• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.216-223
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• 2018

Objectives: The purpose of the study was to investigate factors affecting the assessment of objective and subjective masticatory ability in the elderly, and to evaluate masticatory ability assessment more accurately. Methods: A total of 112 participants were recruited after oral examination in senior citizen welfare facilities. The participants' masticatory ability was evaluated objectively (Mixing ability index; MAI), and subjectively (Key food intake ability; KFIA). Participants' general characteristics and oral health-related variables were also recorded. Based on masticatory ability assessment, participants were classified as either high or low. IBM SPSS Statistics Ver.23.0 was used for all analyses, including descriptive statistics, Chi-square test, Mann-Whitney U test, Spearman rank correlation, and Logistic regression analysis. Results: Higher masticatory ability was positively correlated with higher scores on MAI and KFIA. Additionally, there was a significant positive correlation between MAI and KFIA. When analyzing factors affecting objective and subjective masticatory ability assessments, Functional tooth units (FTUs) were revealed as a related factor. In subjective masticatory ability assessment, oral moisture, difficulty in chewing, and the Geriatric Oral Health Assessment Index (GOHAI) were also influential factors. Conclusions: In order to accurately assess masticatory ability, it is necessary to use both objective and subjective measures. Additionally, to improve the masticatory ability in the elderly, treatment should be provided to improve overall oral health and satisfaction.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.215-225
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• 1996

Decentralization to local governments and amending of Health Center Law are to promote the efforts of health planning at the level of local agencies. In the health facility planning, it is important to take into account that what to be built, where to be located, how far should be service area and so forth, because health facilities are immovable, and require capital as well as personnel and consumable supplies. The aim of our study, answering to the question of 'where to be located?', is to determine the best location of urban health sub-center. At the local level, planning is the matter of finding the best location of specific facilitiy, in relation to population needs. We confine the accessibility, which is basic to location planning, to geographic one. Location-Allocation Model is used to solve the problem where the location is to maximize geographic accessibility. To minimize the weighted travel distance, objective function, $R_k=\sum{\sum}a_{ij}w_{i}d_{ij}$ is used. Distances are measured indirectly by map measure-meter with 1:25,000 Suwon map, and each potential sites, 10 administrative Dongs in Kwonson Gu, Suwon, are weighted by each number of households, total population, maternal age group, child age group, old age group, Relief for the livelihood, and population/primary health clinics. We find that Kuwoon-Dong, Seodun-Dong, Seryu3-Dong, according the descending orders, are best sites which can minimize the weighted distance, and conclude that it is reasonable to determine the location of urban health sub-center among those sites.

• 한국산업보건학회지
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• 제31권2호
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• pp.156-172
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• 2021

Objectives: To investigate the trends of industrial injuries among long-term health care workers in Korea Methods: T7866 injuries were selected from the total industrial injuries approved by the Industrial Accident Compensation Insurance Act(Occupational Safety and Health Act) among long-term health care workers between 2007 and 2016 in Korea. We analyzied the trends of industrial injuries according to work process, occurrence type, and causes. Results: The industrial injuries among long-term health care workers increased since 2012. The mostly occurred area for industrial injuries were low back areas, which is related that the most serious industrial injuries occurred when the one long-term healthcare worker lift manually the recipient, from bed(ondol, Korean floor heating system) to a wheelchair, bed to bath bed, and wheelchair to bath chair. In addition to this, lack of workforce, increased work intensity due to overwork contributed the increasing of occupational injury. Conclusions: This study suggests that the main causes of industrial injuries were Lack of facilities and equipment for small private long-term care institutions, The physical load that goes into lifting the recipient directly, work intensity such as excessive workload and increased work speed. We suggest that the social publicization of long-term care service for the elderly, avoiding ways to lift recipients directly, introducing lifting machines as well as improving working methods, and reducing the workload of caregivers are required.

