• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.520-532
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• 2003

Purpose: The purpose of this study was to identify the health status and request of community residents. This study is part of development of efficient health life enhancement programs. Methods: The subjects of this study were 586 households in a rural community and well-trained interviewers visited every household in the designated area and individually interviewed heads of households for general information and health service utilization. The data were collected using a questionnaire for seven months from March 25 to September 24, 2002. The data were analyzed using frequency. percentage by SPSSWIN (v 10.0). Results: 1. 58.9% of subjects were above sixty, and 60.8% of them were women. 2. The most serious problems they identified were health problems (45.6%), and the second was(##-was+were) economic problems(22.0%). 3. Almost half of the study population regarded themselves as healthy (46.2%). The types of illness they had were neuralgia, arthritis, hypertension, diabetes, and heart disease. 4. Most of the study population answered that they didn't do anything special for health enhancement. 5. Among medical facilities, hospitals or medical clinics (55.3%) were most commonly utilized when they were sick. 6. The highest request of the subjects was 'Home visiting service (45.4%)', and 'free treatment connected to the service of hospitals' was the second. What they needed most regarding health enhancement programs in health life enhancement centers was 'free health examination (58.2%), and heath education programs (57.7%). 7. As a result of investigating the subjects' demand for nursing services in health life enhancement center, 'the clinical examination' was the most requested, and next was 'blood pressure check', 'emergency treatment', and 'rehabilitation service', in that order.

• Journal of Hospice and Palliative Care
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• v.10 no.3
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• pp.128-136
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• 2007

Purpose: The purpose of this study is to investigate the current state of the home-based cancer patient management project of public health centers throughout the country. The results of the investigation is employed to identify obstacles to the execution of the program and, finally, to develop an efficient management program of home-based cancer patients. Methods: Data on the home-based cancer patient management project were collected and analyzed through visiting interviews or telephone interviews with 225 public health centers throughout the country for six months from July to December, 2006. Results: Obstacles to the present execution of the home-based cancer patient management project were identified. Some of them are : (1) patients' low trust in cancer patient management by local health centers, (2) absence of programs customized to local communities, (3) lack of personnel and vehicles for home-based cancer patient management, (4) lack of education program for personnel in charge of home-based cancer patient management, (5) problems in public health doctors, weak connection to private medical institutions, (6) absence of medical institutions and hospice facilities for cancer patients, and (7) non-standardized volunteer workers, so on. Considering all these problems, some effective management methods are proposed. The basic concept is to keep the autonomy and variety of the local helath centers. And based on this concept, three models of (1) public health center controlled model, (2) medical institutions and hospice facilities-entrusted model and (3) medical institutions and hospice facilities-cooperative model are developed. Conclusion: By adopting an adequate model among proposed three models, the public health centers are expected to achieve an efficient utilization of material resources and manpower. In addition, by inventing their own programs that are proper for the local societies, they can improve the home-based cancer patient management.

• Journal of agricultural medicine and community health
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• v.15 no.1
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• pp.41-48
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• 1990

