• Title/Summary/Keyword: School Doctor

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Effects of Usual Source of Care by Patients with Diabetes on Use of Medical Service and Medical Expenses (당뇨병 환자의 상용치료원 보유가 의료이용 및 의료비에 미치는 영향)

  • Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.1-17
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    • 2017
  • Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

Factors affecting the Organizational Commitment of Industrial Accident Hospital Employees by Job Category (병원 구성원들의 직종별 조직몰입의 영향요인에 관한 연구)

  • Bang, Yong-Joo;Ha, Ho-Wook;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.7 no.4
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    • pp.24-56
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    • 2002
  • The purpose of this study was to analyze the characteristics of socio-demographic, organizational culture, organizational conflict and organizational commitment, and to examine the interrelation of influential factors in the organizational commitment. The data for this study were collected through a self-administrated survey with a structured questionnaire to 1,027 subjects from several medical doctor staff members, nursing staff members, administration staff members, pharmacist, and technical expert of eleven hospitals. The data were collected by self-reporting questionnaire from July 29 to September 7, 2002. In this analysis frequency test, t-test, ANOVA, multiple regression were used. The main results of this research is as following; 1. According to socio-demographic characteristics the respondents' level of the organizational commitment was higher in a administration staff members than others, for males than females, and for employees aged more than forty, as working for longer time, and as higher level of the working position. 2. According to the organizational culture characteristics the progressive culture, affiliative culture, and task-focused culture among many types of organizational culture were moderately and positively correlated with the level of the organizational commitment while the hierarchical culture was negatively correlated. 3. According to the organizational conflict characteristics as the respondents who got less conflict experience in the organization, their level of the organizational commitment was higher. And, technical conflict experiences were expressed greater than hierarchical conflict experiences. 4. According to the job satisfaction characteristics as his or her satisfaction that is about the promotion, working itself, salary, and fellowship in the organizational was higher, the level of the organizational commitment was higher. The most important factor of the satisfactions was the fellowship among the respondents while the level of job satisfaction for the promotion and salary was average. 5. Overall, according to the result of Multiple Regression as older age and longer working hours, the level of the organizational commitment was higher and as a higher level of the satisfaction for the promotion, working itself, salary, and fellowship in the organization, it caused more effective factors for the organizational commitment. 6. According to the result of Multiple Regression for the doctor staff members in special hospitals rather than general hospitals the hierarchical culture and task focused culture was positively correlated with the satisfaction of working itself while hierarchical conflict factors in the organizational conflict characteristics was negatively correlated with the organizational commitment. For the nursing staff members the affiliative culture and the job satisfaction for the promotion, working itself, salary, and fellowship were positively correlated with the organizational commitment. For the administration staff members as the job satisfaction for the fellowship was positively correlated with the organizational commitment. For medical and pharmacy staff members as more working experience, correlation with the organizational commitment was positive. Besides, as he or she has a high perception of the affiliative culture, it caused statistically more effective factors for the organizational commitment. For the skill and technicians, male worker expressed greater organizational commitment in the organization than female worker. And also older age along with higher education also showed higher organizational commitment. Moreover, the job satisfaction for the fellowship was positively correlated with the organizational commitment. This study identified the major effective factors of the organizational commitment and analyzed the differences among the job category. In that respect, it is significant for the study to be able to provide a reference for managing hospital of industrial accident and organizational development. However, this study has a problem, which is not to identify a valuable model for examining the relationship between organizational factors such as organizational culture, conflict, satisfaction, and commitment. Therefore, further study is needed and strengthened in the field of organizational commitment for hospital for industrial accident.