• 보건행정학회지
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• 제2권1호
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• pp.17-41
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• 1992

During the month of October, 1990, 676 practicing physicians in Taegu City were surveyed by mail questionnaires about their general characteristics and the reasons why they chose Taegu as a practice location and 331 out of them responded completely. Collected data were analyzed to provide basic reference data for future health manpower policy which intends to solve the problem of geographical maldistribution of physicians, The major findings are as follows: For the question asking why Taegu area is favored, following lists are as the order of their magnitude of the reasons replied by more than 20% of the respondents: 1) Taegu is a foundation of life until now(81.3%) 2) Better educational environments are available for their offsprings(73.7%) 3) They can have intimate relationship with acquaintances or friends sharing same or similar interests(61.0%) 4) Due to characteristics of their specialty, metropolitan seems to fit better(52.0%), 5) They graduated from the medical school in Taegu(49.8%) 6) Never thought of selecting practice location in other area than Taegu without any specific reasons(45.9%) 7) Intelligent communications are available with other physicians(39.9%) 8) More opportunities to participate in social life, such as medical, or alumni association etc., can be given(33.2%) 9) No specific knowledge or relationships with other area are available(32.6%) 10) They finished internship or residency training in Taegu area(31.4%) 11) Facilitation of transferring patients including emergent patients can be obtained (30.8%) 12) Continuing medical educational programs are available(29.9%) 13) Sufficient medical demands are provided because of the large population(28.1%) 14) More chances to be grown up as a medical professionals can be achieved(25.7%) 15) More leizure time can be utilized for cultural activities(23.9%) 16) They had experiences to work in hospitals or facilities in Taegu area(23.3%) 17) Medical facilities of fellow physicians or alumni can be used(20.5%) In addition, 37% of female physicians answered that their spouse strongly influenced them to choose Taegu, and 33.3% of physicians with age of thirty replied that parents did so. Physicians of specialty in radiology, clinical pathology, anatomical pathology, and anesthesiology considered that patients from other hospitals and medical facilities would be referred often to them and that less competition seemed to be expected in their specialty (30.8%). In contrast, general practitioners anticipated that larger population would increase the medical demand(62.5%). 28.6% of medical practitioners who graduated medical schools in other are than Taegu and 22.0% of medical practitioners who were trained in hospitals of other area than Taegu were influenced to choose Taegu by their spouses. In consideration of above findings, we may conclude that long term and rational manpower policies should be implemented to solve the problem of geographical maldistribution of physicians as well as short term physician-inducing policies, and they have to be incorporated with equitable community development.

• 대한예방한의학회지
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• 제4권2호
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• pp.1-24
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• 2000

This study was conducted to examine utilization patterns and determinants of oriental medical services. Data were collected from 545 residents in Taegu city The results of this study are summarized as follows 1) 37.8% of subjects used oriental medical services in the past year. Especially, the female, the ages of 50 and 60 over, the single. low-educated. high-income class, white-collar class, medical insured tended to use more oriental medical services than another groups. 2) 46.7% of users of oriental medical services reported that number of visits in the past year was 2 - 5 times 37 1% of them was 1 times, and 4.5% over 10 times. 3) According to the reasons to choose the oriental medical facilities, most was 'on their own judgement'(48.8%) and 'by the advice of relatives and friends'(42.0%) Regarding to the objectives of using oriental medicine, 68.3% was 'treatment', 31.7% 'health counselling and promotion'. And among diseases of users, diseases of musculo-skeletal system was the highest(54.5%). 4) 57.9% of oriental medical services users had experience of utilizing western medicine on the same diseases. Among peoples with experiencing western medicine on the same diseases. 54.4% received oriental medical services 'in addition to western medicine', 45.6%'in place of western medicine 'And 41.2% of using both services reported that they had difficulty in deciding to choose the type of services -oriental medical services or western medicine-for their diseases. 37.3% of them answered that 'providing relevant information' was the most desirable measure to solve this problem, 27.3% 'establishment of effective referral system between oriental and western medical facilities '23.6% 'cooperative medical treatment systems in the same facilities', 11.8%'integration of oriental medicine into western medicine 5) According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. 6) In regarding to the priority of improvement of oriental medical system,'expansion of insurance benefit package 'ranked first. 'expansion of insurance benefit Package 'ranked second, 'improvement of scientific methods and diagnostic technique 'third, and 'safety of herbal medicine' fourth in order. 7) The significant factors influencing the utilization of oriental medical services were kindness of oriental medical practitioners, efficacy , travel time, age To be brief, utilization rate of oriental medical services in urban area generally tends to be high. There, however, have been various barriers to limit oriental medical services, such as incomplete benefit package of oriental medical insurance and lack of coordination and referral system between oriental and western medical services, lack of scientific diagnostic procedures, high price etc . For the development of oriental medical services, Much attention to remove these limiting factors should be placed. In addition, kindness of oriental medical practitioners , which is expected to be more important factor in the consumer - focused health care environment than ever, should be kept high consistently. Since this study was conducted for specific residents of an urban city. further research including more sampling in different urban areas should be required to generalize the results of the study.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.153-174
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• 1995

