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Improvement Plan to Facilitate a Landscape Architectural Promotion Facility and Complex System (조경진흥시설과 조경진흥단지 제도 활성화 방안 연구)

  • Kim, Yong-Gook;Kim, Shin-Sung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.1
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    • pp.9-16
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    • 2018
  • Landscape architecture is an indispensable professional service in building sustainable land and urban environments. The landscape architecture industry is closely related to the promotion of the health and welfare of the people, urban revitalization and residential environment improvement as well as job creation. Despite various public interest values of landscape architecture, the growth engine of the landscape architecture industry, which is supposed to improve the quality of landscape services, has stagnated. In 2015, the Landscape Architecture Promotion Act was enacted to provide a landscape architectural promotion facility and complex system to support revitalization through the integration of the landscape architecture industry. The purpose of this study is to suggest an improvement plan to enhance the effectiveness of the landscape architectural promotion facility and complex system. The results of the analysis are as follows: First, workers and experts in landscape architecture recognized the need for policies and projects to promote the landscape architecture industry. Second, the industrial types suitable for the landscape architectural promotion facility were landscape design, landscape maintenance and management, and landscape construction industry. Meanwhile the industrial types suitable for a landscape architectural promotion complex were landscape trees and landscape facilities production and distribution. Third, the expected effect of the designation of the landscape architectural facility was 'the increase of the business opportunity through the expansion of the network'. On the other hand, that of the landscape architectural promotion complex was 'the activation of various information sharing'. Fourth, 'the size of the local government landscape architecture industry and the capacity to cultivate' was the most important among the designation criteria of the landscape architectural promotion facility. As for that of the landscape architectural promotion complex, the 'feasibility of promotion plan' was the most crucial. Fifth, 'tax benefit and deductible exemption' was considered as a necessary support method for the activation of the landscape architectural promotion facility, and 'maintenance and management fee support' was recognized in the case of the landscape architectural promotion complex.

A Study on Users' Recognition of Selection Attributes for Connection between Recreational Forest and Rural Tourism Village (자연휴양림과 체험마을 연계를 위한 이용객의 선택속성 인식 연구)

  • Lee, Yong-hak;Cho, Yeong-Eun;Kang, Eun-jee;Kim, Yong-Geun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.1
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    • pp.16-28
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    • 2016
  • The study was conducted to compare and analyze the importance and performance of leisure destination selection attributes of persons who use recreational forests and rural tourism villages. This researcher investigated the use patterns of users to identify the ground for connection between recreational forest and rural tourism village, analyzed their recognition differences in physical selection attribute, program selection attribute, and service selection attribute in order for leisure destination selection, and conducted importance-performance analysis(IPA analysis) to draw a plan for connection. The main results and suggestions are presented as follows. First, recreational forests were visited by family users in order for rest and emotional cultivation and provided experience programs using simple public interest function of forest, whereas rural tourism villages were visited by family users, friends and co-workers, groups and club members to experience a variety of annual programs and understand regional cultures. It was found that it was necessary to connect natural forest with rural tourism village in order to meet the leisure needs of the people changed in diversified ways. Secondly, it was found that the connection between rural tourism village and recreational forest visited mainly for simple rest led to positive visit intention of users. It was expected that there will be various kinds of uses, including experience program participation, child education, and safe accommodations security. In other words, the connection between recreational forest and rural tourism village is an alternative to trigger actual demands and recreational forest activities with high quality. Thirdly, in the case of users of recreational forests, their performance of all selection attributes was lower than their importance of them. Therefore, overall improvements were needed. In particular, needed were the diversity, benefit, and promotion of programs, improvements in locality(themes), supply of lodges and convenient facilities, booking system, the purchase system of local special products, and professional skills of operators and managers. On contrary, the performance of program selection attribute of rural tourism village was high. Therefore, it was found that program attribute of rural tourism village was the main connection factor to activate recreational forest use. Fourthly, according to IPA analysis, the proper connections between loges, convenient facilities, and nearby touristattractions, which give high expectations and satisfaction to users, needed to remain. And it was required to make common efforts to accomplish the goal (income creation) of rural tourism village and improve booking system for visitors and performance of local special products sales opportunity. In addition, the essential factors to induce users' leisure destination selection were found to be maintenance of the use fee system of recreational forest, diversity of rural tourism village program, and retention of locality.

