• Health Policy and Management
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• v.29 no.3
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.11 no.1
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• pp.5-13
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• 2004

The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

• Journal of environmental and Sanitary engineering
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• v.23 no.3
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• pp.1-8
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• 2008

Currently, medical waste stoker incinerator is widely used in the emission control technology of health-care risk waste and miscellaneous contaminated waste. In the past, wet type control technology was used to remove the major harmful gaseous contaminants of medical waste such as HCl, $NO_x,\;SO_2$, CO, DUST, Dioxin. However, the treatment cost for wastewater was high and it has a disadvantage for frozen system during winter season. Therefore, in order to obtain effective treatment, the dry type control technology was developed and widely used to remove the gaseous contaminants. In this study, pre-coated bag filter using hydrated lime, ($Ca(OH)_2$), was applied to the dry type control system and the optimum dose of hydrated lime was investigated. The treatment results showed that the dust collection rate was approximately 26.7%. Moreover, the HCl removal rate using pre-coated bag filter ($50mg/sm^3\;Ca(OH)_2$) was 13.52%, which was significantly higher than 3.26% obtained from conventional bag filter.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.388-407
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• 1995

This study is (a) to describe the history of Total Quality Management (TQM) generated in the industry, health care service, and nursing society ; (b) to define the concept, total quality management including the definition of quality ; (C) to explain the each principle of TQM theory developed by main theorists, E. Deming, J. Juran, and B. Crosby ; (d) to give the examples related to TQM implementation at the health care organization ; and (e) to mention the extent to which the health care organizations are able to evaluate their cultural organization toward TQM and have had the way to measure the effect of TQM implementation. TQM referred to Continuous Quality Improvement(CQI), Quality Improvement(QI), and Total Quality Improvement(TQI), was not recognized by experts in the United States industry, but by economists in Japan until the end of the 1970's. However, the United States' government led to introduce the principles of TQM to general industry as well as health care service area so that TQM became a main philosophy to manage the organizations in health care service. TQM is a structured, systematic process for creating organization-wide participation in planning and implementing continuous improvement in quality. E. Deming established the "Chain reaction in Quality" and the fourteen point of TQM. The Chain reaction in quality is to describe the relationship among the reduction of waste, rework, and delay, quality improvement, customer satisfaction, and productivity. There are fourteen points to explain the principles of TQM by E. Deming. Juran defined the "Quality Trilogy" to improve the level of quality in any organization. Quality Trilogy has three steps such as quality planning, quality control, and quality improvement for implementing the TQM projects. Crosby describes his TQM theory by establishing "Four Absolutes" and "Fourteen steps in TQM" implementation. Until now, most healthcare organizations have made efforts to organize the TQM task team and to implement TQM principles with various issues. There are three priorities to select the TQM issues : High-volume, High-risk, and Problem-prone. However, there is no absolute, credible measurement yet to evaluate the effects of TQM implementation in health care organization regardless of the classification of health care organizations, geographical background, and social influence. Thus, developing the evaluation way in terms of TQM is the foremost task in health service area. The most important thing for TQM implementation in the organization is to settle up the concept, cultural transformation from traditional management toward quality.

• Journal of Korean society of Dental Hygiene
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• v.9 no.3
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• pp.282-293
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• 2009

The purpose of this study was to examine the degree of infection control implemented at dental offices and factors affecting it in an attempt to help promote the health of dental health care workers. The subjects in this study were 180 medical personnels who worked at dental offices in the region of South Jeolla Province. A self-administered survey was conducted from April 1 to May 30, 2008, and the collected data were analyzed. The findings of the study were as follows: 1. As for the implementation of infection control at the dental offices, what the health care workers investigated did the most was post-treatment hand washing(95.0), a constant separation of infectious wastes(94.4), wearing rubber gloves all the time during medical instrument cleansing(92.8) and pre-treatment hand washing(91.7). 2. In regard to the implementation of infection control at the dental offices, what the dental personnels did the least was drying their hands with air(5.0), wearing goggles in times of treatment(23.3), receiving regular education on infection control(26.7) and putting sterilizers to a performance test on a regular basis(43.9). 3. The dental health care workers were significantly different according to age in the management of contagious diseases(p=0.005). Their career made a significant difference to the management of contagious diseases(p=0.000) and instrument cleansing/sterilization(p=0.043). The service area made a significant difference to wearing and managing personal protective clothes (p=0.040) and waste management(p=0.040). 4. Concerning the relationship between the acquisition of dental hygienist certificate and the practice of infection control, whether the dental health care workers were certified or not made no significant difference to that. 5. As to the correlation among the factors affecting the prevention and management of contagious diseases, there was a positive correlation among hand washing(r=0.379), wearing and managing personal protective clothes(r=0.349), instrument cleansing/sterilization(r=0.323) and waste management(r=0.388). All the factors made a statistically significant difference to the prevention and management of contagious diseases(p<0.01).

