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A study on the current status and development of the new health technology assessment of Korean medicine field (한의 신의료기술 평가 활성화 방안 제언)

  • Park, Minjung;Jung, Youjin;Son, Soo Kyung;Kwon, Soohyun;Kim, Nankwen;Kim, Jong Woo;Park, Dong Ah;Chung, Seok-Hee
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.59-75
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    • 2019
  • Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

A Study on the Preparation of Contents for Promoting the Establishment of a Disaster Safety Village in Rural Areas (농촌지역 재난안전마을 만들기 활성화를 위한 컨텐츠 마련에 관한 연구)

  • Koo, Wonhoi;Bae, Minho
    • Journal of the Society of Disaster Information
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    • v.14 no.4
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    • pp.387-398
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    • 2018
  • Purpose: The purpose of this study is to promote the disaster safety village establishment project that fits the characteristics of rural areas by investigating and analyzing the operation cases of contents with regard to disaster safety villages in Korea and Japan. Method: The contents of project related to disaster safety villages in Korea and Japan were classified into resident participation contents, structured contents and unstructured contents, for examining the characteristics of such contents through investigation and analysis, and the contents (draft) of disaster safety village that fitted the characteristics of rural areas were presented. Result: The contents of resident participation include basic safety education, CPR education, life experience training of evacuation shelter, evacuation training, concurrent training of farming activity and disaster activity and creating a village safety map in connection with competent authorities. The enactment of an act and an ordinance for the establishment of disaster safety village, expert dispatch system, storm and flood insurance system and funding system to raise the fund for establishing a village were presented as unstructured contents. In addition, the production of self supporting evacuation shelter, wireless evacuation announcement system, disaster prevention system for a river, emergency evacuation sign, village safety map sign and the establishment of disaster prevention park were presented as structured contents. Conclusion: The unstructured contents are the establishment of foundation for preparing laws and institutions and the structured contents should be installed by utilizing eco-friendly methods in consideration of the environments of rural areas along with securing the safety. Moreover, resident participation should utilize the contents by considering various items such as age, characteristics and environments of residents in rural villages.

Effects of Positive Psychological Capitals on Service Quality and Mediating Effect of Job Satisfaction in Professional Care Workers (요양보호사의 긍정심리자본이 서비스 질에 미치는 영향과 직무만족의 매개효과 검증)

  • Lee, mun-jae;Cho, Choon-Bum;Kim, Jung-Hwa
    • 한국노년학
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    • v.39 no.3
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    • pp.531-548
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    • 2019
  • The purpose of this study is to provide basic data in order to improve service quality based on empirical analyses about a relationship among positive psychological capitals, service quality, and job satisfaction of professional care workers under the Long-Term Care Insurance in South Korea. In this study, total 430 numbers of the workers who were currently working in nursing homes for the elderly at the cities of Ansan, Anyang, Bucheon, and Kwangmyeong in Gyeonggi Province, South Korea, participated in self-report questionnaires. Only 393 questionnaires were used for the final analyses after excluding the ones that neither were not returned nor didn't completed it all. These are major results. First, positive psychological capitals affect positively on service quality. Second, job satisfaction works as a mediating effect in the process of positive psychological capitals affect on service quality. Based on above results, it is possible to suggest it as down below. First, it is required to have policies that will be helpful for both positive psychological capitals and capacity building through human resource management in systematic approaches. Second, it is also required to acknowledge that having positive psychological capitals is effective to improve both their job satisfaction and service quality. Therefore, it is necessary to change environmental circumstances in relevant institutions where this acknowledgement will be applied.

The Effect of Perceived Customer Orientation on the Customer Intention in Fintech Service: Focused on the Technology Acceptance Model (핀테크 서비스에서 지각된 고객 지향성이 고객 의도에 미치는 영향: 기술수용 모델을 중심으로)

  • Jinyong Choi
    • Information Systems Review
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    • v.23 no.1
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    • pp.93-113
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    • 2021
  • Service orientation and customer orientation are recognized as important success factors in service companies. However, these constructs are evaluated through self-diagnosis within the service company based on service delivery experience. For this reason, Fintech companies that provide financial services based on non-face-to-face channels such as mobile APP have limitations in evaluating their service orientation and customer orientation. Therefore, in this study, the perceived customer orientation is conceptualized so that service orientation and customer orientation can be evaluated through customer evaluation. In addition, the antecedents and consequences of the perceived customer orientation based on the technology acceptance model were demonstrated. As a result, it was confirmed the mediating effect of perceived customer orientation in the relationship between perceived ease of use and usefulness and customer's continuous use intention and word of mouth intention. This study laid the foundation for the Fintech companies that provide all financial services throughout non-face-to-face to measure their service orientation and customer orientation through customer evaluation and utilize them in establishing service operation strategies.

