• Health Policy and Management
• /
• v.18 no.1
• /
• pp.63-84
• /
• 2008

The aim of this study was to analyze the correlation between professional autonomy and ideology among Korean physicians and to investigate how these factors affect job satisfaction like social status satisfaction and economic reward satisfaction. This study utilized a self-administered questionnaire survey and collected data nationwide between July and August, 2003. 211 responses were used for final analysis. SPSS 12.0 was used for a chi-square test, one-way ANOVA, Pearson correlation analysis, independent t-test and hierarchical multiple regression analysis. The results of this study were as follows. First, many variables of ideological factor were related to job satisfaction. Second, physicians expecting the change of political influence has patient-centered attitude. Third, there were many relationships between professional autonomy and ideology variables. Fourth, physicians expecting the change of political influence and customer-centered healthcare system showed more job satisfaction. In conclusion, professional autonomy is related to ideology, and in order to enhance job satisfaction, ideological factor needs more development. In addition, market-oriented healthcare system would contribute to enhance the job satisfaction of physicians expecting the change of political influence and customer-centered healthcare system.

• Journal of Preventive Medicine and Public Health
• /
• v.21 no.2 s.24
• /
• pp.442-450
• /
• 1988

Effects of various factors related to the process of social action of hospital services on the selecting a hospital were investigated by using of questionnaires answered by 1,319 patients in a certain University Hospital, in Chungchongnam-Do, from November, 1986 to November, 1987. The results summarized were as follows ; 1. Each of the examined factors, that is, sincerity of an attendant physician in medical treatment and explaining the condition of a disease, confidence to doctor and nurse, doctor's and nurse's response to calling by patient, kindness of the hospital staffs and food handlers, sanitariness of hospital, cleanness of clothes and bed sheets, hospital foods, and rest surroundings, are not solely decisive to attitude of hospital utilization, but the factors effects compositely on hospital utilization 2. Hospital services of the social action process are more effective to hospital utilization in cases of the hospitalization caused by the traffic facility than for the medical skill and facilities.

• Korea Journal of Hospital Management
• /
• v.8 no.1
• /
• pp.95-111
• /
• 2003

The purpose of this study was to evaluate the information searching behavior of consumer by type of medical institution. A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling in nationwide level, excluding Jeju-Do. Personal survey was conducted through door-to door survey from 27 July to 10 August 1999. The main results of this research was as following; 1. The proportion of information searching of respondents ranged from 91.5-95.2%. Even though the proportion of user in university hospital was slightly high, there was not significant statistically by type of medical institution. In terms of information source, personal informer was most common information source in all type of medical institution. Public informers were more frequently used in university hospital visitors and professional informer in general and university hospital visitors. 2. Comparing to searching intensity, user informer and professional informer's influences were more powerful, but not statistically significant. In analysis of unit influence for information source, written informer or public informer was more powerful in clinic visitor, professional informer and written informer in university hospital visitor. 3. Information which consumer want to know mostly were about on special potential and career of physician. The clinic visitor wanted to know about institutional location and kindness of medical personnel. The university hospital visitor also wanted to know about facilities and convenience of process. Comparing to institution selection criteria of consumers at 1991, quality related criteria were recognized more importantly in outpatient and dental services. But in case of inpatient services, convenience factor was recognized more importantly. In conclusion, the effort for specific marketing plan by type of medical institution should be needed. And more concern on information searching behavior of consumer will be needed.

• Journal of Preventive Medicine and Public Health
• /
• v.29 no.3 s.54
• /
• pp.617-637
• /
• 1996

Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet welt stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1981. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers in a coal chemical factory, there were 794 with dermatomycosis, 296 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal prouct manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatoses in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precise diagnosis, report and prevention of the occupational dermatoses. a. Dermatologist, preventive physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workersr Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.1 s.45
• /
• pp.117-134
• /
• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• Korea Journal of Hospital Management
• /
• v.1 no.1
• /
• pp.108-135
• /
• 1996

