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Policy Measures for Improving Health Care Services in Rural Areas (농촌보건의료서비스 향상을 위한 제도 개선방안)

  • Moon, O.R.;Lee, L.S.;Park, J.Y.;Ko, D.H.;Lee, K.H.
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.97-119
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    • 1991
  • Korea has made a rapid economic development since the last three decades. This has helped Korea narrow the gap in health service differences in resource availability and in quality of care. However urban and rural differentials are still remarkable. This study has maintained that health status of rural residents is inferior to that of urban dwellers. Therefore, this study was carried out to develop policy measures for improving health services in rural areas. In order to achieve the objective of this study the authors collaborated closely and made field visits, interviews and conducted an extensive literature review regarding rural health services. The following policy options are recommended as a summary ; First, the quality of rural health personnel is a single most important factor influencing the level of rural health services. An innovative program for public health doctors to the internship and/or residency training program such as specialty board program of family medicine. Second, dissatisfaction regarding employment of public health doctors is problematic. More rational employment and deployment programs are needed to meet their personal desire. One way to do this is to make it wide open and competitive. Third this study shows how to increase physician productivity in the rural public health sector. Incentive system needs to be elaborated for the career development of rural health workers. University linked job opportunity as clinical professor is an example. Fourth, without straightening the function of health centers and subcenters, the future of rural health services is doomed to failure. Straightening primary health care is one way to enrich the program of public health facilities and reactivating the operation of health center/hospital is another. A close linkage of public facilities with private hospitals is a minimum requirement for the operation of health delivery system within a health district. Fifth, some measures are urgently required to enhance hospital services in medically underserved areas. Financial subsidy, tax exemption, long-term public loans and higher priority of health manpower deployment are some of them. Sixth, new health programs should be in tiated to meet changing needs of peoples in rural areas. Home health care program, hospice program, nursing home, residential program for the elderly are recommended.

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Emotional Labor, Job Satisfaction and Turnover Intention of Nurses in the Regional General Hospital (지역 종합병원 간호사의 감정노동과 직무만족도 및 이직의도)

  • Jeong, Yeon-hee;Lee, Chang-suk;Choe, Hana;Park, Ju-young
    • The Journal of the Korea Contents Association
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    • v.16 no.1
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    • pp.708-719
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    • 2016
  • This research is conducted to grasp emotional labor, job satisfaction, and related turnover intention of nurses at a regional general hospital; to lower level of emotional labor; to raise job satisfaction; to reduce turnover intention; to perform efficient personnel management; and then, to provide qualitative nursing care. Convenient sampling of 100 nurses at a general hospital in D city, who agreed to participation in the test, was made and an analysis method of t-test, ANOVA, Pearson's correlation was used from April 6 to April 12, 2015 by using questionnaires. According to the research, average score of emotional labor was $3.37{\pm}.85$; average score of job satisfaction was $2.86{\pm}.66$; and, average score of turnover intention $3.47{\pm}.87$. Emotional labor had negative correlation with job satisfaction (r=-.56, p<.001) but it showed positive correlation with turnover intention (r=.67, p<.001) while job satisfaction revealed negative correlation with turnover intention (r=-.64, p<.001). According to result of the research, it is required to prepare systematic measures in order to lower level of emotional labor of nurses who play important role of the hospital and to raise job satisfaction, and it is also required to make positive efforts to solve fundamental problems to provide high quality caring service through satisfying nurses' morale.

The study of Health Care Utilization and Direct Medical Cost in the Diabetes Mellitus Client (당뇨병 질환자의 의료이용 및 직접의료비 연구)

  • Yoo, In Sook
    • The Journal of the Convergence on Culture Technology
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    • v.1 no.4
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    • pp.87-101
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    • 2015
  • This study was aimed to make data how much spent money of medical utilization and direct medical cost. In order to research we were using Korea Health panel 2012 Statistics which data contained Diabetes mellitus client 812 people in age 19. The method of this study was emergency cost, admission medical cost, out patient department cost(client own due, National Health insurance service due, not insurance fee). The result of this study, Diabete Mellitus client were using 198 times during 1 year per 100, total medical direct cost were 859,942 won, 447,359 won, 363,255,508. And admission times were 5.6 times per year, total direct cost was 772,240 won, 4,061,982 won, and 3,298,329,384 won, and out patient clinic using number was 10 times, medical cost total direct cost containing total direct cost was 11,978 won, 26,020 won, and 21,129,240 won. From this research we conclusion that the occurrence of diabetes mellitus can be increased medical cost and direct medical cost and it can be huge burden to client including their family and quality of life in the future. We suggest that in order to prevention and management of diabetes mellitus healthy diet, activity, blood sugar, and blood management should be encouragement.