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A study on physical examination of middle school students (중학교 체질검사 실태에 관한 연구)

  • Park, Sung-Hee
    • Journal of the Korean Society of School Health
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    • v.14 no.1
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    • pp.131-143
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    • 2001
  • The primary aim of this dissertation is to contribute to the improvement of methods in physical examination by providing quality information for the current school system and advice for improving status. Present status, controversial points and possible remedies in physical examination were analyzed on a frequency and percentage basis. An $x^2$-test was used to verify the statistics between the results from the examination and each variable. In case of multiple categories of variables, an $x^2$ cs was adopted. Chronological data as well as both total and sampling physical examination data verified the statistics using an $x^2$-test. This thesis is based both on the data from middle school health care specialists in Gyunggi Province and on the analysis of physical examinations reported from local schools to the municipal education agency from 1997 to 1999. The results of the study are as follows: First, according to the survey, only 29.0% of the total schools had their school doctors examine all the students while most of the educational institutions failed to implement the whole process of physical examination on the list. It also turned out that the more students the schools have, the lower the rate of implementation of physical examination by school doctors(p=0.014). Second, the average time a school doctor spends for checkup turned out to be approximately 1.7 minutes per student This means that the quality of the physical examination is not guaranteed in the process. Third, 47.7% of those surveryed say that a dental examination was performed, each taking 21.24 seconds on average. In addition, it shows that some 31.5% wanted to have a task force team for dental checkups at the local health center. Given the fact that dental caries among students is progressively on the rise, the dental health centers that are now set up in some elementary schools should be expanded to cover the whole educational institution in order to raise awareness of the importance of dental care. Fourth, 48.5% of those surveyed say that a comprehensive physical examination should be adopted to promote the health of high schoolers. Since it takes a lot of public funds to implement a comprehensive method, it is essential to make sure that in-depth studies should be based on the frequency and methods of physical examination. Fifth, regarding such diseases among 3rd year middle school students in 1999, statistics shows that there was a slight difference in the prevalence rate of color blindness, and allergic diseases for male students ; and color blindness, hearing disturbance and allergic disease for female students. For those items, however, it is too little to say that there is a significant difference and accordingly it is assumed to be a problem of the measuring process. Sixth, the result of analysis on the sample physical examination and the total physical examination of the year 1999 shows as follows: For male students in the 3rd year of middle school, a slight difference appeared to those students in 11 items including eye problems and eye disease, otitis media, tonsillar hypertrophy, spinal shape, respiratory urinary allergic disease and other abnormal diseases(p<0.05). Particularly, the prevalence rate between students with and without disease was shown to be two times more in the following: eye problems, otitis media, tonsill hypertrophy, allergic diseases, etc. For female students in the 3rd year, prevalence rate showed little difference in 14 items(p<0.05). For items including eye problem, otitis media, tonsill hypertrophy, allergic disease, etc. it was shown that the rate was two times more between students with and without diseases. Physical examinations under the current school system are not producing any fundamental results for the health of the students. Methods and results are not trustworthy. Accordingly, a drastic overhaul of the current practices is needed in frequency, methods and items on the list in order to promote the health of the students. Cost-benefit studies as well as political considerations to ensure the development of efficient methods for physical examination are urgently needed at this moment.

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Health Management and Services of School-Nurse in Special Schools (특수학교의 보건관리)

  • Lee, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.176-192
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    • 1991
  • School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

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A Study of Knowledge, Attitude, and Practice Relative to Maternal and Child Health Among Women Residing in Apartments at Yonsei Community Health Area (연세지역 아파트 주민의 모자보건에 관한 실태조사)

