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Factors Affecting the Intention to Revisit and to Recommend to others a Korean Medicine Clinic (한방의료기관의 재방문 및 추천의사에 영향을 미치는 요인)

  • Kim, Jae-Woo;Kim, Sung-Ho;Kang, Jung-Kyu
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.2
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    • pp.75-85
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    • 2022
  • Objectives : The purpose of this study is to analyze the association between the satisfaction of Korean Medicine users and their intention to revisit and to recommend to others. Methods : This study conducted frequency analysis, chi-square test, and logistic regression analysis on 1,010 male and female Korean Medicine users aged 19 or higher in the country using data from the 2017 Korean Medicine Utilization and Herbal Medicine Consumption Survey. Results : The results of analyses revealed that the facilities in Korean Medicine clinics, the results of treatment, and the attitude of nurses and medical staff were the significant influencing factors on the intention to revisit and to recommend to others. Other than the above factors, the attitude toward medical treatment of Korean Medicine doctors and the satisfaction with an explanation of the treatment procedures were found to be important influencing factors on the intention to recommend to others. Conclusions : In order to increase the intention to revisit and to recommend to others a Korean Medicine clinics, the top priority lies in both proving high-quality medical services and promoting kind attitudes of medical staff.

A Study on the Determinants of Intention to Take Herbal Medicine among Individuals with Experience in Korean Medicine (한방의료 경험자의 첩약 복용 의향의 결정요인에 관한 연구)

  • Jae-Woo Kim;Sung-Ho Kim;Jung-Kyu Kang
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.59-67
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    • 2024
  • Objectives : This study aims to systematically examine the determinants of the intention to take herbal medicine among individuals with experience in Korean medicine. Methods : This study utilized the 3,245 respondents from the 2020 Korean Medicine Utilization and Herbal Medicine Consumption Survey who reported having used Korean medical services; the responses were selected through a complex sample analysis, and analytics techniques including frequency analysis, Rao-scott chisquare test, and logistic regression were used to analyze the responses. Results : The results of data analysis reveal that the intention to take herbal medicine in the future among these individuals was significantly influenced by factors such as enrollment in private health insurance, the facility environment of Korean medical institutions, and treatment outcomes. Conclusions : Therefore, it is imperative for Korean medical institutions to continuously try reasonable action strategies, including improving medical facilities/environments and building institutional mechanisms among medical staff and members to enhance the quality of Korean medical services. Additionally, the Ministry of Health and Welfare needs to make policy efforts to reduce patients' medical expenses, such as reducing the co-insurance rate in the pilot project of applying health insurance to herbal medicine.

Health Care Utilization and Its Determinants among Island Inhabitants (도서지역주민의 의료이용양상과 그 결정요인)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Park, Chong-Yon;Lee, Myung-Keun
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.287-300
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    • 1987
  • Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on S islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory carl utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.

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An Observation on the Incidence of Drowning Death in Korea (익사(溺死) ($WHO-E_{929},\;E_{934}$)의 역학적(疫學的) 관찰(觀察))

  • Chee, Chang-Yong;Kim, Young-Chun;Lee, Byung-Joo;Chu, In-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.79-86
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    • 1968
  • This paper describes the incidence and some epidemiological features of drowning accident out of a series of our study on the epidemiology of various accidents in Korea. By the daily press it is apparent from the frequent reporting of swimming accidents that the incidence would be high. In the rural areas, there are, at present, about 1,250 artificial lakes and farm ponds to be utlized for rice production. The reservoirs, irrigation ditches and riversides are also used for recreation. In most places facilities for aquatic activities is meager, and safety measures for the prevention of drowning is not sufficiently enforced. In the survey crude data on drownings were collected from the concerned governmental statistic books for the period 1955 to 1967 which were compiled not in a uniform way. Drownings were classfied into two categories, one is accidental drowning, E 929 and the other is due to cataclysm, E 934, according to the WHO international classification of diseases. Epidemiological variables in relation to drowning accident were obtained through qualitative analysis of informations from the popular news papers. The following summary may be drawn; 1. The average number of deaths due to accidental drowning totaled 1,088 annually and the mortality rate per 100,000 population was 3.4, The 42.0% of all drownings were rescued and the remaining were not saved. 2. The sex ratio (M/F) of the victims for all ages was 5 to 1, which had a wide range of difference among the age groups. The young ages less than 20 years occupied 68.0% of all deaths. 3. The percentage distribution of the causes of accidents revealed 31.9% for careless swimming, 45.5% for unskilled, 10.6% for swimmer's cramp and 6.0% for drunked. The distribution of places where accidents occurred showed 88.0% for rivers, water reservoirs, irrigation ditches and 12.0% for regular swimming pools. The seasonal distribution of cases indicated 85.0% of the total were seen during the summer months, June-August, and 50.0% of them occurred on Sundays, 4. The average annual deaths due to cataclysm were 402 and mortality rate per 100,000 population was 1.6, but the number of victims due to cataclysm varied greatly each year. 5. The accident cases due to cataclysm were classified into 60.0% for injuries, 40.0% for deaths. The 26.8% of all deaths were missing cases. 6. The deaths due to either accidental drowning or cataclysm totaled 1,490, and the death rate per 100,000 for the whole country was 5.0.

