• Journal of Preventive Medicine and Public Health
• /
• 제43권6호
• /
• pp.496-504
• /
• 2010

Objectives: The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly. Methods: The data in this analysis was the health insurance claims data between July 1999 and December 2008 (114 months). The study group was divided into two age groups, namely 60-64 years old and 65-69 years old. This study evaluated the impact of policy change on office visits, the office visits per person, and the percentage of the copayment-paid visits in total visits. Interrupted time series and segmented regression model were used for statistical analysis. Results: The results showed that outpatient cost-sharing decreased office visits, but it also decreased the percentage of copayment-paid visits, implying that the intensity of care increased. There was little difference in the results between the two age groups. But after the introduction of the coinsurance system for those patients under age 65, office visits and the percentage of copayment-paid visits decreased, and the 60-64 years old group had a larger decrease than the 65-69 years old group. Conclusions: This study evaluated the effects of outpatient cost-sharing on health care utilization by the aged. Cost sharing of the elderly had little effect on controlling health care utilization.

• Journal of Preventive Medicine and Public Health
• /
• 제25권3호
• /
• pp.303-311
• /
• 1992

It is very important to estimate the future medical care expenditure, because medical care expenditure escalation is a big problem not only in the health industry but also in the Korean economy today. This study was designed to project the medical care expenditure in view of population age change. The data of this study were the population projection data based on National Census Data(1990) of the National Statistical Office and the Statistical Reports of the Korea Medical Insurance Corporation. The future medical care expenditure was eatimated by the regression model and the optional simulation model. The significant results are as follows : 1. The future medical care expenditure will be 3,963 billion Won in the year 2000, 4,483 billion Won in 2010, and 4,826 billion Won in 2020, based on the 1990 market price considering only the population age change. 2. The proportion of the total medical care expenditure in the elderly over 65 will be 10.4% in 2000, 13.5% in 2010, and 16.9% in 2020. 3. The future medical care expenditure will be 4,306 billion Won in the year 2000, 5,101 billion Won in 2010, and 5,699 billion Won in 2020 based on the 1990 market price considering the age structure change and the change of the case-cost estimated by the regression model. 4. When we consider the age-structure change and inflation compared with the preceding year, the future medical care expenditurein 2020 will be 21 trillion Won based on a 5% inflation rate, 42 trillion Won based on a 7.5% inflation rate, and 84 trillion Won based on a 10% inflation rate. Consideration of the aged(65 years old and over) will be essential to understand the acute increase of medical care expenditure due to changes in age structure of the population. Therefore, alternative policies and programs for the caring of the aged should be further studied.

• 기본간호학회지
• /
• 제3권2호
• /
• pp.285-297
• /
• 1996

This study has been done for the purpose of investigating the degrees of death orientation and terminal care performance. The factors related to these two variables, and the relationship between death orientation and terminal care performance. The subjects of study were 128 nurses who implemented nursing care for terminally ill patients at C University Hospital in Kwang Ju city. The data were collected from March 13 to 19, 1996, by means of Death Orientation by Thorson Powell(1988) and Terminal Care Performance Scale by researcher. The data were analysed by t-test, ANOVA, Duncan test and Pearson's correlation coefficient. The Results of this study were summarized as follows : 1. The mean score of death orientation was 61.4. The degree of death orientation showed no significant difference depending on the general characteristics of nurses. 2. The mean score of terminal care performance was 45.5. In comparison of the degree of terminal care performance among three domains, the mean score of each item tended to show higher degrees in order of 'Psychological domain(2.4)', 'Physical domain(2.2)', 'Spiritual domain(1.9)'. 3. The degree of terminal care performance showed significant differences in age(F=11.48 p=.0001), marital status(t=10.49 p=.0015), religion(t=5.01 p=.0270), period of clinical experience(F=10.30 p=.0001) and ward unit(F=3.73 p=.0036). The degree of terminal care performance in physical domain showed significant differences in age(F=7.26 p=.0010), marital status(t=9.72 p=.0023), period of clinical experience(F=7.03 p=.0013), ward unit(F=6.23 p=.0001). The degree of terminal care performance in psychological domain showed significant differences in age(F=8.73 p=.0003), marital status(t=4.22 p=.0419), religion(t=5.59 p=.0196), period of clinical experience(F=6.36 p=.0023), ward unit(F=3.33 p=.0075). The degree of terminal care performance in spiritual domain showed significant differences in age(F=8.30 p=.0004), marital status(t=10.45 p=.0016), religion(F=5.41 p=.0216), period of clinical experience(F=8.80 p=.0003). 4. The relationship between the degrees of death orientation and terminal care performance showed no correlation(r=-.026 p=.7746).

• Tuberculosis and Respiratory Diseases
• /
• 제58권6호
• /
• pp.600-606
• /
• 2005

Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

• 아동학회지
• /
• 제30권6호
• /
• pp.281-295
• /
• 2009

Representative services of the afterschool in Korea are After-Schools of the Ministry of Education, Science and Technology, Community Child Centers, After-school Child Care, and Youth After-school Academy of the Ministry of Health, Welfare and Family. Each service is distinguished with its own founded laws, subject children, specialists, principle management agent, a number of participants, and more. Research issues of afterschool are development of new afterschool programs, evaluatjon of the effectiveness of the afterschool, establishment of policies related to cooperative efforts among the different services of the afterschool, obtainment of legal status, and enhancement of the credential of its personnels. To guarantee the quality of the Afterschool and improve personnels' working conditions, various means are to be implemented. In regard to programatic and policy issues, the afterschool is needed to establish a system for training the afterschool coordinators and of its accreditation and to develop more child-centered afterschool programs. Also, it is needed to legislate fundamental law and consolidate communication system among the services of the Afterschool in pursue of their effective utilization and actual expansion.

