• Title/Summary/Keyword: care policy

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A Study on Proposal to Develop Senior related Policies : Convergence Approach of both Age Norm and Hoping Activities (우리나라 노인 정책 방향 제언을 위한 탐색적 연구 : 노인 연령규범과 희망활동의 융복합적 관점을 중심으로)

  • Koo, Hye-Gyoung
    • Journal of Digital Convergence
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    • v.14 no.4
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    • pp.101-110
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    • 2016
  • With the result of Korean national senior's real life state survey analysis that is triennially conducted based on Article 5 of Welfare of the Aged Act, this study categorized the senior according to age norm cognition, and figured out the characteristic of each category, and analyzed their needs for life satisfaction and hoping activities. Because the senior at present are on higher level of health, education, and economy than 20 to 30 years ago, it is about time to repeat discussion about the policies established in the past in terms of society, culture, industry, welfare, employment, and participation as a convergence approach. As a result of analysis study, the senior divided into three groups:, resignation type, progressiveness type, and saving appearances type. Their life satisfaction level and hoping activities by senior segment groups are different. By results of this study, the preservation of income for senior will be needed, and they don't want volunteer activities so that there are another policy system will be needed to vitalize senior's social participation for their healthy physical and mental life. Korean senior were satisfied with family members relationship, -although Korean senior's life satisfaction level is not higher so that the new policy to care senior by senior system will be reviewed more actively.

Relationship between Percutaneous Transluminal Coronary Anigioplasty Volume and Associated Immediate Outcome (경피적 관동맥 확장술의 시술량과 조기 시술결과의 관련성)

  • Kim, Yong-Ik;Kim, Chang-Yup;Lee, Young-Sung;Kim, Sun-Mean;Lee, Jin-Seok;Oh, Byung-Hee;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.9-20
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    • 2001
  • Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

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Predicting Ripple Effect Affects Difficulty of Decision-Making: The Mediating Effect of Perceived Accountability for Results of Decision-Making (파급효과 예측과 의사결정의 어려움: 의사결정 결과에 대한 책임감과 부담감의 매개효과)

  • Minjo Lee;Hyekyung Park
    • Korean Journal of Culture and Social Issue
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    • v.23 no.4
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    • pp.557-585
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    • 2017
  • In this research, it was examined whether predicting the ripple effects of events influences decision-making difficulty. In addition, it was examined whether perceived accountability for decision-making results mediates the relation above. In Study 1, participants were presented with policy decision-making vignettes and were asked to report on the ripple effects of their policy decisions as well as on the difficulty of making the decision. Consistent with the hypothesis, the bigger the expected ripple effects, the greater difficulty participants felt in making policy decisions. In Study 2, ripple effect magnitudes were experimentally manipulated such that participants were led to predict big ripple effects in one condition and relatively small ripple effects in another condition. It was investigated whether participants predicting bigger ripple effects would perceive decision-making to be more difficult than participants predicting smaller ripple effects. Whether this relation would be mediated by perceived personal accountability for the results of decision-making was also examined. Consistent with expectations, it was found that in the moral domains of Harm/care, Fairness/reciprocity, and Ingroup/loyalty, participants predicting bigger ripple effects reported more difficult decision-making than their counterparts. The relation above was mediated by perceived personal accountability for decision-making results only in the domain of Ingroup/loyalty. In combination, these results showed that bigger predicted ripple effects contributed to greater decision-making difficulty. In addition, participants felt more responsible for the results of their decisions when predicting bigger ripple effects, which led them to feel greater decision-making difficulty in the domain of Ingroup/loyalty. The implications of these results and future directions for research are discussed.

〈 Field Action Report 〉 The Strategies to Address Regional Health Inequalities in Gyeongsangnam-Do: Health Plus Happiness Plus Projects (〈사례보고〉 경상남도 지역 간 건강불평등 완화사업: 건강플러스 행복플러스 사업)

  • Jeong, Baek-Geun;Kim, Jang-Rak;Kang, Yune-Sik;Park, Ki-Soo;Lee, Jin-Hyang;Jo, Sun-Rae;Seo, Gi-Deok;Joo, Sang-Jun;Oh, Eun-Suk;Kim, Seung-Jin;Jo, Seong-Jin;Kim, Seung-Mi;Yeum, Dong-Mun;Sim, Mi-Young
    • Journal of agricultural medicine and community health
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    • v.37 no.1
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    • pp.36-51
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    • 2012
  • Objectives: This study was conducted to implement Health Plus Happiness Plus projects in Gyeongsangnam-Do and assess the policy implications of initiatives to address regional health inequalities. Methods: Health Plus Happiness Plus projects were started as strategies to address regional health inequalities in Gyeongsangnam-Do. The principles of these projects are taken from the Health Action Zones initiatives in England: participation, partnership, resource concentration in project areas. The time period for these projects is from 2010 to 2017, and the total budget is 5.6 billion won. In 2010, a 6.8 hundred million won total budget was invested in 17 project areas. Such investments fell into four broad categories: establishment of the means and local framework; survey development to analyze the health determinants; development of an education and training center; and establishment of a technical support center. Results: Education and training programs for practitioners and coordinators were provided, and project teams and project promotion committees were established in project areas. Health survey result briefing meetings were held, and 17 health committees were established in project areas. Conclusions: Health Plus Happiness Plus projects have some problems in relation to participation and partnerships, however, if these principled projects are performed continuously, they will contribute to a reduction of standardized mortality rate and regional health inequalities in Gyeongsangnam-Do and the improvement of residents' well-being in project areas.