A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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The Characteristics and Medical Utilization of Migrant Workers (외국인 노동자의 특성과 의료이용 실태)

  • Ju, Sun Me
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.2
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    • pp.164-176
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    • 1998
  • This study deals with the current medical utilization for migrant workers and the characteristics of them. The purpose of this study is to provide the basic information to establish proper medical policy. For the study self-made questionnaire was used, which was answered by 453 migrant workers working in the area of manufacturing and non-technical work in 10 cities like Seoul, Inchon, Namyangju, Sungnam, Kwangju, Pyungchon, Kunpo, Kimpo, Masuk in Kyungki-do and Chunan in Chungchungnam-do. Besides, 303 medical records of those who had visited free medical check-up center were analyzed. The period of accumulating data is 6 months, from November 1st, 1996 to April 30th, 1997. The characteristics of migrant workers and current medical utilization are analyzed by percentage and the relation between characteristics and current medical utilization were analyzed using ${\chi}^2$-test, t-test, ANOVA. The finding of this study was as follows : 1) The number of nationality was 16. The first majority was Philippians as 32.0%. Among 16 nationalities Southeastern and Northern Asians were 48.9%, Southwestern Asian was 46.5%, the rest was 7.3%. Men were 81.0%, those who are aged from 26 to 30 were 39.0%, Graduatee from high school 92.7%, Christians 56.3%, unmarried 55.4% and salary from 600,000 Won to 800,000 Won 53.8% averaging monthly payment 669,810 Won. As for their residence, those who resided over 3 years were 31.9% and the illegal residence reached 77.4%. As for Korean language, those who speak in middle level were 5.6%. 2) As for kind of work and circumstances, manufacturing was 81.1%, 4 off-days per month 72.2% and 9-10 working hours per day 42.1%. As for accommodation, residence in fabric was 62.6% and one or two members as roommate 40.2%. 3) The characteristics of health behavior showed that 89.4% of migrant workers had 3 meals, 70.9% of them did not drink alcohol, 73.5% of them did not smoke. 4) As a characteristic of health status, 71.8% of them perceived of their health. 76.1% thought that they had no illness before coming Korea. Among them who recognized their illness, those who had problem in circulatory system was 35.3%, respiratory system ENT 19.1% and nervous system 19.1%.66.2% of those having illness had already had sickness when coming to Korea. 5) During last one month, 79.2% of them were known as ones having no illness. Among the sick, those who had problem in circulatory system was 31.6%, nervous system 23.7% and respiratory system 21.1%. 60.3% of the sick were not cured at that time. 6) Sorting the symptom of those who visited free medical check up, dental care was 24.2%, orthopedic 14.0% and digestive system 13.8%. Teethache was 34.4%, stomach problem 11.6%, upper respiratory inflammation 10.2% and back pain 5.9%. Averagely they visited free medical check up 1-2 times. According to symptom, epilepsy 25.5 times, heart and vascular disease 9 times, constipation 2.8%, neurosis 2.38 times and stomach problem 2.34 times. 7) The most frequently visited medical service by migrant workers was hospital. The most mentioned reason was good healing as 36.3%. The medical service satisfied migrant workers mostly was hospital as 64.3%. The reason of satisfaction was also good healing as 45.9%. 8) 77.2% of respondents did not spend money for medical check. Average monthly medical cost was 25,100 Won, 3.7% of income. Those who had no medical security was 73.4%. In their case, 67.7% got discount from hospital or support from working place and religious organization. 9) As for the difference of medical utilization according for the characteristics of migrant workers, legal workers and no-Korean speaker used hospital more frequently. 10) Those who were satisfied most of all with the service of hospital were female workers, hinduists and buddhists, legal workers or manufacture workers. 11) Christians, those who have 3 meals or recognize themselves as healthy ones mostly had no illness. As a result, the most of migrant workers in Korea are from Asia. They are good educated but are working in manufacturing and illegal. Their average income is under 700,000 Won which in not enough for medical cost. They have no medical security and medical fee is supported by religious organization or discounted. Considering these facts the medical policy by government is to be established.