In order to find out the status of health care of the old aged people (age of 65 and over) in a rural area, a study was carried out, through analyzing the data of health care clinic for 207 old aged people with geriatric diseases, and of questionnired survey for 84 old aged people with geriatric diseases in a rural community. Su Dong-Myun. Nam Yang Zu-Gun, Kyung Gi-Do, Korea, during the year of 1989. The following results were obtained. 1) The composition rate of population of age of 65 and over was 9.8% in total, and sex-specific composition rate was 9.3% in male and 10.4% in female. 2) Utilization rate of health care clinic for old aged people with geriatric diseases was the highest rate with 37.9%, through individual letters at the first time, and showed gradually decreasing tendency afterward. 3) In the means of utilization advices to health care clinic for the old aged people. the individual letters(37.9%) at the first time were more effective than public information of the old aged hall or/and Myun office(18.4%). 4) In opinion on utilization of health subcenter-health care clinic for the old aged people "will utilize"(59.5%) was the highest and "do not know"(26.2%) "be difficult to utilize" (9.5%) and "will not utilize"(4.8%) were in the next order. 5) Out of 84 respondents, the old aged people With geriatric diseases, 73.8%(about three-fourths) of them answered "their diseases to the aggravated" (29.8%) "not to be changed"(25.0%) and "to be unknown"(19.0%), and the others(26.2% of them) "to be changed for the better". 6) Out of 62 respondents(the old aged people), answered their geriatric diseases not to be changed for the better, "no curative effect" was the highest with 43.5% of them. "could not know" (33.9%), "would not treat"(19.4%) and "could not be treated"(4.8%) were in decreasing order. 7) The old aged people, responded their diseases to be changed for the better, answered that they(patients) should make themselves(68.2%) responsible for basic effort of health care. However the old aged people responded their diseases not to be changed for the better answered that they should impute the responsibility of basic effort for health care to medical facilities or other conditions(63.0%). 8) In the reason of failure that the old aged people responded their geriatric diseases not to have curative effect, mis-control of regular habits of daily life was the highest(57.1%), and failure of taking selected medicine steadily(28.6%), and abuse of medicines(14.3%) were in decreasing order. 9) The reason order of being changed for the better that the old aged people responded their diseases to have curative effect, was keeping and control of regular habits of daily life (46.7%), taking selected medicines steadily(33.3%) and others (20.2%) respectively. 10) The courses of geriatric diseases itself are so chronic, duplicate and uncertain, and the old aged people activities for disease control are so slow, various and uncertain that continuous health education in home or/and community unit must be essential factors for effective geriatric health care.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of Preventive Medicine and Public Health
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• v.7 no.1
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• pp.211-222
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• 1974

The survey was carried out on 1,031 primary school children for about 1 month, from June 1, to June 30, 1974, for the purose of understanding indirectly scio-medical status of a remote rural area, reflecting health status of primary school children. The summarized results were as follows: 1) The average age of surveyed children according to school year by sex was older in girls than in boys. The entrance in school at suitable age was peaked as 80.9% in boys of 5th school year and 72.4% in girls of 3rd school year, and also sunk 68.8% in boys of 2nd school year and 58.7% in girls of 1st school year. 2) Prevalence rate according to W.H.O. diseases classification during last a month and a year. a) During last month: The diseases of respiratory system remarked the highest 101.1 in boys and 116.6 in girls. The next were diseases of digestive system (24.2 in boys and 32.1 in girls), The girls were higher than boys in prevalence rate. b) During last year: The diseases of diegestive system ranked the highest 133.0 in boys and next, the diseases of respiratory system (108.6 in boys). c) Present illness: Number of code III ranked the highest 129.2 and next XII(127.3) in boys but inverted in girls such as XII(144.9) and III(116.7) and also, Number of code XVII was prevalenced twice in boys than in girls. d) Chief complaints by sex: Abdominal pain ranked the highest 71.2 per 1,000 population and next headache (34.7) in boys but headache ranked the heighest 88.5 and next abdominal pain (63.3) in girls. e) Water drinking habit: Number of code IX was higher in habit of raw water drinker than in habit of boiled water drinker and healthy children were higher in boiled water habit group than in raw water habit group. The diseases of respiratory system were the highest 124.74 in girls and next, the diseases of digestive system (52.3 in girls). According to school year, healthy children were increased to higher grades. 3) Average sick day per total surveyed children and patient during last month and last year. a) Per surveyed 1,031 children was 0.28 days during last month and 0.98 days during last year. And also per patient was 1.78 days during last month and 3.22 days during last year. b) Average sick day was higher in girls than in boys during last month, but inverted during last year. 4) Average absented day per total surveyed children and patient during last month and last year. a) Per surveyed 1,031 children were 0.43 days during last month and 3.81 days during last year (omitted 1st school year). b) Per absented children were 2.0 days during last month and 7.10 days during last year. c) Per absented children were 8.16 days in boys and 3.17 days in girls. 5) Utilization of medical facilities: The drug-store was consulted 91.2% of the total utilized boys and girls. The strengthening of medical facilities and medical care activities in health subcenter is urgently required 6) Medical Expenses by period and sex: a) Average medical expenses per surveyed 1,031 children were 35.95 won, per patient were 298.04 won during last month. b) Average medical expenses per survey children (omitted 1st school year) were 80.56 won, per patient were 243.98 won and per treated patient were 318.87 won during last year. c) Medical expenses were higher in boys than in girls. 7) Rohrer index by sex, present illness and school year. a) Average Rohrer index was 129.8 in boys and 126.2 in girls. b) Average Rohrer index was increased for 1st school year to 2nd school year and thereafter falling down step by step by school year. c) Under 151-160 Rohrer index number of code III was the highest and above 151-160 Rohrer index of code XII was peaked.