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.457-468
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• 1993

본 연구는 1차 의료기관과 3차 진료기관의 검사 내용 및 이들 간의 중복검사율을 파악할 목적으로 대구직할시내 1개 3차 진료기관에 1992년 3월 16일부터 4월 11일까지 진료의뢰서를 갖고 내과, 일반외과, 정형외과, 신경외과 외래를 방문한 초진환자 498명을 대상으로 설문지 및 의무기록을 통해 조사하였는데 그 결과를 요약하면 다음과 같다. 대상자는 3차 진료기관이 속한 중진료권에 거주하는 환자가 48.8%였고 나머지가 대진료권에 속한 환자였으며, 1차 의료기관의 방문목적이 진단과 치료를 위해서 방문한 경우가 74.1%였고 진료의뢰서를 발급받기 위해서가 25.9%였다. 진료의뢰서를 본인이 원해 발급받은 경우가 전체의 52.6%였는데 순수하게 의사의 판단에 의해 발급받은 환자가 47.4%로서 아직도 환자 의뢰체계가 제대로 완비되었다고 말하기 어렵다. 진료의뢰서의 발급기관은 의원급이 67.5%, 병원급이 16.3%, 보건기관이 14.2%였다. 1차 의료기관에서 검사를 하고 3차 진료기관을 방문한 환자는 49.4%였는데, 이 중에서 진료한 1차 의료기관에서 다른 진료기관으로 검사를 의뢰해서 검사를 실시한 경우가 7.8%였다. 1차 의료기관에서는 대상자의 20.9%가 X-ray 검사를 받았고, 10.6%가 소변검사, 9.0%가 심전도검사를 받았으며, 의료보험 비급여 대상종목인 컴퓨터단층촬영과 초음파검사는 각각 3.4%, 6.4%였다. 3차 진료기관에서도 방문환자의 45.2%가 X-ray 검사를 받았고, 간기능검사 24.7%, 소변검사 19.1%, 심전도검사 15.7%의 순으로 나타났다. 1차 의료기관에서 검사를 받은 사람 중 검사결과지를 지참한 환자의 비율은 컴퓨터단층촬영이 76.5%로 가장 많았고, 다음이 초음파검사로 31.3%여서 고가 의료장비 이용시 검사결과지 지참율이 높았다. 1차 의료기관과 3차 진료기관에서의 중복검사율은 각 진료과에 따라 특성이 있으나 전체적으로 보면 갑상선 기능검사가 71.4%로 가장 높았고, 다음이 혈액검사(Routine CBC)가 67.9%, X-ray검사가 64.4%였다. 그리고 초음파검사 62.5%, 컴퓨터단층촬영 11.8%, 심전도검사 35.6%, 위내시경검사 45.2%였다. 1차 의료기관에서의 검사결과지를 지참한 경우만을 기준으로 하면 혈액 검사가 75.0%, 간기능검사가 72.7%로 높았으나 X-ray 52.2%, 초음파검사 60.0%였는데, 고가장비인 컴퓨터 단층촬영은 15.4%였다. 이상의 결과에서 3차 진료기관에서는 1차 의료기관에서 실시한 검사를 중복검사한 경우가 많고 1차 의료기관에서의 검사결과지를 지참하는 환자의 중복검사율도 특수한 경우를 제외하고는 큰 차이가 없었음을 감안할 때 진료의뢰시 보다 상세한 진료결과지를 지참하도록 하는 등 환자의뢰체계를 합리적으로 개선하여야 확인검사로 인한 중복검사를 경감시킬 수 있을 것으로 생각된다. 아울러 불필요한 검사를 줄이기 위해서는 의료분쟁을 줄일 수 있는 방안이 마련되어야 하고, 의료보험수가의 조정도 필요할 것이다.

