• Health Policy and Management
• /
• v.6 no.2
• /
• pp.58-90
• /
• 1996

This study provides an empirical analysis of location competition for demand maximization by central place theory among physicians in nonmetropolitan areas of Korea. The results show that the primary care physicians distribute themselves evenly from urban communities to rural communities. The subspecialists, however, cluster together in major cities rather than decentralize themselves in rural counties. This study establishes the three statistical models : Primary care physicians, subspecialist physicians, and total physicians. Two models of primary care physicians and total physicians have a strong significance in multiple regression analysis (p=-.0001). The primary care model explains approximately 45% of the variation and the total physicians model explains approximately 70% of the variation in physician/1,000 population ratios across national counties. The subspecialist physicians model analysze the tobit regreassion because of the left consored and truncated values(57 cases = 0). In all three models, analysis of the coefficiencts for physician centralization degrees in the 0- to 5- and 5- to 10-km rings around the core county reveals each a positive and negative association betwee these degrees and the physician/1,000 population ratios in the core county. Also, the results provide moderate evidence that the relationship between clinic physicians and community hospitals is competitive, and the relationship between clinic physicians and pharmaceutists is synergistic. This suggests that public policy makers and local self-governing bodies must take an active role to ensure procider availability and the regional health planning in all nonmetropolitan areas of Korea.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.16 no.3
• /
• pp.49-56
• /
• 2010

In Japan, a lot of elderly housing types have been developed in order to meet various needs of the older person and the change of social situations. Elderly housings can be divided into three categories elderly housings for healthy older persons, elderly care homes for the healthy and elderly care facilities for the unhealthy. Elderly housings include public and private rental housings. Sometimes they can be designated only for the elderly. Elderly care homes for the healthy elderly include full fee charging elderly housing, elderly homes, low fee charging elderly homes and care houses. Elderly care facilities for the unhealthy elderly consist of full fee charging elderly care homes, group homes for the dementia, elderly health facilities, nursing homes, elderly hospitals, and so on. However "elderly care facilities" have been proved not to be efficient for the delivery of elderly welfare services nor satisfactory to the frail older person. Therefore, based on the concept of the "Normalization", daily services have been provided for the elderly in order that they can live at their own home in the community for themselves. As a result, Japan aims not only to reduce elderly welfare expenses but also to increase elderly users' satisfaction. Emphasis on non-institutionalization and in-home services, regional characterization, harmony between Hard and Soft, user oriented services, substantiality, universal design and so on are sought for the sake of those goals.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.3 no.4
• /
• pp.35-49
• /
• 1997

The percentage of postnatal disabled people and elderly population is rapidly increased by the industrialization, and the improvement of medical technology. The disparity between the city and rural area is in the way to disabled people who need rehabilitation. To solve these problems, Community Based Rehabilitation(CBR) is suggested by WHO. In this study, at first, the CBR model considering the specific characteristics of AnSan City are presented. Secondly, the first, the second, and the third rehabilitation facilities in AnSan City are classified by the CBR model. Thirdly, the estimation of optimum space for physical therapy and occupational therapy at rehabilitation center and public health center are sugested, which are the second level rehabilitation facilities. There are some differences in the distribution of population between new and old area in AnSan City. In other words, the subject population of CBR program in old area is relatively higher than that of new area. So, the CBR program for AnSan City must reflect their regional characteristics. In this study, the therapeutic boundaries of second level rehabilitation facilities is decided through the survey of physical therapists and occupational therapists in general hospitals and nursing homes.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.29 no.1
• /
• pp.40-49
• /
• 2022

Purpose: This study aimed to analyze the effects of fatigue, resilience, and self-leadership on nursing service quality of local medical center nurses who nursed COVID-19 patients. Methods: The participants were 135 nurses who worked at regional public hospitals located in H-gun, G, and C-city in province C. The collected data were analyzed using descriptive statistics, t-test, analysis of variance (ANOVA), Pearson's correlation coefficients, and stepwise multiple regression using IBM SPSS Statistics version 25. Results: The participants' nursing service quality showed significant positive correlation with resilience (r=.53, p<.001), and self-leadership (r=.60, p<.001). The factors affecting participants' nursing service quality were commitment to self-leadership (β=.57, p<.001) and work position (chief nursing officer) (β=.26, p<.001), which explained 42% of the participants' nursing service quality. Conclusion: During a crisis such as the COVID-19 pandemic, it is necessary to help nurses enhance their self-leadership skills and build their career continuously by developing relevant policies, systems, and nursing intervention programs. Future studies could expand the knowledge base by including more participants to explore other ways to improve nursing service quality during the COVID-19 pandemic.

