• Women's Health Nursing
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• v.8 no.3
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• pp.389-401
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• 2002

This study aims to find factors that affect variations in cesarean section frequency rates among OBGY clinics in Metropolitan areas. The factors include patient, medical supplier characteristics and economic factors. This study is a cross-sectional analysis using health insurance delivery claims from July to December 2000 and files of the NHIC(national health insurance corporation). Multiple regression was used to analyze the dependent variable of cesarean section frequency rate at each clinic. The results are as follows : Cesarean section frequency rate is increasing in proportion to the number of the following patients : repeated caesarean section, disproportion, obstructed labour, fetal distress, emergency caesarean section and self-employed patients. There are geographic variations as well. Cesarean section frequency rates are higher in Inchon and Gyonggi province than in Seoul. The higher number of total delivery the clinic has, the lower rate of cesarean section it has. Clinics with high frequency rates in 1999 showed higher rates the next year. Further research is required to develop evidence based delivery modes and change strategies for increasing normal delivery and activating midwife clinics.

• Women's Health Nursing
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• v.17 no.2
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• pp.109-117
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• 2011

Purpose: This study examined the impact factors of cesarean section based on the ecological approach in Korea. Methods: Population-based data (Korea Institute for Health and Social Affairs) were used from 2,849 delivery cases during 2003~2009. Data were analyzed using geographic statistics with STATA 10.0 and hierarchical logistic regression with SPSS/WIN 12.0. Results: The range of cesarean section rate was 28.8~44.7% with geographic distribution. The proportion of mother's problem was increasing in choice of cesarean section. According to the ecological model, age of mother (OR=1.08), time of birth (OR=0.79), delivery in hospital (OR=1.83), delivery in clinic (OR=1.46), and education of mother (OR=2.61) had significant impact on cesarean section. Conclusion: This study contributes to provide the impact factors of the high cesarean rate in Korea ecologically. Policy maker and health care provider can consider these results to reduce cesarean section rate.

• Journal of Technologic Dentistry
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• v.33 no.4
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• pp.361-368
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• 2011

Purpose: This study is to analyze the curriculum satisfaction and to provide basic information for effective school management of Dept. of Health section. Methods: This survey, modified questionnaires based on Hee-Joo Moon's(2005), is accordance with undergraduate students and shows very high credibility upper than Cronbach's Alpha. 1,500 questionnaires are distributed(01. Oct. 2010~30. Oct. 2010) but only 1,213(80.8%) are returned and, except for 14 insincerely answered, 1,199(79.9%) are used. Results: The results of the study are following. The population characteristic of this survey is that 445(18.1%) are male, 739(61.9%) are female, 595(49.6%) are in health section, and 604(50.4%) are in none health section. 628(53%) chose getting jobs as their motivations for school choice and 727(60.8%) chose getting jobs and career guidance as theirs. The satisfaction of male students was higher than that of female students based on the comparative analysis of the curriculum satisfaction. The satisfaction of the students in none health section was higher than that of those in health section based on the comparative analysis of the curriculum satisfaction. This survey indicates that once the satisfaction with the major courses and career guidance increase, the overall satisfaction grows. Conclusion: The keys to improve the curriculum satisfaction including students' in department of dental technology are to provide and develop differentiated curriculums and support programs that meet students' expectations. In addition, the customized curriculums based on the level and aptitudes of female students are needed.

• Health Policy and Management
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• v.1 no.1
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• pp.27-41
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• 1991