• Journal of the Korean Society of School Health
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• v.6 no.1
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• pp.9-44
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• 1993

An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.125-129
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• 2016

Background: Patients with differentiated thyroid cancers (DTC) who receive radioactive iodine-131 (RAI) are released from isolation when their dose rate is below the regulatory requirements. The purpose of this study was establish predicting factors for early release from the isolation facility after RAI administration in patients with DTC. Materials and Methods: This was a prospective study which included 96 (58 females and 38 males) patients with DTC who had received RAI from April 2013 till August 2015. The study was duly approved by the ethical committee of the institute. Patients who had complete information of primary tumor size (PTS), serum TSH, stimulated thyroglobulin level [sTg] with antibodies (IU/ml) at the time of RAI treatment were included. All had a normal serum creatinine level. To attain lower effective half-life good hydration and administration of soft laxative were ensured. Dose rate was measured (immediately, 24 h and 36 h) at 1 meter distance from anterior mid trunk and a dose rate <$50{\mu}Sv/h$ was considered as the releasing criterion. At 24 h 50 patients were released while the remaining 46 patients were released at 36 h. A post-ablative whole body scan (PA-WBIS) was performed 5-8 days after RAI ablation in all patients. Results: Patients released after 24 h were significantly younger, had smaller lesions with higher proportion of papillary cancer, lower sTg, lower sTg/TSH ratio and had received a lower dose of RAI as comapred to those who were discharged after 36 h. Serum TSH and gender were not found to have any significant correlation between two cohorts. ROC and multivariate analysis have shown age ${\leq}37years$, PTS ${\leq}3.8cm$, $RAI{\leq}150mCi$, $sTg{\leq}145ng/ml$ and $sTg/TSH{\leq}1.085$ as strong indepedent predictors for early release. Conclusions: We conclude that younger age (${\leq}37years$), smaller tumor size (${\leq}3.8cm$), lower RAI dose (${\leq}150mCi$), lower sTg (${\leq}145ng/ml$) and a lower sTg/TSH ratio (${\leq}1.085$) are significant independent predictors for release at 24 h after RAI treatment in DTC patients. Effective utilization of these factors could help the treating physicians to use limited number of internment facilities with higher throughput, lower cost and lower psychological stress to patients.

• Journal of Preventive Medicine and Public Health
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• v.26 no.1 s.41
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• pp.1-19
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• 1993

Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered faliure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is sucessful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical issurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician prefered pros and 17.7 percent cons, but 38 percent of practicing pharmacist prefered pros and 45.5 percent cons. And pharmacist knew better the content of functional division between physician and pharmacist than physician. As a reason for pros of enforcing functional division between physician and pharmacist, practicing physician emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist prefered generic name (44.0%, 89%) mostly, but physician prefered brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the govermental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached ; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the goverment should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.

• Journal of agricultural medicine and community health
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• v.6 no.1
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• pp.33-41
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• 1981