This paper investigates the current feature of management strategy of hospitals in Korea, and examines the relationships between adoption of a particular strategic orientation and the hospitals environmental and organizational characteristics, strategic behaviors and management improvement activities, and financial performance. Data were collected from CEOs of 88 hospitals among 650 hospitals for a 13.5% response rate using the self-administered questionnaire by mail survey. The major findings that obtained are as follows: 1. Only 37.2% of response hospitals carried out strategic planning, Most of these hospitals established the first strategic planning in 1991(81.3%) and renovated strategic planning by 4 or 5 years(56.3%), and modified strategic planning with flexibility(59.4%). Most strategic plans were documented, but informalized(68.8%). And only 29.0% of these hospitals had independent planning division. 2. Hospital services that CEOs assessed rank ordered for their impact on profitability are as follows: i)diagnostic ultrasound facility, computerized tomography scanner, obstetric inpatient unit, therapeutic X-ray, and physical therapy at present. ii)diagnostic ultrasound facility, physical therapy, computerized tomography scanner, emergency department, and health screening at future. And the services rank ordered that CEOs hoped to introduce are as follows: emergency department, physical therapy, health screening, volunteer services, and computerized tomography scanner. 3. Using a typology developed by Miles and Snow(l978), the strategic orientation of response hospitals are shifting significantly from defenders in the past to analyzers in the present, and to prospectors in the future(p<.01). 4. With regard to hospital environmental and organizational characteristics such as ownership, physician training, location, bed size, and hospital management training career and specialty of CEOs, the four strategic orientation archetypes varied not significantly. But, hospitals with a analyser orientation in the present and a reactor orientation in the future perceived competition significantly higher than the other three archetypes(p<.05). 5. The four archetypes rank ordered in terms of appling strategic behaviors and management improvement activities are as follows: prospector, analyzer, reactor, and defender. 6. The four archetypes differed significantly in terms of their financial performance using revenue per bed(p<.05). Reactors and prospectors in terms of total revenue per bed, prospectors in terms of outpatient revenue per bed, and reactors and prospectors in terms of inpatient revenue per bed had the best performance.

• Journal of the Korean Society of School Health
• /
• v.7 no.1
• /
• pp.9-28
• /
• 1994

This study is to investigate the status and problems in the anual physical examination in elementary & secondary schools. The study helps the introduction of health assessment. Two hundreds and forty nurse teachers of elementary & seconcary school in Seoul received in-service traomong fpr 20 daus frp, September 7 to September 27, 1992. Questionnaires were given to the 240 teachers and the number of collected questionnaire is 112. The result of the questionnaire analysis is like the following. First, the answered teachers aged 35~39, 36.6%; experience 6~10 years 37.5%; the number of class 31~40, 28.6%. Among the answered of the school doctors is practicioners. The doctors major subjects are 26.8% of internal medicine and 35.7% of surgery. Second, in elementary & secondary school nurse teachers received in-service training for the primary health assessment. And then 37.5% of schools practiced the health assessment. The term of the health assessment is largely a-year-length, occurately its rate of schools have practiced the assessment reaches 81.0%. The number of health assessment are consist of eyes, nose, ear, throat, skin, spine, heart and other abnormal regions and diseases all over the body. And 83.3% of the rate of the health assessment includes all these contents. The period of the health assessment is 7 to 28 days. Third, the physical examination conducted by school doctors is 91.0%. The method is various; one is 56.6% of the students who checked first by he nurse teacher. The number of 15.1% of the schools is directly checked by the school doctor. The invited medical doctors are divided into two categories. The number of general physician is 61.9%. Contrary to that school doctors are 38.1%. The contents of the medical examination is all the items printed on the medical examination sheet. To follow the medical examination sheet the number of school is 59.6%. Eyes, throat, skin and heart etc. partly medical examination is 40.4%. The rate of schools that used only stethoscope, tongue pressor as the medical instruments reaches 53.4% and 87.1% of elementary & secondary school give the invited doctors the allowance a nurse teachers conference decided. The number of 8.9% schools pay the doctors independent allowance. The medical examomatopm allowance is 200 to 250 won per capita. The rate is 56.1%. Forth, after the medical examination 72.1% of school sends letter to the parents to notice the result of the examination. The number of response from parent is 12.5%. The observation record in secondary school is 70.6% for junior, and 80.0% for senior respectively, and 65.5% is for the elementary school children. To conclude the regular physical examination in elementary & secondary school is very important. Because the students are in the stage of rapid growth and development. Early finding of the students diseases can help to cure with ease. In the light of public health the management of health program in the elementary & secondary school is of consequence.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.5
• /
• pp.104-115
• /
• 2016

