• Research in Community and Public Health Nursing
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• v.12 no.1
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• pp.22-31
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• 2001

Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

• Journal of Environmental Health Sciences
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• v.42 no.6
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• pp.396-408
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• 2016

Objectives: The purposes of this study were to determine the relationship between the prevalence of allergic diseases and urinary cadmium concentration among children from six to 12 years of age, and to evaluate the association between cadmium in urine and other immunologically related factors in two elementary schools with different environmental conditions. Methods: Data on physician-diagnosed prevalence over the past 12 months and potential risk factors for allergic disease were collected from survey results drawn from 236 children living in different regions (central urban vs. suburban) from April to July in 2014 by an ISAAC questionnaire. We analyzed cytokine levels in serum through enzyme-linked immunosorbent assay and urinary cadmium concentration by use of inductively coupled plasma mass spectrometry. Results: Concentrations of urinary cadmium in suburban and central urban children were $0.11{\pm}0.11ug/L$, $0.14{\pm}0.17ug/L$, respectively (p>0.05). Results from the analysis of the t-test and chi-square test showed that urinary cadmium levels were positively associated with environmental factors (paternal smoking status, passive smoking, traffic volume and experiences of outdoor odors) and individual genetic factors (parental allergic disease). Cadmium concentrations in urine were also positively associated with the prevalence of allergic disease and immune-related cytokines (eosinophils, IgE, IL-5, IL-33, IL-17). Conclusion: This study suggests that genetic factors (parental history of allergic diseases), environmental factors, and regional status (suburban and central urban) should be considered as probable factors increasing the concentration of urinary cadmium, which has the potential to influence the allergic disease prevalence of school-age children.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.15-27
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• 2003

Objectives: This study was conducted to compare the medical care patterns of hypertensive patients between rural and urban areas. Methods: We selected one rural county(Region A where there were 19 public health centers; one health center, 8 health sub-centers and 10 community health posts) and two urban districts(Region B and C where there was no health sub-center and community health post) in Daegu city. Region B had similar socioeconomic characteristics with rural county A while region C had different characteristics. The medical insurance records of 14,422 incident patients (2,501 in region A, 4,873 in region B and 7,048 in region C) with diagnostic code of hypertension from September 1998 to August 1999 were reviewed. Incident patient was defined as a patient who had no record of medical fee claim for hypertension to the national health insurance corporation in past 6 months and visited a medical facility for hypertension for the first time. The data for annual visit days, annual prescription days and annual total medical expenses were abstracted. The medical care pattern was categorized by the number of annual visit days and prescription days. The most proper care group was defined as the patient who visited 6-15 days with 240 prescription days or more in a year. Results: The type of medical facilities for the most visit was clinics, 373.% and it was followed by general hospitals, 28.2%; public health centers, 24.7%; and hospitals, 9.8% in region A(p<0.05). In region B, it was clinics, 63.1% and followed by general hospitals, 27.6%; health center, 5.2%; and hospitals, 4.1%(p<0.05). In region C, it was clinics, 53.8% and followed by general hospitals, 35.0%; health center, 6.3%; and hospitals, 4.9%(p<0.05). Annual mean total medical expenses per patient was highest in region C(won195,993) and followed by region A(won191,683) and region B(won178,713). The proportion of the most proper care group was 7.7% in region A, 5.2% in region B and 6.7% in region C(p<0.05). According to the type of medical facilities for the first visit, the proportion of the most proper care group was highest(14.7%) in the patients of public health centers, and it was followed by general hospitals, 8.8%; clinics, 3.6%; and hospitals, 2.0% in region A(p<0.05). In region B, it was highest in general hospitals, 9.7% and followed by hospitals, 4.0%; health center, 3.6%; and clinics, 3.4%(p<0.05). In region C, it was highest in general hospitals, 10.1% and followed by clinics, 5.2%; hospitals, 4.1%; and health center, 3.1%(p<0.05). Conclusions: The proportion of proper care for hypertension was higher in rural area and it was attributed to the care of health center, sub-centers and community health posts which appeared to follow patients better than hospitals and clinics.

• 대한예방의학회:학술대회논문집
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• 1998.10b
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• pp.175-176
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• 1998

• Journal of the Korean Institute of Rural Architecture
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• v.12 no.4
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• pp.29-36
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• 2010

The purpose of this study is to have detailed data of the distribution, locations, and the amount of people in the waiting line of the nursing home. Also, we studied the accessibility to the facilities by using Web GIS to analyze the transit time it takes from the nursing home to health center and hospitals. We can provide the basic data that could contribute when future plans for the nursing homes' locations, health and medical policy are made. The results are as follows. 1. The nursing homes are stiffly concentrated in regions of Seoul and Gyeongi-do where large number of the elderly covered by long-term care insurance and the waiting line was very long for the elderlies to enter the nursing homes. In these cities of Ulsan and Jeju where number of the elderly covered by long-term care insurance is relatively small, there were less facilities. 2. The nursing homes located in urban areas had higher occupancy rate and higher number of people in the waiting line. 3. The average time taken by driving from the nursing homes and health center was 10 minutes and there was not a noticeable difference between the cities. Driving from the nursing homes to hospitals in rural areas took 22 minutes which is 2.5 times of the time taken for urban areas. Daegu-si and Incheon-si had relatively short distance from the nursing homes and the hospitals while Jeju-do had the furthest. For rural areas, it is needed for health center to be equipped with a wider medical coverage, have closely connected with hospitals to minimize the differences they have from ones in rural areas. It is also needed to have ambulances equipped for tele-medical examination and treatment system.

