• KIPS Transactions on Computer and Communication Systems
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• v.12 no.11
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• pp.337-346
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• 2023

There is a need to develop an app for a caregiver health management that can provide continuous management in response to changes over time, because elderly people have low digital utilization capabilities, difficulty maintaining regular and continuous self-management. Based on this need, this study designed an app with a user-friendly UI and simple structure for the elderly. The app developed in this study supports regular management of health data such as blood pressure, blood sugar, and heart rate, as well as specific information on physical, disease, cognitive, communication, and environment in the care field. The app developed in this study supports care services by automatically entering data through integration with health management devices, automatically analyzing and visually representing recorded data to understand trends and volatility, and adding scalability to connect with various health management and medical support platforms. The effectiveness and satisfaction of the developed app were confirmed to be significant in the field verification results.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.53-60
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• 2016

Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.

• Journal of Korean Clinical Nursing Research
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• v.20 no.1
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• pp.40-52
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• 2014

Purpose: This study was done to develop an evidence-based nursing clinical practice guideline (PU CPG) for pressure ulcer prevention and management in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by Gu et al. (2012) which consists of three main phases and 9 modules including a total of 24 steps. Results: The newly developed PU CPG included the introduction, pressure ulcers, summary of recommendations, recommendations, references, appendices, and glossary. The total number of recommendations was 148 in 4 sections (organizational policy, assessment, pressure ulcer prevention and management, and education) and 16 domains. Of the recommendations 4.7% were graded A, 16.9%, B, and 78.4%, C. Conclusion: Results indicate that this new PU CPG is an evidence-based practice guidance for pressure ulcer prevention and management and can be recommended for dissemination and utilization by nurses nationwide to improve the quality of pressure ulcer prevention and management. Regular revision is recommended.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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• pp.212-227
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• 2020

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.1
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• pp.141-159
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• 2004

Purpose: The purpose of this study was to investigate the degree of information technology application, and to identify the effect of information technology application en knowledge management process in clinical nurses. Method: Participants were 629 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Thee structured instruments were used to collect the data: Information Technology Application scale, Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), and one for general characteristics. The data were analyzed using reliability analysis, descriptive analysis, one-way ANOVA, $Scheff{\acute{e}$ test, correlation analysis, partial correlation analysis, and multiple regression analysis with the SPSS for Windows 10,0 program. Result: 1) The HIS application degree, IT application ability, and IT application frequency were significantly correlated with the degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization(p=.000). 2) The 3 variables, HIS application degree, IT application ability, and IT application frequency explained 47.2% of the total variance of the degree of knowledge management process activation, and 352% of me total variance of Knowledge Storage. And 2 variables, HIS application degree and IT application frequency explained 17.6% of the total variance of Knowledge Creation, 39.9% of the total variance of Knowledge sharing, and 33.8% of the total variance of Knowledge utilization(p=.000). 3) As a result of multiple regression analysis, the key determinant of the degree of knowledge management process activation for nurses was HIS application degree The HIS application degree, IT application frequency, position, IT application ability, and continuous total numbers of years working at the present hospital explained 51.1% of the total variance of the degree of knowledge management process activation(p=.000). Conclusions: These results suggest that the information technology application positively affects the nurses' knowledge management process. From the above findings, information technology application is empirically verified as a useful and effective method to activate knowledge management process, and knowledge management.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.415-427
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• 2003

Purpose: The purpose of this study was to investigate the degree and pattern of knowledge management process, and to identify the relationship between knowledge management process and organizational effectiveness in clinical nurses. Method: Participants were 665 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Four structured instruments were used to collect the data: Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), cCommitment Questionnaire(Mowday, Steers, & Porter, 1979), General Satisfaction Scale(CooK, Hepworth, Wall, & Warr, 1981), and one for general characteristics. The data were analyzed using factor analysis, reliability analysis, descriptive analysis, cluster analysis, one-way ANOVA, Scheffe test, correlation analysis with the SPSS for Windows 10.0 program. Result: 1) The average score for knowledge management process in nurses was $3.08{\pm}.54$ on a 5-point Likert scale. In order from highest mean score, the elements of knowledge management process, were Knowledge $Utilization(3.35{\pm}.57)$, Knowledge $Sharing(3.07{\pm}.58)$, Knowledge $Creation(2.99{\pm}.63)$, and Knowledge $Storage(2.91{\pm}.82)$. 2) Four knowledge management patterns for nurses, which were derived from cluster analysis, were inactivate pattern, delayed pattern, activate pattern, and high-activate pattern of knowledge management. 3) The degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization, were significantly correlated with nurses' organizational commitment and job satisfaction(p=.000). 4) The nurses' organizational commitment and job satisfaction showed significant differences according to the knowledge management patterns derived from cluster analysis of high-activate pattern, activate pattern, delayed pattern, inactivate pattern(p=.000). Conclusion: These results suggest that there are four knowledge management patterns for nurses, and knowledge management process positively affects the nurses' organizational commitment and job satisfaction. From the above findings, knowledge management process is empirically verified as a useful and effective method to increase organizational effectiveness, and develop the organization.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.107-126
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• 1991

