Objectives : There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. Methods : To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n=60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n=57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. Results : The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. Conclusions : This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.
Objectives: This study is conducted to identify the cancer incidence in Gwangju during the 5-year period from 1998 to 2002 and to assess the completeness and validity of the cancer registry data during this time period. Methods: All cases that had a diagnosis of invasive cancer (ICD-10 sites C00-C97) during the study period were retrieved from the records of the Gwangju Cancer Registry (GCR), which theoretically includes all the cancer cases in Gwangju. All the cases during the study period were analyzed by gender, age group and cancer sites. The completeness (mortality/incidence ratio and age-specific incidence curve) and validity (histologic verification, primary site unknown, age unknown and death certificate only) of the cancer registry in Gwangju were analyzed by gender, age group and cancer sites for the 5-year period. Results: The overall cancer incidence was higher in the males than in the females (age-standardized incidence rates (ASR) 299.8 and 172.4 per 100,000, respectively). In males, the most common cancer was stomach (ASR: 65.8), followed by liver (ASR: 50.5), bronchus and lung (ASR: 50.5), colo-rectum (ASR: 26.7), oesophagus (ASR: 10.6), and bladder (ASR: 10.3) in descending order. In females, the most common cancer was stomach (ASR: 26.8), followed by thyroid (ASR: 20.7), breast (ASR: 20.4), cervix uteri (ASR: 14.3), bronchus and lung (ASR: 13.0), liver (ASR: 10.7) and colo-rectum (ASR: 17.2) in descending order. The overall quality (completeness and validity) of the cancer registry was at the in 'good' level. Conclusions: These results will be useful in the overall context of planning and evaluating of cancer control activities in Gwangju.
Journal of the Korea Academia-Industrial cooperation Society
/
v.15
no.5
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pp.2859-2869
/
2014
The present study aims to examine job satisfaction and stress in relation to features of jobs taken by nursing assistants. The subjects for study are 469 nursing assistants active at work in various medical clinics and hospitals in Seoul Metropolitan City, engaged in a study conducted from May 1, 2013 through September 4, 2013. The positive analysis was verified at a significance level of five percent, and SPSS/WIN18.0 was used for statistics process. The analysis of frequency, t-test, one-way analysis of variance, and multiple regression analysis were conducted, and was then analyzed by multiple range test for statistics. The analysis reveals that job satisfaction level marks significant variance in accordance to the year of nursing assistant certificate acquired, age, and their final academic backgrounds. As to the job satisfaction variances in accordance to job features, the location of working places, fields of jobs, and the mode of jobs mark the highest. The study indicates that standardized directions for tasks in specific fields of jobs and education programs should be implemented for consistent management are requisite for improved efficiency of nursing assistants and professional nursing workforce.
Ku, Jeong-Kui;Hong, Inseok;Lee, Bu-Kyu;Yun, Pil-Young;Lee, Jeong Keun
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.45
no.2
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pp.51-67
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2019
As dental implant surgery and bone grafts were widely operated in Korean dentist, many bone substitutes are commercially available, currently. For commercially used in Korea, all bone substitutes are firstly evaluated by the Ministry of Health and Welfare (MOHW) for safety and efficacy of the product. After being priced, classified, and registration by the Health Insurance Review and Assessment Service (HIRA), the post-application management is obligatory for the manufacturer (or representative importer) to receive a certificate of Good Manufacturing Practice by Ministry of Food and Drug Safety. Currently, bone substitutes are broadly classified into C group (bone union and fracture fixation), T group (human tissue), L group (general and dental material) and non-insurance material group in MOHW notification No. 2018-248. Among them, bone substitutes classified as dental materials (L7) are divided as xenograft and alloplastic bone graft. The purpose of this paper is to analyze alloplastic bone substitutes of 37 products in MOHW notification No. 2018-248 and to evaluate the reference level based on the ISI Web of Knowledge, PubMed, EMBASE (1980-2019), Cochrane Database, and Google Scholar using the criteria of registered or trademarked product name.