• Journal of agricultural medicine and community health
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• v.33 no.3
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• pp.292-302
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• 2008

- Abstract - Objectives: The purpose of this paper is to determine an efficient operation plan for a smoking cessation clinic in public health centers. To do so, the primary success factors in smoking cessation have been analyzed after classifying the smoking cessation programs of public health centers into urban and rural areas. Methods: A study was conducted with 262,837 smokers age 19 or older who were provided with smoking cessation services for more than 6 months through smoking cessation clinics at public health centers(250 clinics nationwide) from July 16, 2006 to July 15, 2007. Results: Urban areas indicated that gender, age, social security, the frequency of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems were all factors that influenced the success of smoking cessation. On the other hand, in the rural areas the total number of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems were the influential factors. Furthermore, the urban area confirmed that the frequency of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems affected traveling while the rural area was affected by social security, the frequency of counseling and re-enrollment. Conclusions: It has been confirmed that the success rate and factors of smoking cessation clinics can vary depending on the region and enrollment method.

• Health Policy and Management
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• v.8 no.1
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• pp.52-96
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• 1998

To find causal factors and improvement plans of organizational commitment of public servants in urban health centers, a hypothetical causal model, which included 2 endogenous variables(organizational commitment & organizational satisfaction) and 15 exogenous variables, was constructed. Exogenous variables consisted of individual factors (sex, age, education, job-grade, and annual salary), psychological variables(pride for organization, extrinsic motivation, intrinsic motivation and support of supervisor) ad structural variables(formalization, centralization, communication, job-conflict, job-decision, and workload). In the hypothetical causal model, organizational commitment was supposed to be effect variable, and organizational satisfaction was presumed to be intervening variable to mediate between organizational commitment and exogenous variables. For data collection, cross-sectional self-administered questionnaire survey was conducted to 1,295 public servants from 32 urban health centers nationwide. The survey responses were from 934, 72.1% of subjects. But 756 responses(58.4%) were analyzed because of excluding ones with missing values. The hypothetical causal model was fitted by covariance structural analysis with maximum likelihood method. Main results were as follows: (1) The fitted causal model accounted for 33 and 55 percent of total variance of organizational commitment and organizational satisfaction of public servants, respectively. (2) In order of effect size, pride for organization, supervisor support, communication, extrinsic motivation and centralization had an indirect effect effect on organizational commitment through organizational satisfaction. However, the effect of centralization was negative. (3) Pride for organiztion, intrinsic motivation, organizational satisfaction, job-conflict, supervisor support, communication, age, centralization, annual salar and extrinsic motivation had indirect or direct effects on organizational commitment in order of effect size. Among them, effects of job-conflict and centraldization were negative. In conclusion, these results suggested that organizational commitment of public servants in urban health centers could be enhanced by pride for organization, intrinsic and extrinsic motivations, prevention of job-conflict and excess centralization, supervisor support and active communication. Especially, pride for organization and intrinsic motivation were expected to play the most important role.

• Journal of Korean Public Health Nursing
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• v.22 no.1
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• pp.5-17
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• 2008

Purpose: To understand the dietary habits and factors influencing the dietary habits in adults of an urban community. Method: The data were collected via questionnaires that investigated dietary habits, health behaviors, health-related factors, and general characteristics. A total of 302 subjects were selected from those who had visited an urban public center over a 2-week period. The data of 294 subjects were analyzed using descriptive analysis, t-test, ANOVA, and multiple regression, after 8 questionnaire were excluded due to incomplete data. Results: The degree of dietary habits was in the middle range. The most positive dietary habit was 'intake fibers from vegetables, fruits, and cereals', followed by 'not enjoy salty food and salt' and 'eating breakfast everyday'. The significant predictors influencing dietary habits were age, present smoking behavior, perceived health status, and drinking frequency, and these variables accounted for 27.3% of the variance in the dietary habits score. Conclusion: Health care providers should focus on health promotion planning regarding dietary habits and other health-related behaviors in combination and use integrated strategies regarding the factors that influence dietary habits and other health-related behaviors.

• 대한예방의학회:학술대회논문집
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• 1998.10b
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• pp.115-116
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• 1998

• Korean Journal of Health Education and Promotion
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• v.25 no.1
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• pp.25-38
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• 2008

Objectives: This study identified the factors associated with successful smoking cessation for 6 months at a smoking-cessation clinic of a public health center in an urban area. Methods: The subjects of this study were 670 visitors to the smoking cessation clinic of Dongjak-Gu public health center in Seoul, from September 6, 2005 to March 24, 2006. The 274 visitors of them responded to the questionnaire with registration, which contained the information related to the study except that of registered card for the clinic. A dependent variable was success or failure in smoking cessation during the 6 month-smoking cessation program, measured the status of smoking cessation in each week by self-report. Independent variable included demographic information, the characteristics in using the clinic, health status and smoking related behaviour, exposure to other smokers in daily life and motivation. Multiple logistic regression model was used to find the factors associated with success of smoking cessation. Results: The success rate in smoking cessation for 6 months was 33.6%. Five pretreatment characteristics were identified as univariate predictors of continuous abstinence. Finally, age, job, and practice oriented motivation were associated significantly with the success of smoking cessation for 6 months from a multiple logistic regression analysis. The lower socio-economic smokers such as people having lower literacy level, lower income people, unskilled workers, and recipients by Medical Assistant Program were more likely to fail in continuous abstinence for 6 months. Conclusions: In order to increase the success rate in smoking cessation clinics of public centers, counselors should activate self confidence and practice oriented motivation of participants for smoking cessation.