• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.107-126
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• 1991

일부 도시 영세지역 주민의 상병양상과 의료이용형태를 파악하기 위하여 1988년 12월 한달간에 걸쳐 대구시 남구 대명 8동 영세지역 677가구 2,591명과 대조지역 688가구 2,682명의 주민을 대상으로 면접조사를 실시하였다. 두 지역의 연령별 인구 구성은 0-4세, 65세이상의 인구가 영세지역이 높았으며, 성비는 차이가 없었다. 교육정도와 경제수준은 영세지역은 낮았고, 의료보호 대상자는 영세지역이 많았다. 15일간의 급성질환 이환율은 영세지역이 1000명당 57.1로 대조지역의 24.2보다 유의하게 높았다. 두 지역에서 9세 이하 연령에서의 이환율이 높았으나 연령 증가에 따른 이환율의 뚜렷한 증감현상은 보이지 않았다. 질병분류별 급성질환 이환건수는 두 지역 모두에서 남녀 공히 호흡기계 질환이 가장 많았으며, 영세지역의 경우 감염 및 기생충 질환이 두번째로 많아 대조지역과는 다른 양상을 보였다. 급성질환 이환자의 15일간의 평균 이환기간은 영세지역 6.6일, 대조지역 5.4일로 영세지역이 약간 길었다. 급성질환 이환자의 15일간 의료기관 이용은 1차 이용에서는 영세지역의 경우 약국이 58.1% 그리고 대조지역에서는 의원이 36.9%로 가장 많았으며, 2차와 3차 이용에서 영세지역은 약국과 한의원, 대조지역은 병원과 의원이 가장 많았고, 미치료율은 영세지역이 8.8%로 대조지역의 4.6%에 비하여 훨씬 높게 나타났다. 급성질환 이환자의 지역별 의료이용행태에서 1차 이용에 있어서는 동네내 이용이 영세지역 73.6%, 대조지역 64.6%로 가장 많았다. 급성질환 이환자의 의료기관 1차 이용시 병원을 이용하는 이유로 가장 많은 것이 영세지역은 '단골'이었으며, 대조지역은 '가까운 거리'였다. 의원, 보건소 및 약국을 이용하는 이유로 가장 많은 것은 두 지역 모두 '가까운 거리'였다. 1년간 만성질환 이환율은 1000명당 영세지역 83.0, 대조지역 28.0으로 유의한 차이를 보였으며, 연령이 증가함에 따라 이환율도 증가하는 경향을 보였다. 만성질환 이환건수는 영세지역에서는 남자의 경우 신경계 질환이 19.6%, 여자의 경우는 신경계 질환 18.3%, 근골격계 질환이 18.3%로 가장 많았고, 대조지역에서는 남자의 경우 심혈관계 질환이 23.1%, 여자의 겨우 위장관계질환이 27.3%로 가장 많았다. 조사 시점전 1년간 만성질환의 평균 이환기간은 영세지역 9.8개월, 대조지역 10.4개월로 대조지역이 약간 더 길었으며, 평균 활동 제한 기간도 영세지역 1.9개월보다 대조지역 2.1개월로 다소 길었다. 만성질환 이환자의 의료기관 1차 이용에 있어서 영세지역은 약국 이용이 24.2%, 대조지역은 병원외래 이용이 34.7%로 가장 많았으며, 2차, 3차 이용에 있어 영세지역에서는 각 의료기관을 고루 이용하였고, 대조지역에서는 병원 이용이 두드러지게 많았으며, 미치료율은 영세지역과 대조지역이 각각 34.7%, 16.0%로 영세지역이 월등히 높았다. 만성질환자의 지역별 의료이용행태에서 1차 이용에 있어서는 동네내 이용이 영세지역 38.3%, 대조지역 45.3%로 두 지역 모두에서 가장 많았다. 만성질환 이환자의 지역별 의료기관 1차 이용시 병원, 의원, 보건소 및 약국을 이용하는 주된 이유는 '가까운 거리'였으며, 한의원을 이용하는 이유는 '좋은 치료결과'와 치료의 명성'이었다. 이상의 결과로 영세지역의 사회경제적수준이 상병과 의료이용행태에 영향을 미친 것으로 생각된다. 따라서 영세지역 주민을 위한 보다 적극적인 보건의료 서비스의 개발과 합리적이고 적절한 의료이용을 위한 지도 및 계몽과 아울러 사회경제적인 요소들의 개선을 위한 노력을 병행해야 만이 효과적인 보건의료 사업이 될 것으로 생각된다.