  • Yu, Seung-Hum;Chung, Young-Sook;Lee, Kyung-Ja;Kim, Kwang-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.4 no.1
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    • pp.77-87
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    • 1971
  • A study of the knowledge, attitude and practices about the maternal and child health of 305 married women residing in apartments at the Yonsei Community Health area was conducted during the period from November to December 1970 using designed questionnaire with well trained interviewers. The results and findings obtained from the study are summarized as follows: A. Pregnancy and Birth Questions were asked about their last child. 1. 16.4% of the women were pregnant. 2. Among 281 women who had experienced delivery, 48.0% were assisted by doctor or midwisves for their last delivery, while the rest of women delivered their last baby at home without any professional's assistance. The higher the level of education or the greater exposure to mass communication, the more the deliveries were assisted by doctors or midwives. Those women who were born and raised in cities had more deliveries assisted by doctors and midwives than those who were not. 3. Kinds of delivery sheets used. Among 141 cases of home delivery 68% used cement bag paper or vinyl sheets. Three% used nothing and remained used unsterile materials. 4. Among 141 cases of home delivery, 70.2% used scissors. The rest of them used other methods. 5. 47.3% of the women had a rest for one month or more after birth. The higher the level of education, the longer the period of rest was observed. 6. 52.4% of the women fed the colostrum to their babies. This was not related to the mother's education. 7 About half(42.9%) of the women had poor knowledge about a proper diet for the pre and post natal period. B. Child Health 1. Knowledge and practice regarding to the immunization for their children: Most of the women (93.2%) could name at least one kind of immunization. 20.3% could name 6 kinds of immunization. Mothers education level did not influence their ability to name immunizations. 85.2% of children had been immunized at least once. 2. Morbidity of last born children: 48.1% of their last born children were found to have been sick during the last year. Less than half(41.5%) of the sick children were seen by doctor. 3. Counselling at well baby clinic: Most of the women(76.5%) had no counselling for their children. Registration rate at the well baby clinic at the Severance Hospital was 13.2%. 45.9% wanted to visit to the well baby clinic at the Severance Hospital. 4. Weaning Period: 44.6% said that the beginning of the weaning for their last born children was from 6 months to twelve months of age. The most important reason of weaning was the health of both mothers and children. 5. Knowledge and Practice regarding birth and death Registration: 64.6% of the women could name correctly the Ku-office as the place for the registration. Only 29.2% registered the birth of their last born children within 14 days. C. Knowledge, Attitude and Practice regarding to family planning Most: of the women accepted the idea of family planning. 97.7% could name at least one contraceptive method. 35.4% were found to be current users of contraceptive methods. The ideal number of children was 3.1 in average.

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A Survey of Guardian's Attitudes toward Behavior Guidance Techniques (행동유도법에 대한 보호자의 인식도 조사)

  • Lim, Hyunsoo;Kim, Misun;Lee, Hyoseol;Choi, Sungchul;Kim, Kwangchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.427-436
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    • 2017
  • The purpose of this study was to examine guardian's attitudes toward behavior guidance techniques used in pediatric dentistry. In this study, 117 guardians participated and the several behavior guidance techniques being used during actual pediatric dental treatment were explained to the guardians prior to writing a questionnaire. The behavior guidance techniques explained were: tell-show-do, voice control, protective stabilization by device, protective stabilization by staff, nitrous oxide sedation, sedation, and general anesthesia. For analysis, 106 completed survey forms were selected. Tell-show-do was rated as the most acceptable technique, followed (in order of decreasing acceptance) by: voice control; protective stabilization by staff; nitrous oxide sedation; protective stabilization by device; sedation; general anesthesia. Acceptance of each behavior guidance technique was not related to guardian age, gender, patient age, patient gender, patient dental experience, type of visit, and position of doctor. Within the limit of this study, the communicative guidance techniques (tell-show-do, voice control) were more acceptable than advanced behavior guidance techniques (protective stabilization, sedation, general anesthesia). The acceptability of general anesthesia was the lowest. The results of this survey may contribute to maintain optimal dentist - guardians communication in pediatric dentistry.