Objective: This study was conducted in order to investigate the effects of individual patient behavior regarding the health and medical care level on their therapeutic compliance for people diagnosed with high blood pressure by a physician, in order to evaluate the impact of treatment compliance. In this study, the therapeutic compliance was defined as the hypertension drug cure rate. The current blood pressure controls were persons about 30 years of age diagnosed with high blood pressure by their doctor one month fraction of the people who take more than 20 days (30 days). Methods: The data was analyzed by using the X2-test for different comparisons of the therapeutic compliance in the individual characteristics and using a two-stage multilevel logistic regression to identify the community variance of the related index of high blood pressure therapeutic compliance using the data from 229 adults over the age of 19 in a community health survey conducted in 2010. The Spss 18.0 statistical program was used with HLM 7 (hierarchical linear model) Results: It was found that the rate of therapeutic compliance was affected by the individual health behavior and health and medical care levels. Conclusion: In this study, although the odds ratio of the variable region of the high level of health care, I was able Unlike previous studies and focuses on the personal level of variation found variations in the local health care level was a significant. More studies on multilevel analysis are needed in the future considering regional level data.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.4 s.48
• /
• pp.747-761
• /
• 1994

Workers' periodic health examination is the main tools used to manage the health problems of most workers in Korea. The most common health problem found in workers' periodic health examination is liver disorder. Liver disorder is also one of the most common health problems in general population and one of the leading causes of mortality in adult population. Regulation proposed by government (No. 207, Ministry of Labor, 1992) defines the criteria for selection of workers with the liver dysfunction for further evaluative examination and the examination items used for diagnosis of the workers with liver dysfunction. This study was designed to evaluate the proficiency of each examination items presently defined in Regulation and propose the optimal examination items for detection of the liver disorders found by workers' periodic health examination. Study subjects are 186 workers with abnormal liver function tests in screening examination of workers' periodic health examination. Questionnaire survey including past history of liver disorder, drinking history, height and weight was done. Physical examination by physician, routine test items defined by Regulation (SGOT, SGPT, $\gamma$-GTP, protein, albumin, total and direct bilirubin, alkaline phosphatase, $\alpha$-feto protein, HBsAg and anti-HBs), anti-HCV antibody test and liver ultrasonography were done. Results are as follows; 1. Result of evaluative examination utilizing only the items defined in Regulation was; There were 75 workers with suspected live. disorder(40.3%), 63 with no liver dysfunction (33.9%), 13 with suspected hepatitis B(7.0%), 10 workers with hepatitis B(5.4%), 10 workers with hepatitis B carrier state(5.4%), 10 with alcoholic liver disorders(5.4%), 5 with fatty liver(2.7%). When alternative diagnostic criteria applying additional examination items (drinking history, body mass index, anti-HCV antibody and ultrasonography) diagnosability of liver disorder was increased. When all four items were included, final results were; 23 workers (17.8%) with hepatitis B (10 carriers, 13 suspects and 10 hepatitis B), 10 (5.4%) with hepatitis C(4 carriers, 5 suspects and 1 hepatitis C), 13(7.0%) with alcoholic liver disorder, 45(24.2%) with fatty liver (40 suspects, 5 fatty liver), 410%) with suspected liver disorders and 44 (23.7%) with normal liver. 2. Of examination items defined by Regulation, only SGOT, SGPT, $\gamma$-GTP and HBsAg were significantly different in abnormal rate and mean value, and all other laboratory findings did not showed significant difference between two groups. Drinking history, body mass index and anti-HCV antibody test which are the items that authors included in this study, also showed significant difference between two groups. Utilization of body mass index (BMI) for abnormal liver function group in diagnosis of fatty liver had high specificity (97.6%) but sensitivity (22.3%) was low. Therefore we suggest that SGOT, SGPT, $\gamma$-GTP, HBsAg, alcohol drinking history, BMI and anti-HCV Ab were useful for diagnosis of liver disorders among worker's periodic health examination.

• Journal of agricultural medicine and community health
• /
• v.45 no.4
• /
• pp.183-193
• /
• 2020

Objectives: As an ecological study, this study was performed to identify the community-level variation of health related quality-of-life (HRQOL), and to explore the factors that explain the variation, using 2017 Korean Community Health Survey (KCHS) data. Methods: Community health indicators of KCHS, which are correlated with the EQ-5D index of Si-gun-gu districts, were selected as independent variables. Multiple linear regression model was used to derive factors that explain regional variations in the EQ-5D index. Results: The EQ-5D index variation in 229 districts nationwide was 1.1 times for extremal quotient (EQ) and 1.0 for coefficient of variance (CV). The Si-gun-gu districts with the EQ-5D index in the lower 25% were more distributed in the province (27.7%) than in the metropolitan area (20.3%). As a result of multiple linear regression analysis, the depressed mood experience rate, perceived stress rate, suicide ideation rate, and physician diagnosed arthritis rate were derived as major factors of the variation. Conclusions: In order to reduce the gap in HRQOL between the districts, the priority of local health policies should be placed on the above factors including psychosocial factors.