier disinfectant (HD) and bronchiolitis and allergic rhinitis diagnoses in Korean children. Methods: This study used data from the $8^{th}$ panel study on Korean children in 2015. Of these 2150 cases, 1598 cases were used for the final study. Diagnoses of bronchiolitis and allergic rhinitis by medical doctors were self-reported as outcome variables. Whether children had used HDs or not, the periods of using HDs were used as independent variables. Results: A total of 77.0% had used a humidifier, and the rate of HD usage among humidifier users was found to be 35.4%. When comparing 'children who had used HDs for less than 12 months' and 'children who had used HDs for more than 12 months' with 'children who had not used HDs', the adjusted odds ratio (OR)s for 'bronchiolitis' were 1.38 (95% confidence interval (CI), 1.36-1.40) and 1.80 (95% CI, 1.71-1.89), respectively. When comparing 'children who had used HDs for less than 12 months' and 'children who had used HDs for more than 12 months' with 'children who had not used HDs', the adjusted ORs for 'allergic rhinitis' were 1.44 (95% CI, 1.42-1.46) and 1.43 (95% CI, 1.37-1.49), respectively. Conclusions: The period of using HDs was statistically significantly associated with increased odds of bronchiolitis and allergic rhinitis. The results of this study will provide a very useful scientific basis for establishing the environmental health policy and using the educational data related to the use of humidifier disinfectant in the future.

Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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Socio-medical Surveys on the Korean Residents in Japan (재일한국인(在日韓國人)에 對(대)한 사회의학적조사(社會醫學的調査))

  • Kim, Byong-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.6 no.1
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    • pp.101-117
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    • 1973
  • Socio-medical survey was carried out on six hundred and thirty Korean households in the cities of Tokyo, Osaka, Kyoto, and Nagoya in Japan from Nov. 1972 to Dec. 1972, and following results were obtained. 1. Age distribution of households showed the highest occurence in the group of 40 to 49 years of age in the both sexes. Families with five members showed highest occurence, and the average number of familial members was 5.7 persons per one household. 2. More than half of the householders were some independent enterprisers rather than to be the employees and most of the household had one familial member engaged in more or less liberal profession. 3. 19.4% of households moved into these cities from 1941 to 1945. 4. 40.5% of all the households had their own houses. The possession rate of one's own house was higher in the households which had long period of residence in Japan. 5. 83.5% of all households had various medical insurances. And the 6.2% of the household which had no insurance stated that the reason for not being affiliated was 'because to be the foreigner'. Household of shorter dwelling period had less tendency to be affiliated to the various insurances. 6. In 41.3% of all the households, average medical expenditure amounted to 1000-5000 Yen per month. And only 25.6% of household stated that they do not worry about the medical expenditure for the futures. 7. 66.3% of households were consulting to medical doctors for their sickness, such as toothache, severe coughing, profuse sputum, children's fever and stomach pain etc. 8. 59.4% of households were using the facilities of health center services. The health center service was used mainly for individual health service rather than the environmental aspect. And 19.8% of households were not aware of health center activities. 9. It was found that 23.5% of households received the screening test of the tuberculosis and adult diseases. Especially, the rate of screening test of the adult diseases showed as following ; stomach cancer, 8.9% ; hypertension, 7.9% ; diabetes mellitus, 2.1% ; and uterus cancer, 1.6%. 10. Birth control was carried out in 17.3% of households but not in 52.5%. The chief reason of birth control was 'because of poor maternal health' (40.0%) or 'should not be done' (5.4%). 11. Most of them are obtaining the knowledges and informations on family plannings. public nuisance problems and nutritions etc. by means of the mass communications, while those no preventing diseases and the environmental hygiene through the administrative organizations.

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The Difference in Attitude toward Medical Care between Patients and Physicians (환자와 의사의 의료에 대한 태도 차이 -한 중소도시의 대학병원과 한의과대학 부속 한방병원을 중심으로-)

  • Kang, Myung-Guen;Park, Jong-Ku;Kim, Han-Joong;Sohn, Myong-Sei;Kim, Dal-Rae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.516-539
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    • 1998
  • The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

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A Study on Regionalization of Telemedicine in Japan : A Case of the Kagawa Prefecture (일본 원격진료의 지역화 형성 및 특성에 관한 연구 : 카가와현(香川県)을 통한 지방의 원격진료 사례를 중심으로)

