Objectives : To help develop strategies to cope with the changes arising from the rapid aging process by predicting the determining factors of intention to actual use of the charged long-term care services for elderly as perceived by the middle aged who play the major role of supports. Methods : Subjects were the parents (men 177, women 507) in their 40s of the students selected from a university of Busan city. A questionnaire survey was conducted for 4 weeks in October 2003 about the knowledge for long-term care service, the intention of actual use, and the preferences about the type of service suppliers. Data analysis was performed with frequency, chi-square test, and t-test using SPSS program (ver 10.0K), along with data mining using decision tree of Enterprise Miner V8.2 by SAS. Results : About half of the subjects (53.7%) had the actual experiences of elderly supports. Intentions to use the charged services were relatively high in home visiting nursing care service (40.1%) and long-term care facilities service (40.4%), and were influenced by previous knowledge about the services. The intentions were stronger in women, those with higher education, and those with greater income levels. Actual elderly supports were mostly (80%) done by women, and the perceived burdens for the supports were bigger in women and those of lower socioeconomic level. Desired charges were about 10,000 won for the bath service, 20,000 won for the rests services per day, and about 500,000 won for the long-term care facilities service per month. From the result of decision tree analysis, the job professionalism was the most important determining factor of intention to actual use of the services with validation as $63{\sim}71%$. Health and welfare mixed type facilities were preferred, and the most important consideration was the level of professionalism. Conclusions : Intention to actual use of the charged services was largely determined by the aspects of time and cost. Polices to increase the number of service suppliers and to decrease the burdens perceived by actual supporters were strongly recommended.
Subjects in this study comprised of general public (907), high school students (772), individuals associated with Oriental medicine (660), and 60 majoring in western medicine, totalling 2,413 individuals. Survey was conducted on the necessity of establishing Oriental medicine school at the national university level and the following result were obtained: - 78.3% (1847 individuals) were in favor of establishing Oriental medicine school at the national university level. - For the validity of establishment, responders expressed opinions of standard and virtuous education, higher quality education, standardized practice, research on difficult to cure diseases, and obtaining competitiveness in the world market. - One to three schools were considered as an appropriate number of schools with less than 80 students per class, Class size may be adjusted from existing schools (52.5% favored decrease in size) and (46.3% favored increase in size). - Educational and research facilities must be accopanied with schools of Oriental medicine as well as clinical training facilities, herbal pharmaceutical research centers, and fundamental medical centers. - Many favored 6 year curriculum as the most appropriate system and the school of Oriental medicine should be established within the university. Based on the information gathered in this survey, we may recognize the limitations of Oriental medicine schools at the private institutional level and support the establishment of Oriental medicine schools at th national university level. This establishment may play as a steeping stone for advancement in education, standardization of research and treatment, and commercialization of Oriental medicine of benefit the general public.
Objectives: This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model. Methods: After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu's responses were organized into 4 phases and evaluated by applying the response model. Results: In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation-based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing. Conclusions: This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.
There are customer services jointly provided by two facilities so that each customer will complete the course made up of both facilities' sub-services. The two facilities are assumed invested respectively by an infrastructure owner and one subordinate facility owner, whose partnership is built on their capital investments. This paper presents a mathematical model of Stackelberg competition between the two facility owners to derive their optimal Nash equilibrium. In this study, each facility owner's profit is consisted of fixed revenue fractions of sold services, operating costs (including depreciation cost) and maintenance costs of her facility. The maintenance costs of one facility are incurred both by failures and deterioration due to usage. Moreover, for both facilities, failures are rectified immediately by minimal repairs and preventive maintenance is carried out at a fixed time epoch. Additional assumptions are also employed to develop the model such as customer arrivals are manipulated to follow a Poisson process, and each facility's lifetime is independently Weibull-distributed. The Stackelberg game proceeds as follows. At the first stage of decision making process, the infrastructure owner (acting as a leader) decides the allocation of revenue shares based on her self-interest. After observing the allocation of revenue shares, the subordinate facility owner determines her own optimal price of services. This paper investigates actions and reactions of the two partners in the system. Then analytical conditions are proposed to achieve a unique optimal Nash equilibrium. Finally, some suggestions for further research are discussed.
