• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.51-64
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• 2002

This study was aimed to provide the basic data for the development of effective educational program by reflecting the opinions of the visiting health service workers. The subjects were 144 visiting health service workers in Gwangju and Jeollanam-do area who responded the mail questionnaire. The data were collected from June to July, 2001 using questionnaire composed of the education need, knowledge by subjective appraisal, and experience of education. The major findings of this study were as follows: 1. The number of respondents who received at least one education within recent three years were 43(29.9%) at the central level, 57(39.6%) at the provincial level and 53(36.8%) at the district level. The satisfaction with education was higher at the central level than at the provincial and district level. 2. Knowledges by subjective appraisal on the 'chronic degenerative diseases management' and 'health promotion' was relatively high. while that of 'rehabilitation' was low. 3. The knowledge by subjective appraisal of visiting health service was related with experience of education and license status. The knowledge was higher in registered nurses than in nurse aids. The curricula related to increased level of knowledge of visting health service workers were 'elderly health care', 'rehabilitation' and 'psychiatric-mental health nursing' educations at the central level 'continuing education for the community health practioners' and 'psychiatric-mental health education' at the provincial level and 'elderly health care', 'rehabilitation' 'psychiatric-mental health' and 'acute diseases control' educations at the district level. 4. The respondents preferred elderly health management as the contents of education, officer group education as the method of education, province(30.4%) as the main body of education, exercise and practice as the form of education, 2-3 times per year as the frequency of education, and 3-5days as the period of education. The findings of this study could suggest that future education program should be planned to increae the knowledge level of visiting health service workers by reflecting their educational need.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.427-440
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• 2000

A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.87-105
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• 2003

Objectives: The purpose of this study was to examine the health care utilization pattern and its related factors of low-income population with abnormal results through health examination. Methods: Analysed data were collected through a questionnaire survey, which was given to 263 persons who 30 years or over with abnormal results through health examination at Health Center. This survey was conducted in March, 2003. This study employed Andersen's prediction model as most well known medical demand mode and data were analysed through 2-test, and multiple logistic regression analysis. Results: The proportion of medical utilization for thorough examination or treatment among study subjects was 51.0%. In multiple logistic regression analysis as dependent variable with medical utilization, the variables affecting the medical utilization were 'feeling about abnormal result(anxiety versus no anxiety: odds ratio 2.25, 95% confidence intervals 1.07-4.75)', 'type of health security(medicaid type I versus health insurance: odds ratio 2.82, 95% confidence intervals 1.04-7.66; medicaid type II versus health insurance: odds ratio 3.22, 95% confidence intervals 1.37-7.53)', 'experience of health examination during past 2 years(odds ratio 2.39, 95% confidence intervals 1.09-5.21)' and 'family member's response for abnormal result(recommendation for medical utilization versus no response: odds ratio 4.90, 95% confidence intervals 1.75-13.75; family member recommended to utilize medical facilities with him/her versus no response: odds ratio 19.47, 95% confidence intervals 5.01-75.73)'. The time of medical utilization was 8-15 days after they received the result(29.9%), 16-30 days after they receive the result(27.6%), 2-7 days after they received the result(20.9%) in order. The most important reason why they didn't take a medical utilization was that it seemed insignificant to them(32.4%). Conclusions: In order to promote medical utilization of low-income population, health education for abnormal result and its management would be necessary to family member as well as person with abnormal result. And follow-up management program for person with abnormal result through health examination such as home-visit health care would be necessary.

• Journal of the Korean Institute of Landscape Architecture
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• v.42 no.5
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• pp.52-63
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• 2014

This is the study on users' perception gap about the effects of leisure space development of the Han River Citizen Park according to leisure constraints and was to identify leisure constraints expressed when using Han River Citizen Park and identify perception on positive and negative impacts according to use behavior characteristics of Han River Citizen Park and leisure space development. In order to compare and analyze the perception gap about the leisure space development of Han River Citizen Park users according to leisure constraints, we classified information and resources, economic affordability, free time on leisure activities in Han River Citizen Park into high influence group and low influence group and did an in-depth analysis. The results are as follows. First, Han River Citizen Park has the nature of neighborhood use with little influence on leisure constraints such as jogging and marathon, biking etc. including walking and relaxation and was a place to visit for simple exercises. Second, in the effects according to leisure space development of Han River Citizen Park, affordable leisure activity costs and ease of access were evaluated the most highly and congestion due to increasing users, increase in administrative operating budget and management personnel were concerned the most. Third, the leisure constraints in Han River Citizen Park were affected in the order of free time, economic affordability, information and resources. There were also perception gaps in congestion due to an increase in administrative operating budget and management personnel, increase in users including improvement of various leisure opportunities and leisure levels, encouragement of pride and attachment for Han river, affordable leisure activity costs depending on the degree of the influence of leisure constraints. Therefore, this study can be said to have the meaning in that we could identify leisure constraints affecting Han River Citizen Park users and resulting perception in leisure space development and revealed that the degree of the influence of leisure constraints varies in the use behavior of leisure space development of Han River Citizen Park and perception of positive and negative development impact. In addition, in order to resolve leisure complaints according to leisure constraints, we studied the need of accompaniment of leisure space operation and management system, development of various customized programs, introduction of recreational space and facilities prioritizing public interest rather than private interest with public relations and information delivery about leisure space of Han River Citizen Park.