A Study on the Changes in Ventilator Care Rate and Outcome of Very Low Birth Weight Infants During Last Four Years (최근 4년간 극소 저출생 체중아의 인공 호흡기 치료율과 경과 변화에 관한 연구)

  • Jung, Byun Kyung;Kim, Yeoung Ju;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1073-1079
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    • 2003
  • Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

Family Welfare Policies and Fertility Rate (가족복지정책과 출산율)

  • Chai, Goo-MooK
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.337-361
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    • 2005
  • This study seeks the implications for the Korean family welfare policies after examining the characteristics of fertility rates and family welfare policies of advanced OECD countries, and comparatively analyzing the fertility rates among clusters of countries having similar family welfare policies. The fertility rates of most advanced OECD countries declined below the population replacement level in the 1970s, and continuously declined slowly after that period. But in the 1990s the fertility rate of some countries increased, on the other hand that of other countries declined. Such a difference of fertility rates suggests that there is some correlation between the fertility rate and the family welfare policy of each country. Advanced countries became concerned about the decline of fertility rate, established the government Population Issues Committee in order to deal with population problems, and increased family welfare supports. But the level and pattern(focusing on maternal employment supports or child-rearing supports) of each country's family welfare policies are differently developed according to its political ideology, cultural and historical background, and economic environments. A comparative assessment of the fertility rate among clusters of countries having similar family welfare policies demonstrates that the higher the level of family welfare supports is and the level of maternal employment supports in comparison with that of maternal child-rearing supports is, the higher of fertility rate is. And a comparative assessment of the fertility rate changes among clusters of countries also shows that the higher the level of family welfare supports is and the level of maternal employment supports in comparison with that of maternal child-rearing supports is, the higher the increase of fertility rate is or the lower the decrease of fertility rate is. The implications for the Korean family welfare policies are summarized as follows. First, it is necessary to establish the government Population Issues Committee which can study systematically fertility rates and population problems, and provide comprehensive population measures. Second, family welfare supports should be expanded through the establishment of family allowances, the prolongation of maternity leave and child-care leave and the upward readjustment of child-care leave benefits, and the extension of public child-care facilities. Third, maternal employment supports such as public child-care facilities and maternity leave should be given more weight than maternal child-rearing supports such as family allowance. Fourth, it is required to prepare social environments which can provide the youth with the hope that child-rearing is not difficult and gives them happiness.

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Trends in the Household Labor Time of Korean Adults by Gender and Generation over the Last 20 Years (1999-2019) (한국 여성과 남성의 세대별 가사노동시간의 변화(1999-2019) : 가정관리 및 가족돌봄 시간을 중심으로)

  • Seo, Jiwon;Ki, Eunkwang;Koh, Sun-Kang
    • Journal of Family Resource Management and Policy Review
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    • v.25 no.2
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    • pp.53-78
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    • 2021
  • The concept of household labor is composed of housework and family care, and it provides a framework for understanding daily life from the perspective of work-life balance. The purpose of this study was to investigate the household labor time of Korean adults by gender and generation over the last 20 years. Data was taken from the five Statistics Korea Life Time Surveys from 1999 (t1) to 2019 (t5) (n=69,196). The major results are as follows: first, gender and generation were found to have a significant relationship with household labor time over the study period. Household labor time for females was 3.8 times that of males in 1999, but females' household labor time decreased over the next 20 years while males' increased, including both housework and family care. The female participation rate in household work also remained steady, while that for males increased. Second, in the younger and middle generations, a similar gender and generational pattern was seen. Third, in the older generation, household time and participation rates for both females and males increased. The family welfare policy and theoretical implications of these results are discussed.

Factors Affecting the Registration and Access Levels of the Pilot Project for the General Physician System among People with Disabilities (장애인 건강주치의 시범사업 수요자의 등록 및 이용수준 영향 요인 분석)

  • Eunhee Choe;Yeojeong Gu;Seungji Lim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.185-195
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    • 2024
  • Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

Health Insurance Benefit Criteria and Quality Assurance Policies of Diagnostic Ultrasound Services in Other Countries (주요국의 초음파검사 시행현황과 질 확보방안)

  • Chung, Seol Hee;Lee, Hye Jin;Kim, Han Sang;Oh, Ju-Yeon
    • Health Policy and Management
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    • v.24 no.2
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    • pp.109-119
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    • 2014
  • In accordance with the government's plan to expand the national health insurance (NHI) coverage for severe diseases such as cancer, heart disease, cerebrovascular disease, and rare and incurable disease, the diagnostic ultrasound services have been covered by NHI from October 1, 2013. The quality is very important factor in providing diagnostic services because they influence on the diagnosis, treatment, and outcome of diseases. In particular, equipments and health care providers plays an important role in providing qualitative services. The purpose of this paper is to examine the major feature of ultrasound services covered by health security system and to review quality assurance policies in other countries such as Australia, Japan, the USA, and Canada. In addition, we assessed the implication of those policies. We especially put emphasis on the types and qualifications of healthcare professionals and measures to manage equipments. All countries have reviewed on policies to promote the quality such as educational requirements of professionals or restrictions on the duration of equipment usage. Various measures should be implemented to assure the qualitative ultrasound service.

Self-perception of the Amount of Medical Aid Use of Outpatient Overusers in Korea (의료급여 외래 과다이용자의 의료이용량에 대한 자기인식)

  • Shin, Sun-Mi;Kim, Eui-Sook;Lee, Hee-Woo
    • Health Policy and Management
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    • v.19 no.2
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    • pp.21-35
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    • 2009
  • Limited studies examined Medical Aid recipients' perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.