• 한국지역사회생활과학회지
• /
• 제21권2호
• /
• pp.179-190
• /
• 2010

The purpose of this study is to examine the relationships between gender, gender role identity, parents' affectionate behaviors and care in Chinese middle school students. Also, this study examines the differences in care among Chinese middle school students with respect to parent's socio-demographic variables. The subjects were 478 3rd grade middle school students in Tianjin, China. The major findings were as follows. There were significant differences in care of Chinese middle school students with respect to mother's job and age. In other words, a higher level of care of Chinese middle school students was shown in students who had an unemployed mother, labour mother or mothers of 46 years and over. As result of examining the main effects of gender, gender role identity and parent's affectionate behaviors caring for Chinese middle school students, there were significant with respect to gender role identity and parents' affectionate behaviors. Masculinity, femininity and androgyny identity demonstrated a higher care than undifferentiated identity. Also, a higher level of care was associated with higher parents' affectionate behaviors. There were interaction effects caused by gender and gender role identity in care for Chinese middle school students. Also, there were interaction effects caused by gender and parent's affectionate behaviors on the nature of care for Chinese middle school students.

• 대한수사과학회지
• /
• 제3권1호
• /
• pp.25-42
• /
• 2008

As the age of the sex crime perpetrators and victims is going down, the importance of Sex Assault Prevention Education (SAPE) is on the rise. In order to see how many students are aware of the SAPE which are currently being conducted in the local schools. A total of 600 students from five different primary schools in Kyongsan City area were questioned with the questionnaire. On the whole, the level of acknowledgement on the sexual assault is estimated as 20.52 out of total point 53.00. The point in each question is shown as low as follows; The notion of Sexual Assault (9.88 out of 19), recognition of Sexual Assault (5.45 out 11), way to cope with the sexual assault (6.60 out of 11), and knowledge on the symptom induced by the sexual assault (4.04 out of 12). The SAPE should be taught to the student from the young age frequently. The efficiency of SAPE will be increased by the health-care teachers who have the professional knowledge with the case studies and teaching materials like CD-ROMs. The health-care teachers as the SAPE lecturers require continuous training.

• Tuberculosis and Respiratory Diseases
• /
• 제75권2호
• /
• pp.52-58
• /
• 2013

Background: More than half of cases for advanced non-small-cell lung cancer (NSCLC) occur in elderly patients with a median age at diagnosis of 70 years. The aim of our study was to examine the clinical features and prognostic factors contributing to mortality in elderly patients with advanced NSCLC. Methods: Following a retrospective review of clinical data, 122 patients aged 70 years and over with a histopathological diagnosis of locally advanced (stage IIIB, n=32) and metastatic (stage IV, n=90) NSCLC between 2005 and 2011 were enrolled. Results: The median age was 76 years (interquartile range, [IQR], 72-80 years), and 85 (70%) patients were male. Fifty-seven (46%) patients had never smoked, and 17 (19%) were in a malnourished state with a body mass index (BMI) of <$18.5kg/m^2$. The initial treatments included chemotherapy (40%) and radiotherapy (7%), but 57% of the patients received supportive care only. The 1-year survival rate was 32%, and the 3-year survival rate was 4%, with a median survival duration of 6.2 months (IQR, 2.5-15.3 months). Male gender (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p=0.005), low BMI (HR, 2.3; 95% CI, 1.3-3.9; p=0.004), and supportive care only (HR, 1.9; 95% CI, 1.2-2.9; p=0.007) were independent predictors of shorter survival based on a Cox proportional hazards model. Conclusion: Elderly patients with advanced NSCLC had a poor prognosis, particularly male patients, those with a low BMI, and those who received supportive care only.

• 한국보육지원학회지
• /
• 제13권1호
• /
• pp.125-141
• /
• 2017

Objective: This study examined the effects of grandfathers' positive parenting behavior, and fathers' positive parenting behavior on school-age boys' school adjustment. Methods: A total of 217 5th and 6th grade male elementary school students (126 5th graders and 91 6th graders) and their fathers living in Seoul and Gyeongnam province participated in the study. The data were analyzed using correlations, and structural equation modeling. Results: Grandfathers' positive parenting behavior indirectly influenced boys' school adjustment through their fathers' positive parenting behavior. It means that fathers who perceived their fathers' parenting behavior as more positive showed a higher level of positive parenting behavior, which led to a more positive school adjustment for their sons. Conclusion/Implications: These results uncovered the pathways from grandfathers' positive parenting behavior to school-age boys' school adjustment through their fathers' positive parenting behavior in an aspect of the intergenerational transmission of parenting. In addition, these findings have implications for future research of developing intervention programs for school-age boys' school adjustment and parent education programs to facilitate fathers' positive parenting behavior for school-age children's school adjustment.

• 한국생활과학회지
• /
• 제19권4호
• /
• pp.589-599
• /
• 2010

When the Korean government announced the lowering of the school entrance age from 6 to 5 years in an effort to increase the fertility rate, one candidate for the Seoul mayor rode on the slogan, 'one dong, one public kindergarten'. This study attempted to show the introduction of a preschool class for six-year-olds being used as analternative to lowering school entrance age in Sweden. First, the current state of preschool class, the Early Childhood Education and Care, and the education system in Sweden were described. Next, the background for the introduction of the preschool classes was analyzed. Thirdly, the effects of preschool class were evaluated from the perspectives of 6 year-olds as well as the institutiona land social status of the ECEC. Results from this study imply not only that the lower school entrance age policy should be abolished but also preschool classes could be considered as an alternative.