• 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.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.14
• /
• pp.6055-6059
• /
• 2015

Background: Medication policy development in Thailand is continually promoting rational drug use. Letrozole, an endocrine therapy drug, is usually prescribed for post-menopausal status early and advanced stage breast cancer. After Ministry of Public Health announced Letrozole as compulsory licensed drug in 2009, more breast cancer patients can access to this drug at low cost especially those within universal coverage schemes. To ensure that Letrozole is rationally prescribed, the drug utilization study was conducted. Objectives: The aim of this study was to describe the appropriate use of Letrozole in breast cancer and the relationship between appropriate use and health benefit schemes. Materials and Methods: A retrospective study to evaluate use of Letrozole in breast cancer patients was performed for six months between January - June 2010 in seven regional cancer hospitals, Thailand. All prescriptions of Letrozole were identified from pharmacy dispensing databases and prescription papers. A medical record review was also performed to evaluate appropriate use referring to the drug use evaluation criteria. The approved criterion of this study was referred from the guideline of Thai National Formulary version 2010. Results: There were 681 prescriptions of Letrozole for 254 breast cancer patients with an average age of $58.6{\pm}10.0years$. The patients in universal coverage scheme (UCS), civil servant medication benefit scheme (CSMBS) and social security scheme (SSS) were 77.7%, 18.5% and 8.7% respectively. 10.6% were prescribed Letrozole for the first time. Letrozole were prescribed by oncologists (82.8%). The average number of tablets per prescription was $58{\pm}10$. Calcium supplements were prescribed concomitant with Letrozole for 19.4%. To assess drug use evaluation criteria, 45 prescriptions were excluded because of uncompleted clinical data, 636 prescriptions were evaluated. The study showed 86 prescriptions (13.5%) with inappropriate use including 6 (0.9%) not prescribed for estrogen receptor (ER) and/or progesterone receptor (PR) positive, 31 (4.9%) not prescribed for post-menopausal and 49 (7.7%) not prescribed for an appropriate duration. Appropriate use percentages in different health benefit schemes were similar, 85.7% of CSMBS, 86.4% of SSS and 86.7% of UCS. The relationship between health benefit scheme and appropriate use of Letrozole was not significantly different, ${\chi}^2$ (2, N = 636) = 0.081, p > 0.05. Conclusions: The study showed inappropriate use in breast cancer patients because of non-compliance with duration, menopausal status and hormone receptor requirements. To prescribe appropriate indication did not referred to the appropriate practice along the treatment. Drug use evaluation proved very useful for detecting the sign of inappropriate use and allows immediate feedback to the stakeholder for developing medication policy in the future. Importantly, there was no significantly difference in appropriate use of Letrozole across health benefit schemes.

• The Journal of The Korea Institute of Intelligent Transport Systems
• /
• v.17 no.2
• /
• pp.58-72
• /
• 2018

Ganghwa has met a new development period in land use and infrastructure based on the 4th National Development Planning, however the public transportation system is not systematically operated yet. This paper analyzes the bus trip pattern in Ganghwa using transportation card data during a week. The result indicates that average 7,100 people use buses a day and the most frequent use occurred in Friday. Clear peak-hours between 7 and 8 A.M. and between 4 and 5 P.M. were appeared due to commuting and school trips. According the result of regression analysis, population and the number of hospitals and schools area showed positive relationships with but trips reflecting regional characteristics. The research contributes to providing basic data for constructing an efficient public transportation system in the future.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.8
• /
• pp.407-414
• /
• 2016

This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.

• The Korean Journal of Health Service Management
• /
• v.3 no.1
• /
• pp.14-24
• /
• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

• Quality Improvement in Health Care
• /
• v.12 no.2
• /
• pp.113-123
• /
• 2006

Objective : This research is focused on understanding the current status of the Health Smart Card already in use in other advanced countries. This research will analyze the current status of the medical institutions Health Smart Card system adoption process and its effects, and provide a basis for future policy decisions for the effective adoption and diffusion of a Health Smart Card system, in the medical field, through the completed research and analysis. Method : This research surveys the domestic, and foreign, status of Health Smart Card usage. The research also presents up-to-date methodology for the evaluation of the effects of medical and health care technology. The research also conducts a survey of the domestic medical institutions that have implemented a Health Smart Card system, and then analyzes the results of the survey. Additionally, the research carried out a survey and analysis of medical institutions with no Health Smart Card system implemented, and considered the factors affecting the diffusion of Health Smart Card systems in considering an effective policy for the introduction and diffusion of such a system. Research Results : Through the study of the methodology of medical and health care information technology in advanced countries, the methodology for assessing Health Smart Card technology has been established, and focuses on 6 aspects. The study on the status of foreign implementation has shown a model for the Health Smart Card system. A survey was conducted on the current status of medical institutions with an implemented Health Smart Card system, and the survey results have been analyzed. Also, factors influencing the adoption of Health Smart Card systems have been analyzed through the survey on those medical institutions that have not implemented a Health Smart Card system. Conclusion : The government must provide institutional measures for sharing medical records by constructing an IT infrastructure at the national level to enable the adoption and diffusion of a Health Smart Card system. Such a network will make connections between medical institutions possible, thus making the diffusion of the Health Smart Card system nationwide. For the successful adoption and diffusion of a Health Smart Card system, a model system development, under a medical record sharing system, should be conducted. Additionally, a regional unit based model should be developed for the model project, as is done in advanced countries, along with the application of such results.