  • Park, Soo-Kyung
    • Journal of the Korean Geographical Society
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    • v.46 no.4
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    • pp.501-517
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    • 2011
  • This research investigates a geographical issue as to which factor discovered in the only Japanese telemedicine with regard to social and medical circumstances performs a role as a determinant in regionalization, especially, local areas in Japan. According to the results, strong human networks based on regionalism are mirrored in regionalization and are associated with not only the development and management of telemedicine operations, but also the choice of telemedicine users concretely. In other words, all processes from the suggestion stage of telemedicine to the practical usage or application stage of telemedicine are involved in the existing human networks within one prefecture (the third diagnostic area); further, personal stakes are transferred to public health care services (telemedicine) and their relationships have been formulated by the telemedicine council including local government, medical association, region-rooted companies, core health centers and universities, etc. Accordingly, the telemedicine council responses to the need of telemedicine users immediately and contributes to develop regional health care. Also, telemedicine users have been connected with each other closely before operating telemedicine; accordingly, the human relationships between doctors and patients or among doctors influence the choice of telemedicine serving sites and their behaviors comes down to regional-based diagnosis via the telemedicine system.

Analysis and Improving ways of Factors affecting the Ill-defined Causes of Death of the Aged in Korea (노인의 불명확한 사망원인진단 관련요인 분석과 개선방안)

  • Park, Sang-Hee;Lee, Tae-Yong
    • Health Policy and Management
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    • v.21 no.2
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    • pp.329-348
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    • 2011
  • This research analyzed 168,010 cases of death of the aged over 65 from 244,867cases of death excluding 7 unknown age cases from 244,874 all age cases of death by using the death data of the National Statistical Office for 2007 to figure out factors affecting the quality of causes of death statistics of the aged and to suggest the ways of improving the quality of death statistics of the aged in korea. This research tried to derive factors affecting ill-defined cause of death category in acordance with WHO's guidelines and to find causes of lowering the accuracy of causes of death statistics of the aged. This research identified the problems of causes of death statistics of the aged by using both demographic characteristics such as sex, age, marital status, educational attainment, residential region, region size and factors of death items as independent variable to find causes of ill-defined cause of death of the aged. Logistic regression analysis was executed to calculate the hazard ratio about the ill-defined causes of death of the aged and multiple regression analysis was conducted to derive factors affecting the ill-defined cause of death by regional groups through using these independent variables such as the component ratio of over age 65, female death rates, doctors insitutions rate, medical institutions rate, attaching rates of death certificate by neighborhood. As a results of this research, R-code was the highest of ill-defined causes of death, accounting for 82.1%, and senility death(R54) of R-code was the highest, accounting for 91.2%. through subdivided order distribution of the ill-defined causes of death of the aged. As ill-defined causes of death by regional groups, attaching rates of death certificate by neighborhood was the most important factor(p<0.05) and also showed regression model's description with 83.8% ($R^2$=83.8%). Furthermore, Jeon-nam was the highest in the regional groups and these regions such as Je-ju, Jeon-buk, Chung-nam were not only attaching the death certificate by neighborhood but also were high at the rate of ill-defined causes of death. Therefore, this research found that both reconsideration about death certificate by neighborhood and education for doctors who write death certificate were needed the most.

Development of a Linking Model between Community Resourses and Industrial Injury Insurance Organs for the Activation of Medical Rehabilitation Services for Industrial Injury Patients (산재환자의 의료재활서비스 활성화를 위한 산재보험시설과 민간시설간의 연계모형 개발)