• Quality Improvement in Health Care
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• v.25 no.1
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• pp.52-65
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• 2019

Purpose: Outbreaks resulting from medication injections have recently been on the rise in Korea despite various established guidelines. The objective of this study was to assess the degree to which healthcare professionals are aware of safe injection practice guidelines and to account for the adherence to and the deviation from safe injection guidelines formulated by healthcare providers. Methods: In November 2016, a cross-sectional anonymous questionnaire covering general characteristics of injections, patient safety culture, awareness of safe injection practices, and adherence to and barriers to safe injection guidelines was issued to healthcare providers who administer medication injections or manage and supervise these injections (N=550). Multivariate logistic regression analysis via enter method was performed to define the influencing factors of adherence of safe injection practices. Results: On average, respondents adhere to 17 of the 24 guidelines. Multivariate logistic regression found that those who were more likely to adhere to safe injection guidelines either underwent a patient safety training experience within the last year, provided care in a setting characterized by a highly developed patient safety culture, or were employed as physicians or nurses, as opposed to some other type of care provider. Barriers to safe injection guidelines were attributable to; thoughts of waste to discard leftover medicine, provisions that made adherence cumbersome, a weak culture of compliance, and insufficient amounts of injectable medicine, products, and education. Conclusions: The results of this study indicate that controllable factors like training experience of healthcare providers and patient safety culture were positively associated with adherence to safe injection practices. It was suggested that the training of healthcare providers on safe injection practices be a continuous process to promote patient safety. Additionally, there should be an increased focus on developing and implementing policies to improve patient safety culture from a prevention rather than post-management perspective.

• Journal of Distribution Science
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• v.18 no.9
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• pp.67-75
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• 2020

Purpose: The purpose of this study is to enhance sales promotion efficiency for using solid refuse fuel facilities. Renewable energy technology using Solid Refuse Fuel (SRF) is an economic efficiency technology that recovers waste by burning various wastes. A survey on the pollutants discharged from the solid fuels facilities was investigated so that the SRF facilities could be expanded, distributed and reflected in the policy. Research design, data, and methodology: In this study, 9 business sites using SRF and Bio-SRF as main raw materials were investigated for 2 years. The characteristics of target business sites such as the type of fuel used, combustion method, combustion temperature, daily fuel consumption and environmental prevention facilities were studied. Results: The average pollution & ammonia concentration of Bio-SRF facilities was found to be 88.15% higher than that of SRF facilities. But the average acetaldehyde concentration of SRF facilities was found to be 88.15% higher than that of Bio-SRF facilities. Conclusions: The main issue is how much electric power generation using combustible materials affects air pollution. The waste recycling law provides the standard value according to the fuel property, but there is a considerable gap with the mixed fuel. Therefore, for efficient utilization of facilities using solid fuel products, additional research is needed to improve the distribution structure of exhaust pollutants is needed.

• Korean Journal of Community Nutrition
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• v.11 no.2
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• pp.229-239
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• 2006

This study was carried out to investigate foodservice management practices of 100 child care centers nationwide, and to provide background information for developing foodservice management policies at child care centers. Approximately 20% of the child care centers had a separate dining room; most of the centers were vulnerable to sanitation or safety problems. The percentage of the centers that planned menus was about 60% and 10% established standardized recipes. Fourteen percent of the centers kept records for distribution and menu evaluation and 33% kept sanitation management records. Since only 7% of the centers employed a dietitian, foodservice in most centers were not managed by professionals. The results of menu assessment revealed that 56.5% of the national/public child care centers received 19 points or higher out of 21 points, whereas 5.6% of the private child care centers received the same scores. Proper usage and storage of raw food, sanitary management of equipment and facilities, waste management/leftover food treatment, and basic facility of cooking zones were performed well by many centers. The overall scores of foodservice performance were only 31.2 out of 60 points, representing relatively poor safety management, food procurement management, and facilities and equipment management. These results indicate that the foodservice management of the child care centers are in a relatively poor state. Since nutrition management of the most centers was performed by non-professionals, it may not be possible to provide proper nutrition for health and normal growth of preschool children and to perform efficient nutrition education programs. The following suggestions are strongly recommended in order to improve foodservice performance at child care centers. First, foodservice administration should be performed by a dietitian, and second, efforts should be focused on strengthening nutrition and sanitation management.

• Korean Medical Education Review
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• v.24 no.1
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• pp.18-34
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• 2022

The purpose of this study is to clarify the background of the controversial attempt to establish a new public medical school linked to compulsory service as a means of strengthening public healthcare in Korea, and to raise anticipated problems with possible solutions. In Korea, healthcare is predominantly provided by the private sector focused on medical care, rather than public healthcare, even under the national health insurance system. The government has been mainly in charge of public health and unmet medical services from a residual perspective, but health inequalities still exist. To resolve this issue, the government created the concept of public health and medical service (PHMS) from a universal perspective and tried to strengthen the infrastructure of public healthcare and to foster core PHMS doctors by establishing a new public medical school linked to compulsory service in medically vulnerable areas. This study investigated the reality and concept of the new public medical school planned by the government, and identified problems such as the possibility of obtaining accreditation and evaluation before its establishment, the side effects of dividing doctors' roles, the waste of huge amounts of resources, and insensitive policies. In conclusion, in order to resolve health inequalities in Korea, we need to train doctors through medical school education that strengthens the social responsibility of doctors along with strengthening public healthcare infrastructure, and to provide a better environment for doctors working in medically vulnerable areas through sophisticated policies.

• Journal of Korean Society of Rural Planning
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• v.22 no.1
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• pp.93-100
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• 2016

Land price can be affected by convenience or psychological repulsion like PIMFY (Please In My Front Yard) or NIMBY (Not In My Back Yard) for various facilities. Services related to public establishment, welfare, medical attention, and amenities in rural areas are comparatively poorer than those in urban areas. The purpose of this study is to estimate the implications of the accessibility to community facilities in rural areas for land prices using a hedonic price model. The accessibility to facilities is estimated by real road distances and the land prices are applied for four types of land usages: field, rice paddy, building lots, and village halls. Community facilities are classified from public and community services view: education, safety, culture, transport, environment, health care, and finance. The results show that the accessibility to health care and transport can positively affect land prices and the accessibility to environment (waste facilities and junkyard) and unpleasant services (funeral hall and charnel house) can negatively affect land prices. Especially, the accessibility to hospital is the most positive influential factor for all types of land usages.