• 한국환경보건학회지
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• 제32권1호
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• pp.36-45
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• 2006

The aim of this study is to examine size-based concentration and genera of airborne fungi distributed in public facilities such as hospital, kindergarten, day-care center and postpartum nurse center and to provide fundamental data in order to prevent respiratory diseases caused by exposure to airborne fungi. Culturable total and respirable concentrations of airborne fungi averaged to $382\;cfu/m^3\;and\;292\;cfu/m^3$ in hospital, $536\;cfu/m^3\;and\;347\;cfu/m^3$ in kindergarten, $334\;cfu/m^3\;and\;266\;cfu/m^3$ in day-care center, and $371\;cfu/m^3\;and\;289\;cfu/m^3$ in postpartum nurse center, respectively. The ratio of respirable to total concentration of airborne fungi in the investigated public facilities was ranged from $55\%\;to\;70\%$ but there was no significant difference among them (p>0.05). The mean I/O ratio of culturable total and respirable concentrations were 0.56 and 0.64 in hospital, 0.72 and 0.91 in kindergarten, 0.33 and 0.45 in day-care center, and 0.63 and 0.73 in postpartum nurse center, respectively. Indoor concentration of airborne fungi did not correlated significantly with indoor temperature and relative humidity (p>0.05) but had a significant positive correlation with $CO_2$ concentration (p<0.01) and surrounding condition (p<0.05). Penicillium spp., Cladosporium spp., and Aspergillus spp. were estimated to over $95\%$ of total airborne fungi identified in the investigated public facilities.

• 한국동물위생학회지
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• 제37권4호
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• pp.297-305
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• 2014

Animals and disease frequency of the rescued dogs were investigated in Incheon Veterinary Medical Association Animal Shelter from January in 2012 to December in 2013. Three zoonoses (rabies, brucellosis, and dirofilariosis) and three infectious diseases (canine distemper, canine parvoviral enteritis, and canine influenza) were examined for stray dogs. Among 5,603 heads, 647 (11.5%) went back to their owner and 969 (17.3%) were adopted to new families. Prevalence of dirofilariosis, canine distemper and canine parvoviral enteritis were 2.2% (16/718), 6.0% (24/399) and 6.1% (24/396), respectively. Positive antibody rates against rabies, B. canis and canine influenza virus were 20.5% (41/200), 0.1% (1/718) and 2.0% (4/200), respectively. Protective antibody for canine distemper virus and canine parvovirus were shown in 47.0% (94/200). The data indicate that control measures including facility standards and disease control program are one of the important aspects of the shelter management because stray dogs are exposed to various infectious agents.

• 문화기술의 융합
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• 제6권3호
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• pp.185-191
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• 2020

본 연구는 상대적으로 인식은 부족하나 점차 교역이 확대되는 동유럽 국가인 루마니아를 대상으로 공공보건시설 색채이미지에 대한 국가 간 문화적, 감성적 인식 차이를 파악하고자 하는 목적을 가진다. 이를 위하여 선행연구 고찰을 통해 색채이미지를 선정하였으며, 공공보건시설인 의료시설 8개소, 사회체육시설 4개소, 요양시설 8개소를 직접 방문하여 환경색채를 측색데이터를 기반으로 설문지를 구성하였다. 한국인 89명, 루마니아인 86명을 대상으로 공공시설 색채이미지에 대한 온라인 설문조사를 실시하였고, SPSS 통계분석 프로그램을 활용하여 빈도 및 교차분석을 실시하여 한국인과 루마니아인의 공공보건시설 색채이미지에 대한 인식차이를 파악하였다. 그 결과, 국가 간 공공보건시설에 대한 색채이미지 인식이 어휘평가와 이미지평가에서 통계적으로 유의한 차이가 있음을 파악하였고, 이는 공공보건시설의 색채이미지가 다른 문화권에 거주하는 집단에게 다른 의미로 해석될 수 있으므로 향후, 이와 관련된 환경 구축 시 문화적 인식차이를 고려해야함을 시사한다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권4호
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• pp.37-45
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• 2019

Purpose: At the time of consensus on the necessity of appropriate guidelines for health care facilities suitable for Korea, the paper aimed to analyze the characteristics in the aspect of the system of the US Health Care Facility Guidelines(FGI Guidelines) and to suggest implications. Since the system is significant for the guidelines to be socially accepted and operated, this study focuses on the system. Methods: Literature studies focusing on the analysis of prior studies and the 2018 edition of the FGI Guidelines were conducted. Results: As a result of reviewing the history and outline of the FGI Guidelines, the derived characteristics of the system were governance, procedure, and composition. First, it had multi-layered organization and multidisciplinary members. Secondly, the focus is on the procedure of gathering opinions from industry and the public. Third, the Guidelines have been continuously evolving to reflect the needs of the times and changes in the medical environment, and the content framework and method of writing are user-friendly in order to prevent confusion caused by vast contents. Implications: First, we need to consider the composition of a private organization to prepare Korean health care facility guidelines. Second, it needs a system that can induce the participation of multidisciplinary experts. Third, a comprehensive and user friendly guideline needs to be constructed.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• 보건행정학회지
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• 제27권2호
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• 한국농촌건축학회논문집
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• 제24권4호
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• pp.1-8
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• 2022