• Journal of Distribution Science
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• v.13 no.10
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• pp.115-122
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• 2015

Purpose - This study was conducted to develop a beekeeping farm management standard checklist. This is essential to increase the competitive power of beekeeping farmers. Checklists in relation to crops and livestock were established by the Rural Development Administration in the 2000s. To date, 60 checklists have been created by crop and livestock experts. However, other farmers outside the 60 checklists are increasing. Therefore, extra development is required for these farmers. This study was conducted to meet farmers' requirements. The special farming dealt with in this study is beekeeping. Such checklists were not developed due to the small number of beekeeping farmers. However, these days, a number of such farmers are emerging. Research design, data, and methodology - Many related experts participated in this study. This study was conducted in four stages. First, a basic outline of beekeeping was created by surveying many kinds of beekeeping experts. The draft of the beekeeping checklist was created by a secondary advisory council. This draft was then sent to 14 beekeeping experts to confirm whether or not it was suitable as a management checklist. For collecting the experts' opinions, a direct visit survey was done through an arranged questionnaire. Additionally, a basic management checklist blueprint was reviewed by many experts. In the third stage, a Delphi survey method was utilized with a special Delphi questionnaire. In this stage, experts who participated in the first and second stages were excluded. As there were uncertain answers among them, a second Delphi survey was done. As a result of this survey, all answers were agreed among them. Results - From the results of this survey, four subjects in the management accomplishment index were determined. These are farming scale, average product per beehive, the sale price of honey (1kg), and the number of bee plates in the beehive. In the case of the management checklist content, five items were determined. These are beekeeping farming facilities, the environment around the farm land and general management, the product management of the beekeeping harvest, the management of the disease and pest, and farming management. This checklist will be utilized for beekeeping farmers to implement in a management situation. Conclusions - These days, the number of beekeeping farmers is increasing. The management checklist for beekeeping farmers will be used to improve their farming situation and marketing. Beekeeping farmers can understand their management by reviewing their checklist. After checking, the situation of management can be analyzed. Farmers can supplement weaknesses with expert advice. This checklist will be used by agricultural technique extension workers for farming management consulting. This checklist has to be complemented by a change in the management of the environment. This checklist will be delivered to beekeeping farmers after a verification survey is done. The result of the checklist score will be utilized for a benchmarking service to be implemented for beekeeping farmers to utilize.

• 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.

• Korean Journal of Environment and Ecology
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• v.30 no.2
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• pp.253-260
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• 2016

This research aimed to quantitatively measure the environmental values of Taebaeksan, Naksan, and Gyeongpo provincial parks located in Gangwon-do. The research was based on the CVM technique which estimates the economic values for all kinds of ecosystem. Also, the estimated value of environment goods can suggest the magnitude of additional utility other than the cost people pay when they visit the provincial parks. Such result can be used as basic data in addition to information on natural ecology or cultural landscape to decide whether the park should be promoted as a national park. The questionnaires-collected from Taebaeksan(180 copies), Naksan(179 copies), and Gyeongpo(180 copies) provincial parks were used to measure the environmental value of each provincial park. Variables that affect the response of 'yes(Y)' or 'no(N)' to the cost suggestion for the economic valuation of environment are estimated under the catagories of environment conservation status (env.), degree of park management (manage.), environmental conservation effort, education (edu.), and income (inc.) of the respondents (execu.), pertaining to the 3 provincial parks in Gangwon-do. The value of natural environment to 1 visitor to the 3 Gangwon provincial parks was estimated by the Logit method that Hanemann proposed using the average of inserted variables. The results showed that the additional environmental value that 1 visitor can gain is 44,060 won for Taebaeksan Provincial Park, 41,191 won for Naksan, and 41,844 won for the Gyeongpo Provincial Park. Taebaeksan Provincial Park's environmental value is estimated at the highest as the respondents judge that its natural environment is well preserved and the facilities are managed well.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• Journal of the Korean Institute of Landscape Architecture
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• v.44 no.3
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• pp.25-36
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• 2016

As the first public park in Korea, birth place of the march first independence movement, and a representative space of leisure of old men, Tapgol Park contains diverse symbolisms and meanings. In 2000, Seoul authorities selected the symbolism of the March First independence movement, and carried forward the sacralization project of Tapgol Park. They eliminated facilities, including vending machines, and restricted most of the leisure activities in the park such as drinking singing dancing, speech, playing chess, writing calligraphy, etc., and loitering. Also, they changed the park's design into a less available space with green areas and switched wooden benches to granite stone. Since the project finished, a representative phenomenon was the elderly men's exodus to Jongmyo Park, where the restrictions were not strong as in Tapgol Park. As a result, the numbers of users in Tapgol Park decreased sharply. However, overcrowded(more than 3000) Jongmyo Park is also in the middle of a sacralization project now. According to an investigation including observation and in-depth interview, most of the elderly men who use the parks almost everyday were in the low economic class. They just visit the parks everyday and chat with their peers, gaining comfort from each other. These phenomena can be interpreted as a social exclusion in society, which made the elderly men move to another place. Meanwhile, although fifteen years has passed since the project was completed, many people still regard the Tapgol Park as a place for elderly men instead of the birth place of the March First Independence Movement. This study focused on such problems and vague place identity, which is neither a memorial place nor a public park. The study discovery the fact they missed the symbolism that Tapgol Park was the first urban park of Korea. Also, it stresses that the monumentality does not need to be sacred, reverent, or inflexible. With this point of view, this study discussed public aspect and everydayness, which are included in most of the urban parks. Finally, this study suggests Tapgol Park as an urban park that has an identity that embraces the condition of monumentality, everydayness, and publicness all together.