To investigate the status of medical accident attack rate and medicare utilization during last 27months from 1st Oct., 1977 to 31st Dec. 1979 in the area under Sam Wha Medicare Insurance Union, the study was carried out through analyzing the medicare records of patients who were enrolled. "The medical accident" in this study was used as the meaning of the state that the people who have been treated morbid condition with insurance money. For the study, 2 doctors and one nurse were mobilized and the results are as follows: 1) The total number of the Medicare Insurance Union members among the 37,044 total population of the study area, (Hea-mi, Unsan, Eumam Myun) were 57, 35 composed of 3,000 males (52.3%) and 27, 35 females (47.7%) in 1977, 3,383 composed of 2,006 males (59.3%) 1,377 females (40.7%) in 1978, 2,573 composed of 1,437 males and 1,336 females (44.2%) in 1979. 2) Total number of medical accident attack cases were 6,774 case (partially overlapped the number of the 1977 with that of the 1978) and average annual medical accident attack rate per 1,000 population was 700.9. 3) Five major disease group in the past three years were disease of the respiratory system (177.7), disease of the digestive system (165.8), disease of the skin and subcutaneous(64.9), symptoms, signs and ill-defined conditions (64.6), any injury and poisoning (51.9). Mental disorders (32.6) was the 6th order disease group. 4) The order of the medical accident attack rate of age group per 1,000 population per year was the year group of 0~4(877.8), 45~64(832.6), 25~44(810.3), 5~14(495.1) 15~24(494.7) 65 and over (460.7). 5) Medical accident attack rate of age group per 1,000 population in the 5 major disease groups were the year group of 45~64 (100.0) in the mental disorders 0~4(525.1) in the disease of the respiratory system 45~64 (328.5) in the disease of the digestive system 0~4 (202.8) in the disease of the skin and subcutanous tissue, 25~44 (98.3) in the accidents and poisoning. 6) Monthly medical accidents attack rate were 87.0 in the winter (Dsc., Jan., Feb.) and 86.2 in the summer (Jun., July, Aug.). So the trend of the medical accidents attack rate during the year was bimount figure. 7) Monthly medical accidents attack rate in the major disease group were highest in Jan., Apr., (31.1) in the disease of the respiratory system, in Jan., Feb., Mar. (24.9) in the disease of the digestive system, in Jan., Jun., Aug. (9.8) in the injury and poisoning. 8) Duration of the treatment of the 93.1% of the total cases were within 5 days. 9) 299 cases (4.5%) of the total number of cases, 6,587 cases were referred to secondary and tertiary medicare facilities. 10) The order of the major 10 kinds of diagnosis of the disease, 6,587 cases during 27 months, were URI and chillness (1,063 cases, 16.1%), gastritis(830 cases, 12. 6%) dermatitis(360 cases, 5.5%), bronchitis(291 cases, 4.4%), neurosis (284 cases, 4.3%), contusion (165 cases, 2.5%), tooth extraction (157 cases, 2.4%), tonsillitis (109 cases, 0.7%), laceration (107 cases, 1.6%), neuralgia (105 cases, 1.6%), arthritis (104 cases, 1.6%), otitis media and mastoiditis (103 cases, 1.6%), so total case were 3,678 cases (55.9%).

• Korean Journal of Community Nutrition
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• v.6 no.2
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• pp.218-226
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• 2001

This study was performed to assess the nutritional status, frequency of visiting and necessity of nutrition programs for 157 elderly(male:49, female:108) visiting public health centers in Puchon. The purpose of the study was to provide the basic data for developing a nutrition service model. The subject were investigated by interviews with a questionnaire to obtain dietary data and other information related to public health center. Blood tests for analyzing biochemical status were also carried out. The elderly showed low income status. Ninety two percent of them showed their monthly income was less than 400,000 won and 72.6% was observed as having 30,000 won/month as their pocket money. The most frequent disease reported as having or being treated were hypertension(32.6%), rheumatic arthritis(28.5%), diabetes(10.2%), and stomach disease(8.2%) for males and hypertension(33.1%), diabetes(19.4%), rheumatic arthritis(16.7%), anemia(11.1%) for females. The nutrients whose daily intakes were less than 2/3 of RDA were calcium(37.5% RDA),vitamin A(49.9% RDA), iron(60.0% of RDA) and protein(62.0% RDA) for males and vitamin A(27.7% RDA), vitamin B$_2$(33.3% RDA), calcium(44.1% RDA), iron(53.3% RDA), and niacin(60.0% RDA) for females, respectively. Prevalence of anemia, assessed by hemogloben using WHO definition, were 4.1% for males and 18.5% for females. The percentage of males with hypercholesterolemia( 220 mg/dl) was 2.1% and 19.4% fir females, Two percent of males and 12.0% of females were observed as having a LDL-C higher than 165 mg/dl. The mean fasting blood glucose(FBG) level of males and female was 84.2 mg/dl and 101.7 mg/dl respectively. Two percent of males and 8.3% of females were found with a FBG higher than 140 mg/dl. Seventy one percent of elderly reported they were visiting public health centers at least once per week or more frequently. They were satisfied most with the low medical bills but showed the lowest satisfaction for the facilities of the public health centers. What the nutrition service programs wanted most was nutrition counseling and guidance.