Perception of the Nurse on the Nursing Malpractice and Its Case (간호사고와 관련판례에 대한 임상간호사의 지각)

  • Jeong, Ji-Yun;Lee, Myung-Ha
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.445-462
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    • 1999
  • The purpose of this study is to provide some basic data for the direction of nursing education and practice to prevent nursing malpractice as investgating perception of the nurse on the nursing malpractice and its case. Data were collected from 450 nurse working in four general hospitals which were located in Chonbuk province from November 9 to 21, 1998 through questionnare. The structured instruments developed by the reseacher were used for collecting data. The Results were as follows: 1) As for the cognition of the nursing malpractice case, the transfusion accident was 37.3%, the side-effects of KCL injection(19.3%), hymen rupture by uterus cancer test, the side-effects of aminophyllin injections on dyspnea patient and the others were 10% below. 2) With regard to the channel of the perception of the nursing malpractice case, mass-communication was taken first and followed through by neighbors, In-service education, school education, continuing education 3) As for the direct${\cdot}$indirect experience of the nursing malpractice case, transfusion accident was 51.3%, the fall of NPO patient after an operation 40.1%, the side-effect of KCL injection 32.5%, suicide of the psychiatric patient 32.5%, and the others were 30% below. 4) The possibility of nursing malpractice case was an average 2.57(${\pm}$0.91) and the highest was the fall of the NPO patient after an operation. 5) The perception on the responsibility of the nursing malpractice in its case was indicated as a joint-fault in ten nursing malpractice instances. As compared to the real decision, nurse's perception of the responsibility in the fall of the NPO patient after an operation, the side-effect of KCL injection, the tracheal edema of the patient who had a thyroid operation, the suicide of psychiatric patient, the hymen rupture by uterus cancer test accorded real decisions. But the other cases were different from the real decisions. These cases were perceived as ones of joint fault even in cases determined as Dr's single fault cases or those in which both doctor and nurse were declared free of fault. 6) Knowledge levels of the nursing malpractice, school education and In-service education were perceived as low but anxiety levels of the malpractice were high. 7) With regard to the countmeasure of the hospital after nursing malpractice, the rate answered as "the practice settled the accident temporarily and forced the person in charge to be punished" was highest. In conclusion, the level of the cognition of the clinical nurse on nursing malpractice cases was low. As nurses' perception on the responsibility of the nursing malpractice case was compared to the real decision, there was a difference in five cases out of the ten cases.

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Virtual Reality for Dental Implant Surgical Education (가상현실을 이용한 치과 임플란트 수술 교육)

  • Moon, Seong-Yong;Choi, Bong-Du;Moon, Young-Lae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.169-174
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    • 2016
  • In this study, we evaluated the virtual reality model for dental implant surgery and discussed about the method to make the surgical environment for virtual reality with practical patient data. The anatomical model for patient face was fabricated by facial and oral scan data based on CT data. The simulation scenario was composed step by step fashion with Unity3D. From incision and sinus bone graft procedure which is needed to this patient model to implant installation and bone graft was included in this scenario. We used the HMD and leap motion for immersiveness and feeling of real operation. Twenty training doctor was attended this simulation study, and surveyed their satisfactory results by questionnaire. Implant surgery education program was showed the possibilities of educational tool for dental students and training doctors. Virtual reality for surgical education with HMD and leap motion had advantages, in terms of cheap prcie, easy access.

A study on the Legislations and Amendments of the Medical and Pharmaceutical Laws and Regulations - Focusing on the Duties of Korean (Oriental) Medicine Doctors and Korean (Oriental) Pharmacists as well as the Public Health System - (한의사·한약사 임무 및 공공제도 중심의 의약법규 제·개정 고찰)