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Displayed Subjects of Practice and Case-Mix of Private Practitioners in Taegu City (개원의의 진료과목표방 및 진료환자 구성)

  • Park, Jae-Yong;Oh, Kang-Jin;Kam, Sin
    • Health Policy and Management
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    • v.2 no.1
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    • pp.42-65
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    • 1992
  • To survey the specialties or sujects of practice displayed by the private practitioners the authors visited 691 clinics in Taegu from April 1 to May 18, 1991, At the same time, a mail questionnaire was administered to ask the number of displayed subjects of practice, and the reasons for displaying the subjects, reasons for not displaying in case of no specialty was displayed, composition of patients, and role as a specialist. The questionnaire was returned by 308(44.6%) practitioners. The distributions of private practitioners by specialty were 13.9% for internal medicine (IM), 11.7% for pediatrics(Ped), 13.0% for obstetrics '||'&'||' gynecology(OBGY), 11.1% for general surgery(GS), 10.0% for family practice(FP), and 5.3% for general practitioner(GP). Ninety percent of the specialists have displayed their specialty in their offices. Among all the private practitioners, 61.9% of them have displayed their subjects of practice and 23.7% have shown telephone number. Among private practitioners who displayed the subjects of practice, 80.6% have signs of 'subjects of practice'. Mean number of the displayed subjects of practice for the all private practitioners is 1.20, and 1.93 for the private practitioners who displayed subjects of practice. FP and GS have displayed their subjects of practice in 91.2% and 87.0% respectively and OBGY have displayed in 32.2%, the lowest percentage among all the soecuaktues. IM specialists displays pediatrics as a major subject of practice in 72.1% the pediatricians display IM in 88.9% the OBGYs display pediatrics in 77.8%, and the GSs display IM in 51.9%. Most commonly displayed subjects of practice are Ped and IM. Sixty-five percent of the private practitioners answered that they don't display their specialties because their clinics are "primary health care facility". The reasons for displaying the subjects of practice and its relevance with their own specialty(45.6%), and the difficulty in clinic management only with the patients for their own specialty(36.9%). The proportion of clinics whose patients of other specialty are than their own specialty accounted less than 10% was 52.8% and that accounted more than 51% was 16.0%. Specially, 51.4% of GS specialists cared more than 51% of patients of other specialty area than their own specialty. Most of the patients of IM, Ped, and OBGY specialists are the patients of their own specialty. However, 56.8% of GS care more of IM patients and only 24.3% of them care mostly GS patients, The respondents to the mail questionnaire who stated that they can not play the role of specialist well are 30.5% and especially 72.9% of the GS specialists state so. The proportion of respondents who do not suffort the private practice of specialists is 71.1%. Among the surgical specialists, 82.7% of them rarely perform operation. The reasons for not performing operation are insufficient insurance fee (76.9%), and risk of operation(58.0%), so as the OBGY specialists. Above finidngs suggest that most of the specialists, especially surgeons, in the private practice can not play their role as a specialist. It is necessary to develop a policy that facilitates the production of practice and the retention of the specialists in the hospitals.s.

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Current Situation and Development Strategy for the Korea-Good Agricultural Practices System (농산물우수관리제도의 현황과 발전방안)

