• 보건행정학회지
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• 제9권4호
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• pp.87-119
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• 1999

The main purpose of this research is to measure and analyze how productive the health centers are and how much inputs(or outputs) in the inefficient health centers should be decreased(or increased) for efficiency. The evaluation of the performance of health centers gives a strong incentive to improve resource allocation in regional health planning. It has been, however, implemented very rarely until now. In this regard, this paper measures the performance of the health centers with a single indicator for multiple-outputs in terms of productivity(technical efficiency), based on Data Envelopment method. The 20 Kyungnam health centers which provide clinic services and specific primary health care services were analyzed. The results show that 50.0% of 20 health centers were productive with respective to overall technical efficiency, 65.0% were productive for pure technical efficiency, and 50.0% for scale efficiency. The inefficient group includes Geoje, Mahsan, Miryang, Sahchun, Tongyoung, Gosung, Nahmhae, Euryang, Hahmahn, Hahbchun health centers. The worst case was identified as Tongyoung health center which represented a 47.5% efficiency, compared with productive health centers. The empirical results for input-output analysis indicates that the low-productive health centers have excessive manpower in administration department, producing low outputs in clinical services and vaccination program. These findings imply that a systemic evaluation of the performance of the Korean health centers and the subsequent structural reform are strongly required.

• 한국의료질향상학회지
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• 제2권1호
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• pp.118-124
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• 1995

Background: Clinical indicators are objective measures of process or outcome of patient care in quantitative terms. This study aims to review the medical records of patients who 'return to operating room during the same admission', which is one of the critical clinical outcomes, and describe the result by unplanned reoperation rate. Methods: Computerized patient registry was used for selecting subject conditions. For medical records retrieved, two nurse evaluators identified the presence of explicit reoperation planning in medical records. Results: Overall reoperation rate was 2.8% and unplanned reoperation rate 1.3%. The main category of reoperation cause was the postoperative bleeding. Duration of stay from previous operation to reoperation of the unplanned group, 12.7 days, was shorter than that of the planned(p< .05). The differences did not reach statistical significance in age, sex and length of stay. Conclusion: Results suggested that unplanned reoperation rate was lower than 'threshold' level other institutions had established. However, this result could become comparable only after management of medical records would be improved and risk adjusted.

• 대한간호학회지
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• 제30권4호
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• pp.836-846
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• 2000

This Meta-Analysis of 18 studies was conducted to determine the magnitude of th relationship between health promotion behavior and each of explanatory variables. The studies were measured using Health Promoting Life Style(HPLP) developed by Walker and others based on Pender's definiton of health promoting behavior. The sample was collected by searching for The Journal of Korean Academy Nursing Society, The Journal of Korean Women's Health Nursing Academic Society,The Journal of Korean Academic Society of Adult Nursing, Journal of Korean Community Nursing, The Journal of Fundamentals of Nursing, The Journal of Korean Nursing Administration Academic Society, The Korean Journal of Child Health Nursing, The Journal of Korean Psychiatric Academic Society, the dissertations for mater degree or doctoral dissertations for the period from 1980 to 1998. The explanatory variables measured more than 2 times in studies were self-efficacy, perceived health status, self-esteem, internal, powerful-others and chance dimensions of health locus of control, perceived benefits, hardiness, wellbeing and clinical demensions of health concepts, and quality of life(life satisfaction). Effect sizes were calculated by unweighted mean r, weighted mean r by sample size and weighted mean r by quality index score after homogeneity test. The mean r effect size indicator range of each predictor variable were as follows; quality of life (0.50- 0.52), self-efficacy (0.46-0.47), hardiness (0.42-0.44), self-esteem(0.41-0.43), health locus of control- internal(0.32-0.34), health locus of control- powerful others (0.25-0.31), perceived health status(0.18-0.19) and clinical dimensions of health concepts (0.16-0.17).