The purpose of the study was to assess the morbidity pattern and the medical care utilization behavior of the urban residents in the poor area. The study population included 2,591 family members of 677 households in the poor area of Daemyong 8 Dong, Nam-Gu, Taegu and 2,686 family members of 688 households, near the poor area in the same Dong, were interviewed as a control group. On this study the household interview method was applied. Well-trained interviewers visited every household in the designated area and individually interviewed heads of households or housewives for general information, morbidity condition, and medical care utilization with a structured questionnaire. Individuals were interviewed from 1 to 30 December 1988. The major results were summarized as follows : The proportion of the people below 5 years of age was 4.2% of the total study population and 5.5% were above 65 years of age in the poor area. This was slightly higher than in the control area. The average monthly income of a household in the poor area was 403,000 won versus 529,000 won in the control area. Fifty-eight percent of the residents in the poor area and sixty-one percent in the control area were medical security beneficiaries, but the proportion of medical aid beneficiaries was 7.8% in the poor area and 4.6% in the control area. The 15-day period morbidity rate of acute illnesses was 57.1 per 1,000 in the poor area and 24.2 per 1,000 in the control area. Respiratory disease is the most common acute illness in both areas. The most frequently utilized medical facility was the pharmacy among the patients with acute illnesses in the poor area. Among them 58.1% visited pharmacy initially while 38.4% of the patients in the control area visited a clinic. Among persons with illnesses during the 15 days 8.8% in the poor area and 4.6% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 3.5 days in the poor area and 3.3 days in the control area. Initially of the medical facilities in Daemyong 8 Dong, The pharmacy in the poor area and the clinic in the control area were most commonly utilized. The most common reason for visiting the hospital was 'regular customers' in the poor area and 'geographical accessibility' in the control area. The one year period morbidity rate of chronic illness in the poor area was 83.0 per 1,000 population and 28.0 per 1,000 in the control area. Disease of nervous system was the most common chronic illness in the poor area while cardiovascular disease in male and gastrointestinal disease in female were most prevalent in the control area. The most frequently utilized medical facility was the pharmacy among the patients with chronic illnesses in the poor area. Among them 24.2% visited the pharmacy initially while 34.7% of the patients in the control area visited the out-patient department of the hospital within a 15-day period. Among the patients with chronic illnesses 34.9% in the poor area and 16.0% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 9.2 days in the poor area and 9.9 days in the control area within a 15-day period. Initially of the medical facilities in Daemyong 8 Dong, the pharmacy in the poor area and the hospital in the control area were most commonly utilized. The most common reason for visiting the hospital, clinic, health center or pharmacy in the poor area was 'geographical accessibility' while the reason for visiting herb clinic was 'good result' and 'reputation' in both areas.

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.614-627
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• 1993

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.323-334
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• 1998

To investigate determinants of health care utilization of the physically disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization .ate was 81.9%(69.1% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically significant relationship with health care utilization(p<0.05). By path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.1%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health concern toward physically disabled should be implemented to increase health care utilization rate.

• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.398-411
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• 2001

The separation system of pharmacy and clinic has begun on the purpose of preventing drug misuse and abuse since July 1st of 2000. The system revealed some conflicts between doctors. pharmacists and consumers. Consequently pharmaceutical law and related policies undergone some change. Now in an early period of the implementation of the system, the necessity to examine relevance of those policies and law enforcement to medical doctors' prescriptions pattern evolves. This study tries to verify the pattern through a field study. For the purpose, 930 prescriptions collected in May of 2001, from a pharmacy located in Gangnam-gu in Seoul, were analysed. The prescriptions were issued from several clinics: 459 prescriptions from otorhinolaryngological clinic(ENT), 177 from internal medicine clinic(IM), 130 from ophthalmic clinic(Opt), 52 from obstetric and gynecologic clinic(OB & GY), and 112 from miscellaneous clinics. ENT, IM, Opt. OB & GY are situated in a clinic building of 40m distance. The general findings are following: 1) $88.8\%$ of the total patients came from 5clinics in nearby single clinic building. 2) Average prescribing days were 6.2 days and the average number of used drugs were 4.0 drugs, i.e. 2-4 times of WHO criteria 1-2 drugs. 3) Use of antibiotics in the oral administration drugs rated $71.8\%(WHO: \;22.7\%)$ 4) Use of injection rated $31.3\%(WHO:\;17.2\%)$ 5) $96.2\%$ of the patients use multiple antibiotics in the injection and oral administration together. 6) The patients had multiple disease : ENT patients 1.7 disease and 1M patients has 2.7 disease in average and several regular prescribing types evolved particularly in the ENT prescription. With this result we found that drugs. especially antibiotics are still abused a lot, and there were significant differences in the number of used drugs and prescrbing days between the clinics. It implies somes differences of the preparation work and time for pharmacists. And preparation can be done in advance by pharmacists' own efforts through noticing regular prescribing types. The study suggests the followings: 1) Patient counseling should be done to minimize the incidence of adverse events. 2) The enforcement of the standardized differential preparation price system should be reconsidered. 3) Preparation of typical regularly appeared prescription in advance. which is regarded as 'a prearranged work between doctors and pharmacists' and has been prohibited should be reconsidered. 4) Drug utilization review program should be established to prevent drugs abuse. especially antibiotics abuse.