• 한국실내디자인학회:학술대회논문집
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• 한국실내디자인학회 2005년도 추계학술발표대회 논문집
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• pp.235-236
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• 2005

A medical college is faculty which performs frequent experiments and holds lots of seminars for these reasons, this place was designed to exchange its concentration, taking its spatial psychology convenience and its functions into consideration. This space has been built up as the technological and multi-functional space to encourage it to accomplish special functions required by each of facilities, such as the president room, a main center of administration in the medical college, an audience chamber, an attached room, the room for alumni, preventive medicine and Micro biological diseases, a legal medicine lecture room, the room for basic medical science and a conference room.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.564-578
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• 1998

본 연구는 우리나라 노인요양시설의 종사자 배치현황을 검토하고, 노인요양시설에 수용되어 있는 노인들의 건강상태와 돌봄 필요시간을 측정함으로써 건강상태와 돌봄필요도에 따라 필요한 돌봄인력의 추정에 기초자료로 활용될 수 있도록 하고자 하였다. 본 연구의 대상은 강원도 2개 요양시설과 서울 2개 요양시설에 수용되어 있는 187명의 노인에 대하여 직접면접조사를 실시하였고, 159 명에 대하여 면접이 이루어져 85%의 조사율을 보였다. 각 시설의 시설장 및 총무를 대상으로 시설인력현황을 조사표를 통하여 직접 작성하게 하였다. 강원도와 서울 일부 요양원에 입소하고 있는 노인들의 인구사회학적 특성에 대해서는 본 대학원 석사과정 학생 6명이 노인들을 대상으로 직접 면접조사를 실시하였고, 돌봄 소요시간의 경우, 입소노인의 돌봄을 담당하는 간호(조무)사 및 생활보조원을 대상으로 조사표를 통하여 직접 작성하게 하였다. 이상의 연구방법을 통하여 다음과 같은 결론을 얻었다. 1. 조사대상 4개 요양시설 모두 노인복지시설의 인력기준에 미달하고 있다. 2. 노인의 건강평가도구 중 ADL이 노인의 총 돌봄 필요시간과 가장 높은 상관성을 보여주고 있고, 다중 회귀분석의 결과, 돌봄 소요시간에 영향을 주는 유의한 변수는 단지 일상생활 수행능력 하나였고, 일상생활 수행능력 점수가 클수록, 즉 노인의 의존도가 클수록 돌봄 소요시간이 커지는 경향이 있었다. 3. 개별 입소노인의 ADL 총 점수를 네 그룹으로 나누었을 때, 그룹별 평균 돌봄 소요시간은 I군에서 IV군이 각각 하루에 15.3분, 21.1분, 36.7분, 88.8분의 돌봄서비스를 요구하고 있다. 4. 노인요양시설별로 ADL 그룹별 환자의 분포를 보면, 전체적으로 II군에 속하는 노인은 40.0%로 가장 많았으며, I군, III군, IV군의 순을 보여주고 있다. 시설별로 ADL 그룹별 환자의 수는 유의한 차이를 보여주지 못하고 있다. 5. 모든 요양시설의 간호사와 보조원 수는 입소노인의 건강상태를 반영하여 추정한 적정인력에 미치지 못하고 있다. 그러나, 법정기준에 의한 간호사와 보조원수는 노인의 돌봄필요도를 반영하여 추정한 수 보다 높게 나타나고 있어 본 연구의 조사대상 요양시설과 비슷한 건강분포를 보이는 노인요양시설의 경우에는 법정기준에 부합하다고 할 수 있다. 그리고, 노인복지사업지침에 근거한 예산지원기준을 적용시킬 때는 모든 요양시설에서 적정인력에 미치지 못하고 있음을 알 수 있다. 6. 무료노인요양시설의 전문인력을 확보하기 위해서는, 무엇보다도 사회복지 시설 종사자에 대한 처우 개선방향과 상응하는 방향으로, 급여수준을 상향조정하여야 할 것이다. 7. 노인들의 요양필요도를 실제적으로 파악함에 있어 ADL을 이용한 건강지표가 장기적으로는 노인요양 시설의 단순 입소판정기준으로 사용될 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.29-44
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• 1989