• 한국병원경영학회지
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• 제24권4호
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• pp.43-56
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• 2019

Purpose: Importance of patient satisfaction related to patient-centeredness has been emphasized, and it is known to have effect on various health outcomes including health resource utilization. However, the effect of patient satisfaction has been discussed mostly in terms of hospital marketing in Korea. This study aims to examine the effect of patient satisfaction in patient-physician communication on healthcare utilization in a nationally representative adult population of South Korea. Method: Patient satisfaction with physician communication is assessed using 4 items in the 2011 Korea Health Panel Survey. Generalized linear regression analysis is conducted using 9,325 adults' healthcare utilization in 2012. Findings: Adjusting for the socio-demographic, economic factors, individual health status, health behaviors and healthcare utilization in 2011, more satisfied individuals, more likely to utilize the outpatient service, especially in clinical setting. Practical Implications: The study findings suggests that in context of South Korea healthcare system such as insufficient medical consultation time and the absence of health delivery system, patient satisfaction as a subjective healthcare quality indicator would have effect on the individual's outpatient visit. This study contributes to stimulate patient satisfaction research and discussion in South Korea to further explore its relationship with potential and various health related outcomes. Further implications of the study are discussed.

• Safety and Health at Work
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• 제8권1호
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• pp.1-10
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• 2017

Considerable effort has been made to address the issue of occupational health and environmental exposure to mercury. This review reports on the current literature of mercury exposure and health impacts on dental personnel. Citations were searched using four comprehensive electronic databases for articles published between 2002 and 2015. All original articles that evaluated an association between the use of dental amalgam and occupational mercury exposure in dental personnel were included. Fifteen publications from nine different countries met the selection criteria. The design and quality of the studies showed significant variation, particularly in the choice of biomarkers as an indicator of mercury exposure. In several countries, dental personnel had higher mercury levels in biological fluids and tissues than in control groups; some work practices increased mercury exposure but the exposure levels remained below recommended guidelines. Dental personnel reported more health conditions, often involving the central nervous system, than the control groups. Clinical symptoms reported by dental professionals may be associated with low-level, long-term exposure to occupational mercury, but may also be due to the effects of aging, occupational overuse, and stress. It is important that dental personnel, researchers, and educators continue to encourage and monitor good work practices by dental professionals.

• Journal of Nutrition and Health
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• 제46권3호
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• pp.239-249
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• 2013

Subclinical vitamin $B_{12}$ deficiency is common in the elderly worldwide. We investigated the change of serum vitamin $B_{12}$ concentration with aging and compared anthropometric data and clinical health indicators between normal (${\geq}$ 340 pg/mL) and low (< 340 pg/mL) serum vitamin $B_{12}$ groups in 470 Korean women aged 65 years and over living in a rural area. Serum vitamin $B_{12}$ concentration showed inverse correlation with age (r = -0.0992, p < 0.05). The normal $B_{12}$ group showed significantly (p < 0.05) higher red blood cell count, hemoglobin, and hematocrit compared to the low $B_{12}$ group, however, no difference in mean corpuscular volume was observed between the two groups. The normal $B_{12}$ group showed significantly lower serum homocysteine concentration (p < 0.01) and prevalence of vitamin D (p < 0.01) or folate deficiency (p < 0.001). Bone mineral density (T-score) was significantly higher (p < 0.05) in the normal $B_{12}$ group, compared with that in the low $B_{12}$ group, and showed positive correlation (r = 0.1490, p < 0.01) with serum vitamin $B_{12}$ concentration after adjusting for age, body weight, and body mass index. No differences in anthropometric data, physical activity, and smoking and drinking habits were observed between the two groups. In conclusion, it could be suggested that older female adults with normal serum vitamin $B_{12}$ level would be less anemic and osteoporotic and more resistant to hyperhomocysteinemia associated chronic diseases than those with low serum vitamin $B_{12}$ level.

• Asian-Australasian Journal of Animal Sciences
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• 제24권4호
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• pp.479-484
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• 2011

The study was conducted on 20 Holstein X Sahiwal cross bred dairy cows, with an average milk production of $2,752{\pm}113.79$ liters in $284{\pm}5.75$ days during a single lactation, that were divided in to two groups of 10 animals. We investigated the oxidative stress and antioxidant status during the transition period in dairy cows. In this study, plasma level of MDA was considered as an indicator of lipid peroxidation and SOD, catalase, GSH and GSHPx as antioxidants. The lipid peroxidation was significantly (p<0.001) higher in cows during early lactation as compared to the cows in advanced pregnancy. A significant positive correlation (r = +0.831, p<0.01) was determined between MDA and catalase in early lactating cows. In early lactating cows, blood glutathione was significantly lower than in advanced pregnant cows. However, early lactating cows showed non-significant negative correlation for all antioxidant enzymes with lipid peroxidation. In conclusion, dairy cows seemed to have more oxidative stress and low antioxidant defense during early lactation or just after parturition than advanced pregnant cows, and this appears to be the reason for their increased susceptibility to production diseases (e.g. mastitis, metritis, retention of fetal membranes etc.) and other health problems.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6439-6444
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• 2015