Objectives: This study analyzes factors related to English communication skills in the dental health services of clinical dental hygienists who provide dental medical services to foreigners. Methods: Surveys were conducted to measure students' English communication skills. Participants comprised 195 clinical dental hygienists working at dental English study cafes or who provided dental medical services to foreigners. After analyzing the differences in English communication skills, hierarchical multiple regression analysis was performed on the factors related to English communication skills. Results: English communication skill of dental hygienists was 1.96 points out of 5 points. The factors related to the English communication skill of the clinical dental hygienists were foreign patient care, language training experience, overseas living experience, and certified English proficiency. The adjusted explanatory power of this model was 53.0%. Conclusions: Dental hygienists in charge of foreign patients have experience in language training and overseas residence, have a language qualification certificate, and have higher English communication skills. It is necessary to develop English language learning programs based on metaverse to develop the English communication skills of dental hygienists who provide dental health services to foreign patients and to operate a creative educational environment to increase interest in learning English.
Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.
Lee, Han Na;Lee, Song Mi;Park, Yoo Kyung;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
Journal of the Korean Dietetic Association
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v.20
no.4
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pp.235-246
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2014
The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.
Kim, Sol;Kim, Su-Jeong;Jang, Mi-Rae;Kim, Min-Gyeong;Seo, Yang-Gyung;Lee, Hee-Yeon;Jang, Young-Eun;Park, Gui-Ok;Kim, Nam-Hee
Journal of Korean society of Dental Hygiene
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v.16
no.6
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pp.969-978
/
2016
Objectives: The purpose of the study was to examine the expected role and competency of future public health dental hygienist. Methods: This study was cross-sectional design. One dental hygienist per 16 cities and provinces was selected from the list of Korea Society of public dental hygienists. After signing in the informed consent, the interview was carried out. Transcripts were made after each interview. Six researchers recorded meaningful contents in the transcripts. They classified and integrated the information that they had recorded commonly or not. Their opinions were converged by conference. Two supervisors verified results whether they were derived from actual recordings for the reliability of the results. The records were confirmed once again and corrected into common message. Results: The main difficult subjects in public health official examination were public health, English, and medical legislation to pass the examine. The preliminary certificates included public health related certificate, computer certificate, and driver's license. In the personality aspect, creativity, activeness, cooperation and good responsibility were very important trait to public health official. Among 16 interviews, 9 were positive and 5 were negative about the future prospects of a public dental hygienist. Conclusions: The future of public health dental hygienist will be positive. Throughout effort to prepare for the public health official, the public health dental hygienist will be expanded and in many ways the dental hygienists will take the charge of the important parts of the public health administration in the near future.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.9
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pp.6061-6070
/
2015
The purpose of this study was to examine relations on the autonomy, nursing performance based on the awareness and satisfaction of electronic medical record system for nurses. This Study was a descriptive survey design using convenience sampling. There were 194 general hospital nurses, who agreed to participate in this study, taken a structured questionnaire during august 2013. SPSS 20.0 version was used for descriptive analysis, frequency, percentage, mean, standard deviation, independent t-test, one-way ANOVA and Pearson correlation coefficiency. The major findings of this study were as follows. The mean score on the awareness of EMR was 3.68, the mean score on the satisfaction was 3.47 and nursing autonomy mean score was 3.25, nursing performance mean score was 3.55. There were significant differences in the awareness according to working field and computer certificate. There were significant differences in satisfaction depending on whether they held computer certificates Head nurses and the above scored significantly higher in nursing performance compared to nurses at the lower position. Also, higher awareness was significantly related to higher satisfaction. Higher satisfaction was significantly related to higher nursing autonomy and performance. The findings of this study imply that nurses need to raise their EMR awareness and satisfaction and make best used of their qualification with their computer certificate.
The aim of this study is to introduce the accuracy of Ir-192 source's apparent activity using the well-type chamber and the Farmer-type ionization chamber in the high dose rate brachytherapy. We measured the apparent activity of Ir-192 that each medical center in the country has and the apparent activity of calibration certificate provided by manufacturer is compared with that by our experimental measurement. The number of sources used for the activity comparison was 5. The accuracy of the measured activity was in the range of -2.8% to -1.0% and -2.1% to 0.2% for the Farmer-type chamber system (Jig) and for the well-type, respectively. The maximum difference was within 1.0% for comparison with two calibration's tool. Our results demonstrate that well-type chamber as wall as Farmer-type chamber is a appropriate system as the routine source calibration procedures in HDR brachytherapy. Whenever a new source is installed to use in clinics, by periods, a source calibration should be carried out.
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