도시지역 주민의 의료기관 이용률과 그 관련요인을 조사분석 하기 위하여 1988년 7월 3일부터 7월15일까지 1단계 단순집락 표본추출을 통하여 선정한 대구시 남구 지역의 450가구를 대상으로 면접조사를 실시하여 431가구 1,723명에 대한 자료를 분석하여 다음과 같은 결과를 얻었다. 대상자 1,000명당 조사기간 2주간의 급성이환율은 101이었고 9세이하군에서 202로 가장 높았고, 지난 1년간 만성이환율은 77이었으며 고연령층, 저소득층 그리고 의료보호 적용군 등에서 유의하게 높았다(p<0.01). 대상자 1,000명당 2주간의 의료기관 이용률은 689이었고, 이중 병의원이용률이 294로 가장 높았고, 약국 보건소 그리고 한의원 및 한약방 순이었다. 성별로는 여자가 785회로 남자 591보다 높았으며, 연령별로는 70세이상 군이 2,022회로 가장 높았다(p<0.01). 그외 특성에서는 의료보호 적용군 2,057(p<0.01), 월30만원미만 소득군 346, 자영업이 907로 가장 높았다. 2주간의 의료기관 이용자 1인당 평균 방문회수는 3.25회이었고, 이중 병의원이 3.26회로 가장 많았으며, 한의원 및 한약방, 약국 그리고 보건소 순이었다. 성별로는 여자가 3.47회로 남자보다 많았다. 그외 50대연령군이 5.02회, 의료보호적용군 6.41회, 월30만원미만 소득군 3.78회, 그리고 생산직이 3.64회로 가장 많았다. 대상자 1,000명당 연간입원율은 27.6이었고, 여자 38.9 남자 16.3으로 여자가 높았고 연령별로는 70세이상군이 133.3으로 가장 높았다. 의료보장상태별로는 의료보험적용군이 비적용군보다 2배이상 높았으며, 의료보호적용군에서는 한건도 없었다. 월 30만원미만 소득군이 20.8로 가장 낮았으며 소득이 증가할수록 입원율이 높아졌다. 직업별로는 무직 및 기타직이 35.9로 가장 높았고, 전문, 관리 및 사무직이 가장 낮았다. 입원의료 이용자 1인당 연평균 입원일수는 총 22.5일이었으며, 성별로는 남자가 28.1일로 여자보다 많았다. 연령별로는 40대가 72.3일로 가장많았다. 직장, 직종 및 지역의료보험적용군이 28.8일, 월 30만원미만 소득군이 44.5일 그리고 무직 및 기타직이 21.9일로 가장 많았다. 대상자 1,000명당 연간 총 입원일수는 560일이었으며, 여자가 661일로 남자보다 많았으며, 연령별로는 70세이상군이 2,800일로 가장많았다. 의료보험 적용군이 비적용군보다 3배이상 많았으며, 직업별로는 무직 및 기타직이 789일로 가장 많았다. 2주간 병의원 이용여부를 종속변수로 한 지수형회귀분석에서 유의한 계수는 9세이하군(+), 70세이상군(+), 급성질병(+), 만성질병(+), 공 교의료보험적용(+), 직장, 직종 및 지역의료보험적용(+) 그리고 전문, 관리 및 사무직(-) 등이었다. 약국이용여부 분석에서는 9세이하군(+), 50-69세군(+), 70세이상군(+), 금성질병(+), 만상질병(+) 그리고 공.교의료보험적용(-) 등이 유의하였다. 2주간의 병의원 외래이용회수에 대한 중회귀분석에서는 급성질병(+), 만성질병(+) 직장, 직종 및 지역의료보험적용(+), 전문, 관리 및 사무직(-) 등이 유의한 변수였으며, 약국이용회수 분석에서는 급성질병(+), 만성질병(+), 공.교의료보험적용(-) 그리고 직장, 직종 및 지역의료보험적용(-)등이 유의하다. 연간 입원의료 이용여부에 대한 지수형 회귀분석에서 통계적으로 유의한 변수로는 9세이하군(+), 70세이상군(+), 만성질병(+), 공.교의료보험적용(+) 그리고 직장, 직종 및 지역의료보험적용(+) 등이었다.