Comparison of the Working Conditions of Dental Hygienists Using Data from Online Job Sites (구인 사이트에 나타난 치과규모별 치과위생사 근무조건의 비교)

  • Oh, Eun-Ju;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.501-507
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    • 2017
  • The shortage of dental hygienists has been a long-standing problem in Korea. Small-scaled dental clinics suffer from a lack of dental hygienists, who seem to prefer working at large-scaled dental clinics. The purpose of this study was to confirm the differences in the working conditions according to the scales of dental clinics. We collected the working information registered via job advertisements through the web-sites of Korean Dental Hygienists Association, Dental Jobs, and Nurse Jobs from July to August 2016. The results were as follows: 96.7% of the advertisements wanted regular workers, while the proportion of part-time workers was the highest (34.8%) in the group with less than 3 employees. The average workdays per week was $5.32{\pm}0.55$ days, and the group with less than 3 employees had significantly longer workdays than the other groups. The daily working time was $8.99{\pm}0.44$ hours, and there was no difference among the groups. Night overtime hours were needed by 54.4%, 45.0%, and 31.3% of the groups with of the groups with 4~7 employees, more than 8 employees, and less than 3 employees, respectively. Information regarding annual leave (60.5%), monthly leave (63.9%), half a day off (32.4%) and vacations (43.1%) were presented in the job advertisements, and these proportions were significantly higher by the group with more than 8 employees. Information on overtime pay (14.4%), night-work pay (13.4%), incentives (34.1%), lunches (60.2%), vacation bonuses (33.8%), and self-development (20.4%) were presented in job advertisements. The group with 4~7 employees had significantly higher proportions in severance pay, vacation bonuses, self-development, and major national insurance. It is necessary to consider the improvement of working conditions, diversity of working styles, and welfare of dental hygienists, and it is suggested that small dental clinics provide more precise working conditions.

The Rehabilitation Services Utilization of People with Disabilities in a Rural Area (농촌지역 재가장애인의 재활서비스 이용실태)

  • Choi, Gyeong-Jin;Kim, Keon-Yeop;Lee, Duck-Hee;Han, Chang-Hyun;Choi, Se-Mook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.227-237
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    • 2011
  • Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

Why Is the Rate of Poor Subjective Health Notably High in South Korea? The Importance of Managing Healthcare Needs (한국인은 왜 주관적 건강상태가 매우 나쁠까? 의료필요 관리의 중요성)

  • Woojin Chung
    • Health Policy and Management
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    • v.34 no.3
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    • pp.334-346
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    • 2024
  • Background: Research on the link between subjective health and unmet healthcare needs is limited. This study examines whether experiences of subjective healthcare needs and unmet needs are related to subjective health in South Korea, where the rate of poor subjective health is notably high. Methods: This analysis utilized data from the Korea Health Panel (2014-2018), incorporating 68,930 observations from 16,535 adults aged 19 or older. The dependent variable, subjective health, was dichotomized into poor (bad or very bad) and non-poor (fair, good, or very good) categories. The primary variables of interest were the experiences of subjective healthcare needs and unmet needs, while control variables included 14 socio-demographic, health, and functional characteristics. The study employed population proportion analysis and multivariable two-level binary logistic regression analysis for each gender, accounting for the complex sampling design. Results: In 2018, the rate of reporting poor health was 8.7% (95% confidence interval [CI], 8.0%-9.5%) for men and 14.7% (95% CI, 13.8%-15.6%) for women. For both genders, compared to individuals whose healthcare needs were met, those without healthcare needs were less likely to report poor subjective health (adjusted odds ratio [AOR], 0.58; 95% CI, 0.39-0.86 for men; AOR, 0.59; 95% CI, 0.37-0.93 for women). Conversely, individuals whose healthcare needs were not met were more likely to report poor subjective health (AOR, 2.31; 95% CI, 2.01-2.65 for men; AOR, 2.19; 95% CI, 1.98-2.43 for women). A policy simulation indicated that reducing the experience of subjective healthcare needs would be approximately 5 times more effective in reducing poor subjective health than a policy focused on reducing the experience of unmet needs. Conclusion: South Korea must make significant efforts to reduce the deterioration of subjective health and promote appropriate healthcare utilization. To achieve this, a set of policies is recommended to address subjective healthcare needs. These policies should include (1) prompting individuals to proactively manage their own health, (2) providing primary healthcare similar to that in advanced countries, (3) ensuring the healthcare delivery system operates effectively, (4) decentralizing the healthcare management system, and (5) reducing the likelihood of people being misled into thinking they have a healthcare need.

A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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Medical Care Expenditure of Residents in Urban Poor Area (도시 영세지역의 가계 의료비지출)

  • Hwang, In-Soo;Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.91-102
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    • 1993
  • This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered questionnaires completed by housewives. The survey was conducted from March 1 to May 31, 1992. The mean age was 31.1 years in the poor area and 37.1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The average monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%), while hospital and clinic(37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2.800 Won in the poor area and 6,300 Won in the control area.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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