• Journal of Preventive Medicine and Public Health
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• v.46 no.2
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• pp.82-88
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• 2013

Objectives: Unprotected leisure time exposure to ultraviolet radiation from the sun or artificial tanning beds is the most important environmental risk factor for melanoma, a malignant skin cancer with increasing incidences over the past decades. The aim of the present study was to assess the impact of skin health information provided by several sources and different publishing issues on knowledge, risk perception, and sun protective behavior of sunbathers. Methods: A cross-sectional questionnaire survey was conducted among Austrian residents (n=563) spending leisure time outdoors in August 2010. Results: Print media, television, and family were perceived as the most relevant sources of information on skin health, whereas the source physician was only ranked as fourth important source. Compared to other sources, information provided by doctors positively influenced participants' knowledge on skin risk and sun protective behavior resulting in higher scores in the knowledge test (p=0.009), higher risk perception (p<0.001), and more sun protection (p<0.001). Regarding gender differences, internet was more often used by males as health information source, whereas females were more familiar with printed information material in general. Conclusions: The results of this survey put emphasis on the demand for information provided by medical professionals in order to attain effective, long-lasting promotion of photoprotective habits.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1999-2004
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• 2013

Asian Americans experience disproportionate incidence and mortality rates of certain cancers, compared to other racial/ethnic groups. Primary care physicians are a critical source for cancer screening recommendations and play a significant role in increasing cancer screening of their patients. This study assessed primary care physicians' perceptions of cancer risk in Asians and screening recommendation practices. Primary care physicians practicing in New Jersey and New York City (n=100) completed a 30-question survey on medical practice characteristics, Asian patient communication, cancer screening guidelines, and Asian cancer risk. Liver cancer and stomach cancer were perceived as higher cancer risks among Asian Americans than among the general population, and breast and prostate cancer were perceived as lower risks. Physicians are integral public health liaisons who can be both influential and resourceful toward educating Asian Americans about specific cancer awareness and screening information.

• Health Policy and Management
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• v.18 no.3
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• pp.41-57
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• 2008

To examine the gap between physician's perceived importance and performance of care and to identify factors associated with the gap. A self-administered questionnaire survey was conducted with 91 physicians working in a University hospital in Seoul. The respondents were asked about their perceived importance and actual performance of interpersonal care on a 5-point Likert-type scale, indicating a higher score as higher importance and performance. Interpersonal care was measured by questions modified from the Korean Standard Service Quality Index, which are grouped into 6 categories: basic services, extra services, reliability, courtesy, convenience, and tangibles. Multiple regression analysis was conducted to find out physician characteristics associated with the gap. All of the 6 interpersonal care categories showed lower performance than perceived importance. The respondents tended to have a worse performance than perceived importance as the number of patients per outpatient care session ($\beta$=-0.0204, p<0.05) and the need for customer satisfaction education increase ($\beta$=-0.2226, p<0.05). Female physicians ($\beta$=0.2336, p<0.05) and those with higher job satisfaction($\beta$=0.0096, p<0.05) showed a better performance than perception. Overall, it appears that lower quality of interpersonal care was delivered to patients than the desired level considered by the responding physicians. Based on the regression analysis results, it is suggested that reducing patient volume per session, fulfilling education need for customer satisfaction, and improving job satisfaction may contribute to reduce the gap between physician's perceived importance and performance of interpersonal care.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.389-397
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• 2022

Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

• Quality Improvement in Health Care
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• v.4 no.2
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• pp.210-221
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• 1997

Background : Willingness to satisfy patients(WSP) among nurses is essential to promoting patient satisfaction which is a critical component in the quality of health care and its outcomes. This study was carried out to empirically find out the affecting factors of WSP among nurses in hospital settings. Methods : The model contains seven job relating determinants and two intervening variables as follows: i) job relating variables of professional status, task requirements, pay, physician-nurse interaction, nurse-nurse interaction, organizational policies, and autonomy, ii) intervening variables of job satisfaction and organizational commitment. Data were collected from 205 nurses in two general hospitals owned by one foundation located in Pusan, Korea, using a structured and self-administered questionnaire. Results : The major results were as follows: First, the results of ANOVA on WPS by personal characteristics showed a statistically significant relationships between WPS and hierarchical orders(p<.01) ana tenure(p<.10). Comparing with the lower orders and shorter tenure, the higher orders and the longer tenure showed better WPS. Second, the results of simple correlation analysis between WPS and determinants and intervening variables showed the following variables, in order of importance, were statistically significant(p<.01): work satisfaction(+), organizational commitment(+), task requirements(+), nurse-interaction(+), professional status(+), physician-nurse interaction(+). Third, the results of path analysis showed that two intervening variables of job satisfaction and organizational commitment, and three determinants of task requirements, professional status, and nurse-nurse interaction had a positively significant direct effect to WPS. Conclusion : The results suggest that nurses who are more satisfied with task requirements, status, nurse-nurse interaction, overall job satisfaction, and organizational commitment, will behave in ways that patients find more satisfied.

