• Title/Summary/Keyword: health care utilization

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A Study on the needs of Dietary Education of High School Students in Daegu and Gyeongbuk Province (대구.경북지역 고등학생의 식생활교육 요구도 조사)

  • Kim, Yun-Hwa
    • Journal of Korean Home Economics Education Association
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    • v.22 no.4
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    • pp.77-90
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    • 2010
  • The purpose of this study was to investigate the practice of eating life and the needs of dietary education of high school students. The data was collected by means of questionaire form the total of 463 high school students who were living in Daegu and Gyeongbuk province. Recognition of the need dietary education was 3.47/5.00, the utilization in daily life was 3.16, the degree of interesting was 3.23, and the degree of difficulty was 2.82. The reason of necessity was health care and growth (54.6%). The reasons of interesting were as follows: various information (28.3%), job choices (21.2%), happy family life (20.7%), cooking practice (19.7%). The degree of dietary education needs was 3.24. The need of cooking ability improvement was highest as 3.59. The practice of eating life was 3.41. Such as hand washing, food hygiene was the highest as 3.71. But the items of healthy eating life and evaluation of eating life were the lowest. The practice in daily life was positively correlated with recognition of the need, utilization, interest. But it was a negative correlation with the difficulty. Therefore dietary education should be strengthened in home economics subject, and to increase the rate of daily practice the teaching content and methods must be improved. In addition, dietary education in schools should be closely connected with families and local communities.

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The Determinants of Community Service Utilization Among Family Caregivers of the Impaired Older Persons (만성질환 및 기능손상노인 가족수발자의 재가복지서비스 이용 결정요인에 관한 연구)

  • Lee, In-Jeong
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.183-205
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    • 2004
  • This Study explored three issues in regard to the determinants of community service utilization among family caregivers of the dependent older persons. First, the differences between users and nonusers of community services were compared regarding to predisposing, enabling, need characteristics of the primary caregiver as well as the elder care recipient. Second, the variables which determined the contact of community services were examined. Third, the influence of the variables on duration of the community services among users was also examined. The data collected from 164 family caregivers were used for analyses. Findings suggest that community service users had higher education and higher emotional support, lower family income than nonusers. The level of cognitive impairment of the elder was also higher for users than nonusers. The entry into community services is more likely for elders cared for by caregivers who have higher educational attainment, lower family income and lower level of instrumental support. Once interaction terms for relationship between need factors and social support are entered, caregivers with poorer level of his/her perceived physical health and lower level of instrumental support are more likely to report use of community services. Among those reporting contact with services, more extensive use occurs for caregivers with lower emotional support and lower depression. The entry of interaction terms for relationship between need and support reveals that the combination of lower support(instrumental and emotional) and elder's greater physical impairment are associated with longer period of community service use. However, the effect of caregivers' depression followed the different pattern. For caregivers with greater depression, more supports are related with more service utilization. According to the results, implications for research and practice are discussed.

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Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

  • Simsek, Hakki Sencer;Tokmak, Aytekin;Ozgu, Emre;Doganay, Melike;Danisman, Nuri;Erkaya, Salim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7793-7797
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    • 2014
  • Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases ($35.2{\pm}10.9$ versus $50.8{\pm}13.4$, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity, PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.

Factors Affecting Occupation Awareness for Dental Hygienist in High School Students (고등학생의 치과위생사에 대한 직업 인지 관련 요인)

  • Cho, Young-Sik;Hwang, Hye-Rim;Joo, Seung-Mi;Choi, Jung-Yoon;Hwang, Mi-Ra
    • Journal of dental hygiene science
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    • v.11 no.4
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    • pp.293-297
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    • 2011
  • The purpose of this study was to evaluate recognition of occupation title for dental hygienist in high school students. Total 210 students of one high school completed a self-reported questionnaire on sociodemographic characteristics, dental service utilization and occupation title awareness for health care personnels. Female and science tract students showed higher level of awareness for dental hygienist but showed no differences according to dental service utilization pattern. The study showed association between occupation recognition for dental hygienist and other health technicians. But there were no association between occupation awareness for dental hygienist and dentist, nurse. Gender, occupation recognition for medical laboratory technologists and physical therapist affect occupation recognition for dental hygienist.

Studies on the variations of hospital use and the changes in hospital revenues of 10 KDRGs under the PPS (일개 대학병원의 환자군별 진료서비스 변이와 포괄수가제 적용에 따른 진료수익 변화)

  • 전기홍;송미숙
    • Health Policy and Management
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    • v.7 no.1
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    • pp.100-124
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    • 1997
  • In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

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A Study on the Patient's Expectation Toward Quality Care of Dental Services (치과의료서비스 향상을 위한 환자 기대도 조사연구)

  • Choi, Jun-Seon;Lee, Sea-Baick
    • Journal of dental hygiene science
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    • v.2 no.1
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    • pp.1-9
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    • 2002
  • The objection of this present study are (1) measurement of patient's expectation toward quality care of dental services. (2) Analysis of differential expectation of dental service by the patient characteristics and (3) presentation of measurement implication for better dental service at the dental clinic. The data used in the study were collected from April 25 to June 9, 2001 and for 77 patients of university dental hospital and 102 patients of dental clinic. The study found, in general, that patient's expectation on the clinic environmental factor was most highly scored followed by dental human factors. The convenience of transportation from the patient's residence to the clinic was highly concerned as be an important factor in dental service utilization.