  • Eom, Seok-Ki;Shin, Min-Seop;Kwon, Soon-Jo
    • The Journal of Korean Medical History
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    • v.26 no.2
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    • pp.175-185
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    • 2013
  • Purpose : The current Medical Law and the Pharmaceutical Affairs Act, which are incapable of utilizing the research results and the advanced academic, clinical, and pharmaceutical system of the present-day Korean (Oriental) medicine, have limitations and create a paradox by provoking social conflict among the professionals in the field. The aim of this study was to find out the legal and systematic problems that contributed to a complicated conflict amongst Korean (Oriental) medicine doctors, doctors, pharmacists, and Korean (Oriental) pharmacists regarding the classification of their functions. Methods : We reviewed the history and characteristics of the legislation regarding the duties of Korean (Oriental) medicine doctors and Korean (Oriental) pharmacists as well as the relevant and important public health policies since the enactment of the National Medical Services Law in 1951. We focused on the laws and regulations that are made in the process of the separating functions of physicians and pharmacists and the dispute between the Korean (Oriental) medicine doctors and the Korean (Oriental) pharmacists in the 1990s and 2000s. Results : The legislations and amendments of the medical and pharmaceutical laws and regulations that reflect the modern academic, clinical, and pharmaceutical system of the Korean (Oriental) medicine and the research results could be summarized as follows: 1) A partial amendment of the Medical Law in 1987, which added the provision of "Oriental health guidance" as one of the duties of Korean (Oriental) medicine doctors, assured a place for Korean (Oriental) medicine doctors in the field of public health. 2) A partial revision of Pharmaceutical Affairs Act in 1994 established a new system for Korean (Oriental) pharmacists, bringing about the creation of dualistic pharmaceutical system that complements the dualistic medical system. 3) The Promotion of the Research and Development of Wonder Drugs by Using Natural Substances Act was legislated in 2000 in order to stimulate research and development of Korean (Oriental) medicine and its industrialization. 4) Oriental Medicine Promotion Act in 2003 was enacted to lay foundation to specify and promote technology and industry that are related to Korean (Oriental) medicine. Discussions and conclusions : Although the dualistic medical and pharmaceutical system is set up by the Medical Law and Pharmaceutical Affairs Act, it is shown that the relevant regulations have been developed from a perspective of the western medicine.

A study on the Laws and Regulations of the Medical and Pharmaceutical System in Korea from the Modern Period to the Early Days of the Republic - Focusing on the Establishment of the Dualistic Medical and Pharmaceutical System - (근대부터 건국 초기까지의 의약체계 법령 고찰 - 이원적 의약체계 정립을 중심으로 -)

  • Eom, Seok-Ki;Kang, Bong-Seok;Kwon, Soon-Jo
    • The Journal of Korean Medical History
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    • v.26 no.2
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    • pp.9-21
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    • 2013
  • Purpose : The purpose of this study was to analyze the history and characteristics of laws and regulations of the medical and pharmaceutical system in Korea-focusing on the Korean (Oriental) medical and pharmaceutical system-from the modern period to the early days of the Republic. We reviewed how traditional notions and categories of Oriental medicine, which were regarded as experiential and conventional, became part of the current dualistic medical and pharmaceutical system, and examined problems and effects during the course of positioning. Methods : We classified the development of the medical and pharmaceutical laws and regulations chronologically, from the Korean Empire to the beginning of the Republic. The abolishment of the traditional medical system that was based on laws and regulations of the Joseon Dynasty, the implementation of dualistic medical system in the Korean Empire, the attempt to demolish Korean (Oriental) medicine under the Japanese colonial rule, and the process of developing a statute-based continental law system were thoroughly reviewed. Results : Although the dualistic medical system was specified in legislation via the enactment of the National Medical Services Law in 1951, we found that it was actually enacted in 1963, when the laws and systems regarding the educational institution of Korean (Oriental) medicine were stably established. Moreover, the dualistic pharmaceutical system was specified in legislation through the partial amendment of the Pharmaceutical Affairs Act in 1994, but we concluded that the actual enactment was rather in 2000, when the first Korean (Oriental) pharmacist was produced. Discussions and conclusions : An effort to establish a dualistic medical system of Korean (Oriental) medicine and Western medicine during the Korean Empire bore fruit a few decades later, after the Republic of Korea was founded. It means the basis for the legal system finally took shape in spite of the numerous attempts during the Japanese colonial era and the beginning of the Republic to abolish Korean (Oriental) medical and pharmaceutical system.