• Safety and Health at Work
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• v.3 no.1
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• pp.11-16
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• 2012

Lead poisoning is one of the earliest identified and most known occupational disease. Its acute effects have been recognized from antiquity when this condition principally afflicted manual workers and slaves, actually scarcely considered by the medicine of that time. The Industrial Revolution caused an epidemic of metal intoxication, urging scientists and physician of that period to study and identify specific symptoms and organ alterations related to chronic lead poisoning. During the 20th century, the acknowledgment of occupational and environmental toxicity of lead fostered public awareness and legislation to protect health. More recently, the identification of sub-clinical effects have greatly modified the concept of lead poisoning and the approaches of medicine towards this condition. Nowadays, lead poisoning is rarely seen in developed countries, but it still represents a major environmental problem in certain areas. Consequently, it may appear as a paradigm of "occupational and environmental disease," and the history of this condition seems to parallel the historical development of modern "Occupational and Environmental Health" as a more complete medical discipline.

• Korea Journal of Hospital Management
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• v.21 no.1
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• pp.51-61
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• 2016

This study attempted to investigate how mass media marketing of a hospital influences patient volume. Additionally, the association of patient volume with exposure time and the type of mass media was examined. Data from a university hospital in Bundang (from January 2014 to November 2014) were used. Degree of physicians' mass media marketing was measured by the number of media exposure. Linear mixed model for repeated measures data was run to identify the associations between the number of media exposure and patient volume. First, the number of hospital physician's mass media exposure and new patients and the first visit patients were positively associated. Second, broadcasting media which has relatively significant in patient volume is TV programs such as cultural programs and news. Third, hospital physicians with higher ranks who were exposed to press media receive more patient appointment. Also, nonsurgical hospital physicians who were exposed to press media receive more patients. Fourth, medical treatment activities for hospital staff who hold the rank of Professor in case of making an appearance at press media have relatively increased. Hospital physician's media exposure, particularly TV programs, was significantly related to patient volume for outpatients.

• Health Policy and Management
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• v.24 no.1
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• pp.35-46
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• 2014

Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.47-73
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• 2017

Medical certificate is a document to demonstrate a patient's health status, made up and signed by a physician, dentist, or oriental physician who attended the patient. It serves as an evidence in many official process including civil or criminal law suit, especially for one's personal injury. The Korean legal system also acknowledges and protects the evidentiary function of medical certificate by mandating physicians etc. to issue medical certificate in good faith and only when they personally attended the patient, and by criminally punishing them when they do not comply with these legal requirements. There are some reasons, however, that medical certificates often do not reflect the true health status of the patient: When physicians attend the patient and collect information regarding the health status of the patient, their priority is and should be the most cost-effective way to meet the health needs of the patient. It does not necessarily correspond to the accurate examination of the health status of the patient. Even when the patient's report on the history of the illness or the injury seems suspicious, physicians might have to avoid disproving it because that kind of attitude might harm the rapport between the physician and the patient. All these can distort the perception of the physicians and this distortion can be reproduced in the medical certificate they made up. Some of these problems might be resolved or at least enhanced by introducing new form of medical certificate which would guide physicians to reveal the nature, factual and theoretical grounds, and the limit of their findings more accurately. Others, however, would not be able to address, because it stems from the conflict between the physician's primary duty, duty to be loyal to the patient's life and health, and his secondary duty to serve as a public or neutral witness on the health status of the patient, and when both values or duties conflict with each other, they should choose the duty to the patient sacrificing the duty to the public or the court.

• Journal of Preventive Medicine and Public Health
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• v.28 no.3 s.51
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• pp.576-587
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• 1995

Authors purposed to observe activities of occupational health nurses and it's related factors, and to suggest the way that induct better occupational health nurses' activities with questionaire to 87 occupational health nurses who individually work as health manager in the plant. The questionaire included type of plant and number of workers, general characteristics, work conditions, activities, etc. Major findings are as follows. 1. 82.8% of occupational health nurses were third decade. 93.1% graduated junior college or college. And 82.8% were not married. 2. General work conditions: 40.2% were belonged to safety-health section, 98.85% were mere clerks. 60.9% worked less than weekly 44 hours, and an annual salary of 50.6 % was between 10 million and 14 million won. 3. Work condition related to health manager work: there was separated health care room in 94.3%, working period as health manager(occupational health nurse) was less than 5 years in 70.1%, 49.4% had the out-of-health manager work. In 87.4%, occupational physician was appointed, only 6.9% of them were full time, 52.9% of them worked little in the plants. The problems related to workers' health were discussed with industrial nurses in 88.5%. 4. Attitude for their work: 88.5% were thought that their work is important for workers' health care, 57.5% satisfied to work as health manager. In 51.7%, motive to being industrial nurse were the appropriate aptitude. 5. Activities: General medical care in 100% were carried out, in 97.7% works related to general health examination, in 100% works related to special health examination were carried. But works related to use of protective apparatus were carried out in 20.8%. 6. Factors related to level of activities: In cases who solved the health related problems by themselves, the level of activites was significantly higher than in others. In cases there were full time occupational physician, the level of activities was significantly lower. 7. Occupational health nurse's needs: 100% wanted regular education, 89.7% wanted the qualifying examination. As the results, author suggests that the right of self-control is given to occupational health nurses and the work of occupational physician is clearly defined for the induction of the better activities of occupational health nurses.