This study aims to investigate the gap in accessibility to urban planning facilities between living spheres in local small and medium-sized cities. In this study, OD data between administrative dongs of public transportation users was constructed to analyze the living shpere, and community analysis was conducted based on cohesion between data. As a result of the analysis, it was confirmed that a total of 10 clusters (mid-living areas) were formed, and the topographical difference between the 11 middle living areas established in the existing Jinju City Basic Plan and the single living areas were actively exchanged to form a community with other administrative dongs. Next, the analysis of the service area of urban planning facilities for mid-living areas was conducted based on the road network. As a result of analyzing the area accessible within 5, 10, and 15 minutes, educational facilities, public facilities, cultural facilities, tourism, and green facilities could be reached within 15 minutes in most mid-living areas. On the other hand, there were many areas where access to transportation facilities, medical facilities, and cultural facilities was difficult within 15 minutes. In particular, the accessibility of the outer living area and the central living area were different. To improve the quality of life of citizens, using urban planning facilities in Jinju-si and establishing related plans in urban basic plans, it is necessary to conduct a study on service areas through network analysis.

• Journal of Preventive Medicine and Public Health
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• 제23권4호
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• pp.436-450
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• 1990

This study was designed to investigate the mar factors affecting selection of delivery facilities by pregnant women. Five hundred women hospitalized at 23 Seoul-area delivery facilities, such as university hospitals, general hospitals, hospitals, and clinics were selected and given questionnaires from April 24 to May 7, 1990. A total of 350 questionnaires were collected and analysed for the study. The results are as follows ; 1. In general, variables which significantly affected the choice of delivery facilities included the age of women, their educational level, the educational level of their husbands, monthly average incomes and residential areas. 2. In analyzing the obstetrical characteristics of the women, those variables significantly affecting the choice of delivery facilities were the gestational period, the facilities for prenatal care, the frequency of prenatal care, the type of delivery, the frequency of miscarriage, previous delivery experiences and the awareness on prenatal care. 3. In comparing the motivation factors for selecting the delivery facilities, all the factors except convenience and need for hospitalization differed significantly among delivery facilities. 4. The factor analysis was assessed for twenty possible factors motivating the choice of delivery facilities. Six factors including personal service, scale of the facility, reputation, urgency, convenience, and experience were noted explaining by 57.7%. 5. In the discriminant analysis used to clarify the major factors affecting the selection of delivery facilities, the 16 significant variables were regarded as independent variables, and the type of delivery facilities was considered a dependent variable. The stepwise method was applied to the analysis. Detected discriminant variables were the facilities for prenatal care, scale factor, personal service factor, urgency factor, convenience factor, reputation factor, experience factor, gestational period, types of delivery, frequency of miscarriage, age and income. These 12 discriminant variables were tested, with reference to discriminant prediction, on their importance in the choice of the delivery facility, by the discriminant functional formula. The test showed a hit-rate of 67.7%. The results suggest that general characteristics, obstetrical characteristics, and motivations for selecting the delivery facilities differ significantly according to the types of the delivery facilities. This study implies that all types of delivery facilities should attempt to acommodate characteristics and motivations of pregnant women. The facilities should be prepared to increase their patients satisfaction with required medical conditions by improving service and responding to the pregnant women's preferences.

• 한국정보통신학회논문지
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• 제23권8호
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• pp.996-1003
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• 2019

지상의 각종 시설물들의 지중화가 이루어지며 상수도 및 오수의 악취, 전봇대 쓰러짐, 전자파 영향 및 선로작업에 의한 단선 등의 문제들은 줄어들었다. 그러나, 맨홀 뚜껑 개방에 의한 추락, 가연성 가스 폭발, 인체 유해 가스 및 산소농도 부족에 질식, 고압선 발열에 의한 화재 및 맨홀 침수 등 새로운 문제점들이 발생하고 있다. 또한, 이러한 문제들이 시민 사회의 피해를 주고 공공안전에 불안요소로 작용하고 있다. 이에 본 논문을 통해 맨홀 내 외부의 안정적인 통신환경을 확보하고, 맨홀 내 시설물을 관리하기 위한 다양한 디바이스들과의 무선 통신이 가능한 스마트 맨홀 디바이스에 중점을 두어 연구를 진행하고 향후 지중 시설물 관리의 방향성을 제시하고 공공 안전에 기여 하고자 한다.