  • Kim, Hee-Girl
    • Korean Journal of Occupational Health Nursing
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    • v.14 no.1
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    • pp.56-70
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    • 2005
  • Objectives: The purpose of this study is to develop a linking model between industrial injury insurance organs and local organizations providing social welfare health services, for the activation of medical rehabilitation services for industrial injury patients. Method: Research design for this study was a multi-step research through literature review, field research, and group interviews with persons in charge, to compare local society-oriented medical rehabilitation programs. The term of researches Sep.1 ~ Nov. 30, 2004. Results: 1. Home nurses from Workers Accident Medical Corporation have been taken to be adequate to case managers, who link industrial accident insurance institutions to local society services for the activation of medical rehabilitation services for industrial injury patients. They have been chosen for case managers because they have richer understanding and experiences of objects of industrial accidents than any other specialists, and because they have proved to be able to provide direct home services as a specialist. We have established the center for case management affairs within the workers accident general hospital, organized the committee for case management with doctors in charge, doctors in rehabilitation, rehabilitation consultants, social welfare workers, physical therapists, and nurses, determined objects of case managements from those of long-term recuperation, and constructed a course of case management containing from case management plans to evaluation. 2. We have made files of community resources, and organized the council of industrial accident administration to have it in charge of the adjustment and linking of services in case management affairs. 3. Because there are inequality of community resources between areas, differences in experiences in and bases for linking, and disparity of core organizations with active linking in the system of linking between public and civil sectors, we have taken a system of linking between parallel organs to be the core. In our linking model, workers accident general hospital, hospitals designated for industrial injury, and rehabilitation hospitals are linked in parallel, inadequate long-term recuperation managers are trusted to an workers accident medical corporations through examination by the examination committee in Korea Labor Welfare Corporation, and are dealt with by the committee for case management. Of the hospitals designated for industrial accidents, those running a home caring center provide home caring services for the handicapped at home from industrial injury. 4. Workers Accident Medical Corporation take part in medical rehabilitation, and Korea Labor Welfare Corporation in vocational/social rehabilitation. Furthermore, in the model, the latter should construct a system for job opportunities through Internet portals and provide cyber vocational consultation and introduction. Conclusion: Improvement of systems is needed to apply the linking model to practical affairs. Because this model is centered for practical affairs, it should be put under the analysis of effects, and evaluation of its adequacy to practical application, and its effects and efficiency through experimental running in the 8 workers accident general hospital in Korea.

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Attitudes toward Complementary and Alternative Medicine in Suwon City (수원시 주민의 대체의학 수용실태 조사)

  • Chun, Ki-Hong;Song, Hyun-Joug;Park, In-Whee;Yoo, Seung-Chul;Song, Mi-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.162-169
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    • 1999
  • Objectives: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. Methods: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc., mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications Results: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou(15.3%) Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. Conclusions: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.

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The Effects of Organizational Structure of Hospital on the Conflict Patterns of Human Resources (의료기관 조직구조가 인적자원의 갈등양상에 미치는 영향)

  • Im, Bockhee;Park, Jikyeong
    • Korea Journal of Hospital Management
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    • v.23 no.3
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    • pp.63-71
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    • 2018
  • The purpose of this study is to explore how the organizational structure of hospitals affects the pattern of conflicts between human resources at hospitals and then to present basic data necessary for conflict resolution. Research data were collected from the personnel of 14 hospitals in P city in Korea. The findings of the study are summed up as follows. First, administrative workers and with fewer years of service thought of the organizational structure as organic. Second, organizational conflict was found to be higher in those at older ages, with more years of service and in middle management positions. Next, as for conflict patterns between occupation types, nurses showed more conflicts with doctors and administrative workers, while administrative workers and public health personnel had more conflicts with nurses. Last, of the organizational structure factors, 'Subdivision of work,' 'Decision making method,' 'Opinion collection process,' 'Codification of responsibilities and rights' and 'Documentation of duties' were found to have negative effects on conflict patterns. Therefore, the findings imply that for decrease in organizational conflicts, hospitals need to be reorganized to have a more organic structure and take such differentiated measures for conflict resolution that consider characteristics of human resources, such as one's age, years of service and position.

Analysis of Lethality in Echinococcal Disease

  • Khachatryan, Anna S.
    • Parasites, Hosts and Diseases
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    • v.55 no.5
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    • pp.549-553
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    • 2017
  • The information on mortality from echinococcosis is important not only for a better understanding of the severity of the disease, but also for evaluating the effectiveness of public health interventions. The aim of this research was to study the causes of mortality from echinococcosis. We have collected and analyzed the materials of 1,470 patients in 10 age - groups in the Republic of Armenia (from 2000 to 2016). To find out the causes of mortality from echinococcosis, we have analyzed the medical histories and protocols of postmortem examinations of 19 deaths from echinococcosis and 17 deaths due to other indirect causes not associated with the parasite. The average annual death rate from echinococcosis is 0.007 per 10,000 population, and the mortality is 1.29 (per 100 patients). The highest mortality occurs in people aged 70-79. Mortality from echinococcosis is also recorded among the unoperated children. The rupture of the parasitic cyst and hepatic insufficiency are major among the direct causes of mortality. Sometimes the hydatid cysts unrecognized during the life were first diagnosed at autopsy. Insufficient qualification of doctors in the field of helminthology, as well as the latent course of the disease or manifestation of minor symptoms in echinococcosis over a long period often led to medical errors. Further decline in mortality can be achieved by early diagnosis, timely hospitalization and treatment before the development of severe complications worsening the prognosis and outcomes of surgical intervention.