The purpose of this study is to estimate cesarean section rate in Korea and analyze characteristics of health care institution which affect regional variation in the rate. We have searched vaginal and cesarean section deliveries among Diagnosis Related Group dat based upon insurance claim bills which have been submitted to Korean Insurance Corporation for two years since March, 1985. The results are as follows: 1. Out of all delivery cases of 87,500, cesarean section rate was 16.3% (14,299 cases). 2. Cesarean section rate varied according to size and ownership of health care institutions. In above 6- bed sized hospitals, the rate was at about 20% higher than small sized institutions, but rather in hospitals that have more than 500 beds, it was somewhat low. Classified by the hospital ownership, the rate was low at 18.4% in hospitals of religious organization and highest at private or corporate hospitals. 3. This study shows large regional variation in cesarean section rate; there are two times differences between region with the highest and lowest rate. Strongly related factors in that variation was the ownership of health care institution and urbanization variables. Low level of cesarean section rate in a region is explained by high proportion of delivery cases at institutions of religious organization and at insitutions in county level site. This result shows that apart from medical conditions of patients, indications of cesarean section differs from health care providers, and especially ownership of institution strongly affect them. Cesarean section rate in Korea is supposed to be at high level and development of utilization review programs to keep appropriate cesarean section rate is needed.

• Journal of Preventive Medicine and Public Health
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• v.44 no.1
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• pp.2-8
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• 2011

Objectives: Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. Methods: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. Results: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. Conclusions: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.

• Safety and Health at Work
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• v.13 no.1
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• pp.66-72
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• 2022

Background: The aim of the present study was to evaluate the psychological well-being (PWB) during the coronavirus disease (COVID-19) pandemic in workers of a multinational company. Methods: Employees (aged ≥18 years) were recruited from Latin American, North American, New Zealand, and European sites of a multinational company operative during all the pandemic period. The self-reported Psychological General Well-Being Index was used to assess the global PWB and the effects on six subdomains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. The influencing role of age, gender, geographical location, COVID-19 epidemiology, and restrictive measures adopted to control the pandemic was explored. Results: A total of 1335 workers completed the survey. The aggregate median PWB global score was in a positive range, with significantly better outcomes detected in the Mexican and Colombian Latin American sites compared with the other worldwide countries (p < 0.001). Among the European locations, a significantly higher PWB score was determined in Spain compared with the German and French sites (p < 0.05). Comparable geographical trends were demonstrated for all the PWB subdomains. Male workers had a significantly better PWB compared with females (p < 0.05), whereas a negative correlation emerged with aging (p = 0.01). COVID-19 epidemiology and pandemic control measures had no clear effects on PWB. Conclusion: Monitoring PWB and the impact of individual and pandemic-related variables may be helpful to clarify the mental health effects of pandemic, define targeted psychological-supporting measures, also in the workplace, to face such a complex situation in a more constructive way.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.485-485
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• 2005

• Health Policy and Management
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• v.31 no.2
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• pp.180-187
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• 2021

Background: This study analyzed the effect of applying the diagnosis-related group (DRG)-based payment system, which was implemented in July 2012 for hospitals and clinics nationwide, on the cesarean section rate. Methods: The subjects of the study were divided into new groups that participated in the payment system after July 2012 and maintenance groups that participated in the payment system before July 2012. As an analysis method, a difference-in-difference analysis, which is a quasi-experimental design, was used. The risk-adjusted cesarean section rate was used as a dependent variable. Results: Seven risk factors (malpresentation of fetus, eclampsia, multiple pregnancies, problems in the placenta, previous Cesarean section, cephalopelvic disproportion, problems in amniotic fluid) were included in the final risk-adjustment model, and found to have a statistically significant relationship with the cesarean section rate. Results showed that the risk-adjusted cesarean section rate increased significantly in new groups after the application of the DRG-based payment system. Conclusion: Study results provided policy implications for the reorganization of the DRG-based system should that reflects the demands of obstetricians, such as organizing a consultative body with obstetricians and establishing a reasonable fee.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.148-155
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• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• Korean Institute of Interior Design Journal
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• no.40
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• pp.102-108
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• 2003

Currently, there is no facility standard for a city public health center. The facility standard of rural public health center is referred to architectural plan of city public health center. This study is about architectural plan of the city public health center and have been in 7 public health centers in Daegu investigated. Conclusions can be summarized as follows: 1) The Mother and child hygienic section, area ratio which is presented by the facility standard of rural public health center must be increased in case of city public health center since function-reinforcement of the mother and child hygienic section is required. 2) Business section, the area ratio which is presented by the facility standard of rural public health center must be diminished for city public health center because it has been excessively allocated.