An Analysis Study on stress factor of Emergency medical Students during preparing Examination for Korea Registered licence (국시를 앞둔 응급구조과 학생의 스트레스 영향 요인에 관한 연구)

  • Jung, Ji-Yeon;Yun, Jong-Geun;Oh, Jin-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.1
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    • pp.194-200
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    • 2012
  • The purpose of this study was to analyze the factors on stresses to Emergency Rescue students' who have national examination ahead. In this descriptive research, 87 3rd-degree-Emergency Rescue students from K city were selected. Collected data was analyzed by using the SPSS PC program for descriptive data, t-test, ANOVA and Pearson's Correlation. In result, stress factors are categorized by curriculum($3.67{\pm}.74$), homework ($3.39{\pm}.93$), environment($3.37{\pm}.93$), examination($3.35{\pm}.74$), employment($3.04{\pm}.75$) and total mean was ($3.36{\pm}.59$). The way to adjust stresses characterized by long-term($3.14{\pm}.54$) and short-term($2.55{\pm}.44$), also the short-term is used more than the other ways. The significant differences between general characteristics and stress factor were gender(t=4.466, p=.040), grade(F=2.53, p=.047). In the correlations between categories of the stress factor and stress degree, the examination(r=.81, p=.000), curriculum(r=.66, p=.000), homework(r=.80, p=.000), environment (r=.74, p=.000), and employment(r=.62, p=.000) were significant. In conclusion, it is needed to study for managing stress according to various subjects.

Clinical outcome of coronary artery bypass surgery according to using cardiopulmonary bypass machine (심폐기 사용여부에 따른 관상동맥우회술의 임상성과)

  • Cho, Yeon-Hee;Kim, Hyung-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.9
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    • pp.146-155
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    • 2018
  • This study was conducted to evaluate the clinical outcomes of coronary artery bypass surgery for ischemic heart disease according to use of a cardiopulmonary bypass machine. The subjects were 10,981 patients who underwent coronary artery bypass grafting for ischemic heart disease from July 2008 to June 2012. Analysis data were retrospectively collected using health insurance claims data. The results of the study showed that mean time to surgery (280 min vs 357 min, p<0.0001) and intubation time (about 24 hours vs 40 hours, p<0.0001) were significantly shorter in the Off-Pump CABG (OPCAB) group than in the On-Pump CABG (ONCAB) group. The rate of reoperation because of postoperative bleeding and hematoma was lower in the OPCAB group (2.7% vs 8.3%, p<.0001). The odds ratio of risk adjusted 30 days mortality rate was 0.339 (0.266-0.434) and the postoperative length of stay was decreased in the OPCAB (p<0.0001). Overall, the 30 days mortality and reoperation rates were lower in the OPCAB, as was the resources use.

Research for the Inclusion of Home-Based Physical Therapy in Long-Term Care Insurance System of Physical Therapists in Elderly Care Facilities (노인장기요양보험제도에서의 방문물리치료 도입에 대한 노인요양시설 물리치료사의 인식조사연구)

  • Lee, Kwang-Jae;Roh, Jung-Suk
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.231-240
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    • 2011
  • This study of the elderly in the future expansion of long-term care insurance as a priority landing at the introduction of physical therapy services aim to provide baseline data and long-term care insurance for him, the elderly that provides physical therapy services under the elderly property of a physical therapist recognition system for the investigation was conducted. As a result, the perception of the elderly long-term care insurance was higher by 88.1% of the higher needs, but also the absolute need for more than 40 years of age the response was higher with 60.3 percent. In addition, the number of visits that care should be priced higher relative to the 59.7 percent was the highest opinion. Visit of physical therapy services include the most important therapeutic approach to life and 40% was the highest forum, visit the Nursing Center as a service principal points that you need to visit the rehab center, accounting for 69.4 percent opinion. The expected effect of physical therapy visits conducted in a 50-point scale showed an overall average 41.44 points and 42.48 points, especially over the age of 40 appear in the overall expected effect was higher.

Clients Satisfaction with Oral Hygiene Care Services System Provided by the Dental Hygiene Clinics in the Department of Dental Hygiene, Yonsei University (연세대학교 치위생학과 구강위생교육실을 방문한 대상자의 구강위생관리 서비스체계에 대한 만족도 조사)

  • Kim, Nam-Hee;Kwon, Hye-Ri;Kim, Da-Hye;Kim, Da-Hee;Kim, Min-Hee;Yoo, Seung-Hee;Choi, Jin-Ah;Chung, Won-Gyun
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.4
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    • pp.419-431
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    • 2007
  • The setting of dental hygiene clinics is very important to dental hygiene education, which is the place not only to educate students but also to care clients. The purpose of this study is to provide basic research material for improvement of dental hygiene care system in dental hygiene clinics by analyzing the client satisfaction. A questionnaire survey by means of self-entry method was conducted to find out satisfaction of the client, who was visited to the dental hygiene clinics in the department of dental hygiene, Yonsei University. An analysis of frequency, one way ANOVA and T-Test were performed through SPSS 12.0K program. 1. Most clients were mainly composed of students in Wonju College of Medicine. 2. The clients visited for scaling(85.8%) and oral examination(9.73%) were much than treatment(4.42%). 3. Clients aged 21 to 25 were relatively lower in satisfaction with the facilities, system, attitude than any other ages. 4. The dental hygiene students are the lowest group in satisfaction with the facility, system, attitude than medical and nursing students. 5. The clients satisfaction with dental hygiene clinics was decreased in reverse proportion to visiting frequency. 6. Most of the clients pointed out the problems of appointment system(54.0%) and fee(23.0%), which should be improved than any other operation conditions. 7. Most of the clients were not satisfied with chair time and pain during care. 8. Most clients recognized to receive the better care service than other dental offices(81.3%). Especially, they paid attention to oral health education using phase-contrast microscope. 9. Many clients were dissatisfied with facilities of the dental hygiene clinics(71.7%). The problems of appointment system(54.0%) and chair time of dental hygiene care services(63.6%) had also inconvenienced to clients. The dental hygiene clinics in school play a crucial role in dental hygiene education to foster the student to be competent as a professional dental hygienist in the future. Therefore, well-organized dental hygiene care program based on dental hygiene process is essential. It is also required to improve the environment of dental hygiene clinics including facilities, appointment system and fee etc.