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A Study on Public Health Doctors' Participation in District Public Health Program of Health Sub-centers in Korea (보건지소 공중보건의사의 지역보건사업 참여 실태)

  • Lee, Jae-Chun;Park, Yong-Moon;Ahn, Song-Vogue;Lee, Hae-Young;Hwang, Jin-Won
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.53-66
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    • 2003
  • Objectives: To investigate the state of medical care around health sub-centers, public health doctors' participation and opinion in the process of district public health programs. Methods: The study included 1,036 public health doctors who worked at health sub-center all over the country. The data were collected for Feb, 2002 using self-administered questionnaire by mail. Results: One or two doctors were working at health sub-center and 33.5% of health sub-centers was located in the region of the separation of prescription and dispensing. There were another medical facilities in 45.9% of the administrative district(eup or myon) where health sub-centers were located. The count of medical utilization went down to 14.8${\pm}$14.8 per a day in Nov, 2001 from 18.0${\pm}$15.6 in May, 2000, and the decline was much more in the region of the separation of prescription and dispensing. Among public health programs in health sub-centers, public health doctors participated mostly in preliminary medical examination for vaccination and least in health education. They participated in implementation rather than planning or evaluation of health program. Over a half of public health doctors were found to be positive that health programs implemented in their health sub-centers would promote the level of health in community people and they were willing to participate in district public health program if community people were in need. Conclusions: Recently health sub-centers are required to turn into health promotion facilities rather than medical practice facilities. Health program in health sub-centers will be advanced in both quality and quantity by turning the role of public health doctors who have provided medical services mainly into managing health program. Persistent education about managing health program and the policy to motivate participation in health program should be provided for public health doctors.

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Study on Compliance of Personal Health Record Application in Patients with Atopic Dermatitis (아토피피부염 환자의 개인별 증상 기록에 대한 순응도 연구)

  • Seo, Jin Soon;Kim, Young Eun;Kim, An Na;Kim, Ick Tae;Son, Yun Hee;Jang, Hyun Chul
    • Journal of Society of Preventive Korean Medicine
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    • v.24 no.2
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    • pp.71-82
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    • 2020
  • Objectives : The purpose of this study is to evaluate clinical utilization by measuring compliance with the use of mobile health applications (AtopyPHR developed in a previous study) for patients with atopic dermatitis. Methods : Based on the AtopyPHR and the input period and frequency survey results for each symptom item, a scenario for measuring compliance was derived. The study period was 4 weeks. Participants installed AtopyPHR app and Telegram app on their smartphones, conducted user training on the app, and recorded symptoms using the app for 4 weeks. At the 2nd and 4th week visits, the AtopyPHR data recorded by the user can be viewed on the web page and used for medical decision. Compliance was analyzed by the date the symptoms were recorded. Results : There were 28 participants, all (100%) were compliant, and the compliance was 96.8. The patients were 1 to 18 years old, and the average age was 8.2±5.7 years, 10 males and 18 females. The actual date of participation in recording symptoms was 28.6±0.56 on average. Compared to Week 1, compliance decreased at Week 2, and Week 4 had the highest compliance. Daily check, daily emotion, stool/urine/sleep, and meal management showed high compliance, SCORAD and quality of life were higher than required to record. Conclusions : AtopyPHR was effective in compliance. The results of this study could be used to collect personal health data in daily life through the AtopyPHR, improving participant compliance. It is considered to be meaningful because it measured the compliance with the symptom record actually recorded using the mobile app rather than a questionnaire. This study may be useful not only for personal health care but also for medical decisions, as opinions are given by experts who treat atopic dermatitis.

The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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Analysis of Telephone Counseling Service on Child Health (전화 아기건강상담을 통해 나타난 우리나라 어머니들의 육아문제 분석)

  • Song Ji-Ho;Han Kyung-Ja;Oh Ka-Sil;Cho Kyoul-Ja;Lee Ja-Hyung;Park Eun-Sook;Cho Kap-Chul;Tak Young-Nan;Ahn Young-Mee
    • Child Health Nursing Research
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    • v.7 no.2
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    • pp.245-257
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    • 2001
  • This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4%) were mothers. Among them 89.6% were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36%), followed by 28% from Kyung Gi Province, and 20% were from the Kyung Sang area. Among 8,261 callers, 72.8% were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5%) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3%), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25% and 23.3% respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3% with diaper rash being the second highest among the skin problems. About 80% of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.

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