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A Study on the Safety Improvement in Incineration System from the Case Study of Acrylic acid manufacturing process Accident (아크릴산 제조공정 사고사례를 통한 소각 시스템의 안전성 향상 방안)

  • Ma, Byung-Chol;Lee, Keun-Won;Im, Ji-Pyo;Kim, Young-Chul
    • Journal of the Korean Institute of Gas
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    • v.16 no.4
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    • pp.52-58
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    • 2012
  • Recently, waste gas incineration is increasing due to strong environmental regulatory system in Korea. These incinerating facilities are usually connected with the top of the storage tank through pipeline and incinerate off gas with the flame. Therefore, the flame originated from these facilities is likely to move back into pipeline and might cause an explosion of the storage tank. Accordingly, the purpose of this study is to suggest the preventive measures and the way to improve the safety of these incineration systems through the cause analysis of a major industrial accident occurred in a acrylic acid manufacturing process in Korea. As a result of the study, the preventive measures are suggested as follows. (1) Air or inert gas inflow facilities should be well designed to dilute flammable gases into air or inert gas sufficiently before the blower is restarted in order to prevent the explosion (2) It is needed for the detonation-type flame arresters to be installed on the top of the storage tanks. (3) In case of using the deflagration-type flame arresters, it is necessary to install a rupture disk before the arresters, or blow off the flame outside tanks by connecting the tank top and the incinerator with hood-type pipe. (4) TDR should be installed to be restarted automatically after the momentary power failure.

<Field Action Report> Local Governance for COVID-19 Response of Daegu Metropolitan City (<사례보고> 코로나바이러스감염증-19 유행과 로컬 거버넌스 - 2020년 대구광역시 유행에 대한 대응을 중심으로 -)

  • Kyeong-Soo Lee;Jung Jeung Lee;Keon-Yeop Kim;Jong-Yeon Kim;Tae-Yoon Hwang;Nam-Soo Hong;Jun Hyun Hwang;Jaeyoung Ha
    • Journal of agricultural medicine and community health
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    • v.49 no.1
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    • pp.13-36
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    • 2024
  • Objectives: The purpose of this field case report is 1) to analyze the community's strategy and performance in responding to infectious diseases through the case of COVID-19 infectious disease crisis response of Daegu Metropolitan City, and 2) to interpret this case using governance theory and infectious disease response governance framework. and 3) to propose a strategic model to prepare for future infectious disease outbreaks of the community. Methods: Cases of Daegu Metropolitan City's infectious disease crisis response were analyzed through researchers' participatory observations. And review of OVID-19 White Paper of Daegu Metropolitan City, Daegu Medical Association's COVID-19 White Paper, and literature review of domestic and international governance, and administrative documents. Results: Through the researcher's participatory observation and literature review, 1) establishment of leadership and response system to respond to the infectious disease crisis in Daegu Metropolitan City, 2) citizen's participation and communication strategy through the pan-citizen response committee, 3) cooperation between Daegu Metropolitan City and governance of public-private medical facilities, 4) decision-making and crisis response through participation and communication between the Daegu Metropolitan City Medical Association, Medi-City Daegu Council, and medical experts of private sector, 5) symptom monitoring and patient triage strategies and treatment response for confirmed infectious disease patients by member of Daegu Medical Association, 6) strategies and implications for establishing and utilizing a local infectious disease crisis response information system were derived. Conclusions: The results of the study empirically demonstrate that collaborative governance of the community through the participation of citizens, private sector experts, and community medical facilities is a key element for effective response to infectious disease crises.

Relationship between structural characteristics and hospital mortality rates on tertiary referral hospitals in Korea (우리나라 3차진료기관의 구조적인 특성과 병원사망률의 관계)

  • Sohn, Tae-Yong;Yu, Seung-Hum
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.279-294
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    • 1996
  • This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

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An Evaluative Analysis of the Referral System for Insurance Patients (보험진료체계 개편의 효과에 대한 연구)

  • Han, Dal-Sun;Kim, Byungy-Ik;Lee, Young-Jo;Bae, Sang-Soo;Kwon, Soon-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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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.

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Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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Effect of the non-Medical Services on Attitude to Hospital Utilization (의료기술외적 병원써비스가 병원이용태도에 미치는 영향)

  • Lee, Hyun-Kyung;Chang, Im-Won
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.442-450
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    • 1988
  • Effects of various factors related to the process of social action of hospital services on the selecting a hospital were investigated by using of questionnaires answered by 1,319 patients in a certain University Hospital, in Chungchongnam-Do, from November, 1986 to November, 1987. The results summarized were as follows ; 1. Each of the examined factors, that is, sincerity of an attendant physician in medical treatment and explaining the condition of a disease, confidence to doctor and nurse, doctor's and nurse's response to calling by patient, kindness of the hospital staffs and food handlers, sanitariness of hospital, cleanness of clothes and bed sheets, hospital foods, and rest surroundings, are not solely decisive to attitude of hospital utilization, but the factors effects compositely on hospital utilization 2. Hospital services of the social action process are more effective to hospital utilization in cases of the hospitalization caused by the traffic facility than for the medical skill and facilities.

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