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Digit ratio(2D:4D) and gender role orientation in health and medical students (보건의료 대학생의 손가락 길이비(2D:4D)와 성역할 정체감)

  • Kim, Keum-Sook;Cho, Keun-Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2170-2177
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    • 2012
  • The ratio of index finger length to ring finger length(2D:4D) is an index of prenatal testosterone and/or estrogen exposure. The aim of this study is to investigate digit ratio and the type of gender-role orientation, to identify the correlation between 2D:4D and gender-role orientation in health and medical students. Participants were 120 male and 146 female university students majoring in health or medicine. After filling in KSRI(Korean Sex Role Inventory), 2nd and 4th finger lengths were measured on both hands using vernier callipers with photocopy. This study showed 2D:4D in the males was 0.95, and that in the females was 0.96 (p<0.01). 38.3% male students revealed androgyny, on the other hand, 35.6% female students revealed undifferentiated type from KSRI. And also, there was a significant difference in masculinity score between male and female but not in feminity score. There was no significant difference in 2D:4D according gender role orientation. The KSRI masculinity score was negatively related to 2D:4D of left hand in male (p<0.05). The results of this study suggest that a more masculine gender role orientation in males is associated with low 2D:4D revealing higher testosterone and/or lower estrogen level in utero. However, more research in 2D:4D ratio to Korean is needed for support of this result.

The Development of Satisfaction Tool to Health Care Services - focused on Patients and their families - (의료 서비스에 대한 만족도 측정 도구의 개발)

  • Kang, So-Young;Lee, Sun-Mi
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.104-124
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    • 1996
  • Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

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Survey for the Current Status of MCH Service in Rural Area (우리나라 일부 농촌지역의 모자보건 실태조사)

  • Kim, Byung-Sung;Chon, Hae-Jung;Cha, In-Jun
    • Journal of agricultural medicine and community health
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    • v.17 no.1
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    • pp.5-16
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    • 1992
  • The maternal and child health is a basis of national health, and indicates the level of social welfare and health of the country, because it is related with community welfare status, general cultural conditions, and medical and health sciences. This is a study carried out to identify the present practices of maternal and child health care programs implemented by the private clinics located in Guns(counties ; rural area) in Kyungsangnam Province and to propose alternatives to improve their current programs through a self-administrative questionnaire. The subjects were 90 private physicians who operated their own clinics since 1990 and were general practitioners, Obstertrician/Gynecologists or pediatricians: This survey was conducted by mail from 15 January to 25 February 1992. The response rate was 94.4 percent. 1) The major manpower for MCH programs of the studied clinics was physicians and nurseaids. 70.3% of physicians were general practitioners, 81.1% of nursing manpower were nurseaids. 31.1% of the studied clinics employed lab-technicians. 89.2% of them had MCH room whatever the size and the setting, and 84.4% of Ob/Gyn clinics installed laboratory equipments. 2) 55.4% and 63.5% of the studied clinics provided 151 or above consulting services and curative services of MCH per physician a month respectively and 33.8% and 25.7% of them provided 10 or less consulting services and curative services per physician a month. 91.9% of lab-technicians had 10 or less laboratory tests per technician a month. 3) There was a difference between Ob/Gyn and pediatric clinics in terms of services delivered : for example, 80% of Ob/Gyn clinics provided pre- and post- natal care services, while 84.6% of pediatric clinics provided vaccinations for children. It was also found that only a few of general practitioners involved pre-and post- natal care services. 4) There were no clinics which had opened regular health education session but 24.3% of them had opened the sessions irregularly. Ob/Gyn clinics put emphasis on maternity and pediatric clinics did on child health, but general practitioners touched with both maternal and child health. 21.6% of the studied clinics had some kind of educational materials for MCH programs. Most of the materials were pamphlets or small booklets. 5) Proteinuria/glucosuria, blood pressure and blood type were tested in 48.6~69% of the studied clinics ; tests for blood sugar and hepatitis B were provided in 39.2~41.9% of them, most of them were done in Ob/Gyn clinics. 6) 41.9% of physicians, 29.7% of nurses and 45.9% of nurses-aids wanted to receive on-job-training for MCH programs.

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