Background: In India smokeless tobacco users account for 25.9% of total tobacco use, Gutkha being the most common form. This study evaluated the association between serum lipid profile and Gutkha use as an early diagnostic and/or prognostic indicator for oral submucous fibrosis (OSMF) and oral cancer (Oral Ca) in non-smokers and non-alcohol consumers. Materials and Methods: A total of 163 participants were recruited from two sites in India. Participants were divided into four groups: individuals without any Gutkha chewing habit and without any oral lesions (control group), individuals with Gutkha chewing habit but without any oral lesions (GWL), patients with a confirmed clinical diagnosis of OSMF, and patients with a confirmed diagnosis of Oral Ca. Mixed linear modelling (MLM) was conducted to detect the change in mean serum lipid levels among four groups. Results: The sample consisted of 69% males and 31% females. Results of MLM show an inverse relationship between serum lipid levels in OSMF, and Oral Ca groups when compared to the control group. Conclusions: The results of our study demonstrated that GWL, OSMF and Oral Ca patients had lower serum lipid levels. Low serum lipid levels could be an indicator of initial neoplastic changes in oral cancer.

• 한국의료질향상학회지
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• 제28권1호
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• pp.2-13
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• 2022

Purpose: This study assessed the status of the Development and Utilization of critical pathways (CP) in South Korea. Methods: We surveyed 195 hospitals obtained on the Korean Hospital Association website. Data were collected using structured questionnaires for staff members in charge of CP management personnel in these hospitals. The questionnaire included CP developed by the institutions, the coverage rates and completion rates of CP in the current year, and management indicators related to CP. The questionnaire also included CP support systems and content within the institutions and questions regarding the advantages of CP utilization and obstacles associated with the CP development process. Results: Analysis of the responses from 70 hospitals (35.9% response rate) showed that a total of 1,370 CP sets were developed. The number of CP related to surgery departments was 365 (26.6%), and CP related to surgery and procedure was 1,093 (79.8%), respectively. The CP coverage rate was the most frequently used indicator to monitor the effect of CP (97.1%), followed by the completion rate (90.0%) and the length of stay in hospital (61.4%). CP managers reported that CP were highly useful for communication (3.39±0.493) and accurate information provision (3.39±0.491). The perception that CP violated doctors' autonomy in treatment was relatively low (2.87±0.645). Conclusion: It is necessary to establish an infrastructure in hospitals for CP. CP can facilitate communication and provide accurate information.

• 한국의료질향상학회지
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• 제3권1호
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• pp.94-103
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• 1996

Background : Blood pressure is an important indicator in diagnosis and assessing treatment of a patient. Clinical staffs use blood pressure on the assumption that measured value is accurate and reliable. However, whether measured blood pressure is accurate has been rarely investigated in Korea. Objectives : The aims of this study are to evaluate clinical staffs' knowledge and technique as well as accuracy of sphygmomanometer. Also the program to improve the measurement is developed. Methods : Seventy-three registered nurses were asked nine multiple choice questions including Korotkoff sound, cuff size, and deflation rate. Simultaneously characteristics of nurses were examined, age, working place, duration of employment and academic degree. A testing videotape(Standardizing Measurement Video-Tutored Course) was used for evaluating the accuracy of measurement. Testees were to read and record the 12 cases of blood pressure measurement, watching a falling mercury column and hearing Korotkoff sounds. After 10 minutes' education, they were again tested with the same cases. Additionally, 83 mercury sphygmomanometers were checked to find defects such as inaccurate calibration and zero setting, leaky bladder, etc. Results: For the knowledge testing correct response rate was 41.1%. They were the lowest in selecting the proper cuff size and Korotkoff sound. In examining accuracy of blood pressure with videotape, nurses had 67.7% correct response rate. The correct response rate was significantly improved by a session of education. About 23% of sphygmomanometers was without discernable defects. Conclusion : The knowledge and skill of clinical staffs along with the accuracy of equipment have to be improved. A properly designed education program would contribute to the accuracy improvement of blood pressure measurement. Also, more concerns should be given to the precision and maintenance of equipment.