  • Yoon, Deok-Hoon
    • Journal of Food Hygiene and Safety
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    • v.33 no.1
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    • pp.1-11
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    • 2018
  • It is ten years since the Good Agricultural Practices (GAP) certification system was implemented in Korea, and the government aims to acquire GAP certification up to 25% of the total agricultural areas by 2022. As of the end of 2017, 6.3% of the total cultivated area and 8.1% of the total farm households were certified, which is slower than expected. The purpose of this study was to investigate the causes of the GAP accreditation through the surveys and on site inspections of the GAP certified farmers and to propose the development plans according to the problems analysis of the current system in order to expand the GAP certification. Certified farmers recognized the need for agricultural safety and hygiene, but there were a lot of nonconformities regarding practical practices. This is due to the ambiguity of the certification standards and the wrong ways in the training method for the producers. GAP certification is slow to expand to farmers and low consumer awareness is considered a structural problem of GAP certification system, and improvement measures are needed accordingly. It is necessary to convert the state-led GAP certification system into a state-led private certification system. It is necessary for the government to focus on policy, research and follow-up management. In addition, it is necessary to establish a separate organization in the form of a contribution organization for the certification, education, and public relations. In addition, long-term plan must be established and systematically carried out. It is necessary to integrate too many certification agencies compared to the farming scale of Korea, and it is necessary to realize the application fee for realizing the financial independence of the certification body and correct certification work. In addition, inspector qualification standards should be strengthened and training system should be improved to nurture high quality inspectors. Simplified certification standards based on statutes need to be subdivided into practical action plans. In order to improve the GAP certification system, it is necessary to have a discussion through a committee composed of specialists from industry and academia, and it will be possible to contribute to the safety of the food of the people through the production of safe by drawing concrete development plans.

The Study on Production and Performance of Crossbred Korean Native Chickens (KNC) (토종 순종계를 이용한 토종닭 생산 및 생산성 연구)

  • Park, Mi-Na;Hong, Eui-Chul;Kang, Bo-Seok;Kim, Hak-Kyu;Seo, Bo-Young;Choo, Hyo-Jun;Na, Seung-Hwan;Seo, Ok-Suk;Han, Jae-Yong;HwangBo, Jong
    • Korean Journal of Poultry Science
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    • v.37 no.4
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    • pp.347-354
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    • 2010
  • The current work was carried out to investigate the effect of crossbred Korean native chickens (KNC) on performance and carcass ratio. Seven hundred twenty 1-d-old chicks were divided into groups by strain (A, B, C and D) and sex (male and female). Strains were A) (KNC egg-meat type C strains $\times$ KNC meat type S strains) $\times$ KNC meat type H strains, B) (KNC egg-meat type C strains $\times$ KNC meat type H strains) $\times$ KNC meat type S strains, C) (KNC native R strains $\times$ KNC meat type S strains) $\times$ KNC meat type H strains and D) (KNC native L strains $\times$ KNC meat type H strains $\times$ Ross broiler. Experimental diets consisted of 3 phases such as starter(0~5 weeks; CP 20.0%, ME 3,050 kcal/kg), earlier (5~8 weeks; CP 18.0%, ME 3,100 kcal/kg) and finisher (8~12 weeks; CP 16.0%, ME 3,150 kcal/kg). Body weight (BW) and feed intake (FI) was measured every week and carcass ratio(CR) was calculated at 5 and 10 week after starting experiment. There was no difference in BW among strains until 5 weeks (P>0.05), however D strain resulted in a higher BW after 5 weeks (P<0.05). Body weight gain (BWG) and FI in D strain were also significant higher compared to the other strains for all periods. However, D strains showed the lowest (P<0.05) fee conversion ratio (FCR). The other strains except D showed a similar BW, BWG, FI and FCR among strains. In addition, there were no differences in carcass weight (CW) and carcass ratio (CR) among strains at 5 weeks, however D strain showed higher CW and CR at 10 weeks. These results suggested the basic data that needed to develope the new strains.

Comparision of Maternal Charcteristics and Birth Weight among Five Different Categories of Medical Facility for Delivery in Taegu (대구시내 각급 의료기관에서 분만하는 산모들의 특성 및 출산결과의 비교 분석)

  • Song, Jung-Hup;Park, Jung-Han;Kim, Gui-Yeon;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.10-20
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    • 1988
  • This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

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Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

Analysis on the trends and causes of inhabitant's behavioral changes in medical institutions's utilization after enforcement of regional medical insurance. (pilot-project area of regional medical insurance; mainly Kun-wi and Kwang-hwa county) (의료보험(醫療保險) 실시이후(實施以後) 지역주민(地域住民)의 의료기관이용행태(醫療機關利用行態) 변화(變化) 추이(推移)와 그 요인(要因)에 관한 조사연구(調査硏究))

  • Park, Jung-Yeon
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.47-76
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    • 1989
  • The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

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