The purpose of this study is the impact of national fishing port investment and typhoons on fisheries disaster damage. The dependent variables were the amount of damage to fishing ports, fishing boats, fisheries enhancement, external facilities, mooring facilities, functional facilities, fishing port and typhoons. The analysis period is from 2002 to 2018. Since the error term is in a simultaneous correlation, it was efficiently estimated by analyzing it with a seemingly unrelated regression (SUR) method. As a result of the analysis, external facilities have not significance to all models. Investing in mooring facilities increased the amount of damage to fishing ports for five years. Investing in functional facilities reduced the amount of damage to fishing ports and aquaculture over five years. Typhoons have significance to all models, and the amount of damage increased every time a typhoon occurred. Based on these results, as the influence of typhoons increases, it seems necessary to establish preventive measures. Timely investment and maintenance to enable the role and function of national fishing ports are considered important.
Assessment of perceptions of the community, the determinants and development of their behavior regarding common malignancies, helps in establishing evidence-based activities for prevention and early diagnosis of cancer. However information on this important aspect is lacking in our country. Qualitative methods were here used to obtain information through in depth interviews and Focus Group Discussions (FGDs) with all categories of identified stakeholders. Most were unaware of the activities of the cancer control program. Even the providers were not fully conversant. All respondents mentioned lack of diagnostic and treatment facilities in government, primary and secondary level facilities. Perceptions of different categories of stakeholders regarding why many community members did not attend screening camps and other services reflect the determinants of community behavior, acting independently as well as in combination. The cancer control program was thought to be restricted only to some private facilities and overcrowded government tertiary care facilities where the visits were time consuming. Almost all the facilities were considered curative oriented. Issues of supervision, monitoring and feedback were inadequately addressed by providers who were inadequately trained in many program activities. The program lacked effective planning, coordination and appropriate implementation at the grass roots level in Delhi. Social mobilization was grossly inadequate, as most of the community members were unaware of the existence of the program. Misconceptions about the risk factors, signs and symptoms, diagnosis, and treatment were common amongst community members as well as many of the providers. Thus the national cancer control program in our country needs further community participation and social mobilization. Accessibility, availability, acceptability and affordability of various preventive, curative and rehabilitative activities, as well as intersectoral coordination, training, supervision and monitoring of program activities, all need to be addressed to ensure the success of this important public health program.
Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.
The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.
For the longest time, our government has played an inconsiderable role in the public health services of Korea, especially as it relates to their investment. Voices have cried out against increases in national health expenditure and for more establishment of public medical facilities. In light of this, the necessity and importance of public medical facilities have come into focus amidst the recent medical crisis. When public medical facilities filled in the gap created by the suspension or closure of private hospitals and clinics as a result of this national crisis and acted as a safety net, the demand for more establishment of such facilities increased. Although patient diagnosis and treatment are the first priority of public medical facilities, they must also deal with scopes that private medical facilities do not deal with, dislike, or have difficulty with. In this respect, the closure or privatization of public hospitals to reduce their number just because of their low profits or financial burdens that must be carried by the government is to ignore their innate importance and social role; therefore, we must do all we can to block such efforts and further empower these public health facilities according to demands of the time. The improvement of public health services can be realized by redefining its goals and roles, increasing government funding, strengthening of existing public health facilities and reorganizing the public health services system. Even if public health facilities were to increase their medical services and be reinforced, they cannot take on all the services related to public health services, Therefore, in a country like ours where public health services come second to private health services in the health care system, the health of citizens can be safeguarded only when private and public facilities cooperate and private medical facilities share the social responsibilities. Only the show of interest and effort by government, politicians, health professionals, professional organizations and public can initiate the improvement that is sought.
This study explores a model that examines how multidimensional risk factors explain mental health problems of young offenders. One hundred and ninety six students aged 13 to 15 in correctional facilities were assessed for mental health symptoms that examined the effects of multifaceted risk factors on mental health conditions. Consistent with the hypothesis of this study, secure unit students appear to have experienced various forms of risk factors and those factors have influenced mental health conditions. Results show that correctional facilities should reframe therapeutic and preventive approaches to disadvantaged students and develop integrated services and programs for rehabilitation and reintegration into society. It is recommended that those involved in treatment plans in correctional facilities consider that different treatment plans are necessary for each young offender.
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