• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.728-739
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• 1998

To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.267-273
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• 2004

Objectives : This study was aimed at investigating the medical service utilization pattern of patients who use public medical aid compared to those who have health insurance. Methods : We selected every patient between the age of 18 and 69 who used public medical aid from January 1, 1999, to December 31, 2001, in Gwangju metropolitan city, South Korea. For comparison, a list of patients with health insurance was gathered for same period. Then the medical records of those who had been hospitalized for acute appendicitis were selected among both groups. Of those records, we compared the number of cases of ruptured appendicitis to cases of whole acute appendicitis in both groups. Regarding coding for ruptured appendicitis, International Classification of Diseases - 10 (ICD-10) was used. Multiple logistic regression was used as a statistical tool to determine the effectiveness of risk factors. Results : Even after adjusting for risk factors, such as age and sex, the proportion of perforation of acute appendicitis among public medical aid patients was found to be significantly higher than among insured patients. Conclusions : This comparative study on ruptured appendicitis among public medical aid patients and insured patients, indicates that the proportion of perforation of acute appendicitis could be an index showing that these types of patients utilize medical services differently than insured patients. We know that when abdominal pain is not properly treated at the outset, it easily develops into ruptured appendicitis complicated with peritonitis. Considering this data analysis, we guess the public medical aid system to have significant problem with medical accessibility. So additional and systematic research on the pattern of utilization of medical services of public medical aid patients is needed.

• 산학경영연구
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• 제5권
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• pp.215-240
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• 1992

The major purpose of this study is to find the problems that the statistics of industrial accidents showed and to prevent the preventive countermeasures for effective security management. An industrial accident is a disease resulting from exposure during employment to condition or substance detrimental to health or life. This is caused by the conditions of employment and is not projected by the man. This results generally from the comprehensive factors. The claiments of 1990 are 7,542,752 members and the economic deficit is up to 2,696,757 million won. Because of this severe damage, the preventive of the industrial accident is highly required. The way of preventive countermeasures could be presentation as follows. First, for securing the safety, precaution about the tools, machineries and working condition is needed from the time of installation. Second, a traing system for the managerial class the specialists or engineers should be established. Cultivation of the appropriate personnel and enhancement of technique for safety are prerequists for reduction of the industrial accidents. Third, the health checkup system must be improved. For the prevention of the occupational disease and good health of the workes, experts who knows workers health must be appointed. In conclusion, industrial accident is not unavoidable result of the advance of the industries but the result of the incapability of management that can not meet the requirement necessary for the prevention of industrial accident. Therefore, each corporation should be regard the above mention and make effective safety control that is free from the industrial accident. The implement of organizational safety programs, similar to the application of company health plan, involves shared administrative responsibilities among top executive line personnel, staff specialists, first line supervisors, and organizational employment.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.77-84
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• 1988

환경수로부터 Legionella속 균의 분리를 위해 대구시 내 24개의 대형건물의 냉각탑수를 대상으로 1987년 7월과 9월 2차례에 걸쳐 총 48개의 검수를 채취하여 Legionella속 균의 분리를 시도하였다. 9월에 채취한 냉각탑수 24개중 3개에서만 Legionella가 분리되었으며 동정 결과 이들은 모두 L. pneumophila로 판명되었다. 이들의 serotype, 지속성, 병원성을 밝히기 위해 계속적인 연구가 요망된다. 이상의 결과로 보아 우리 나라의 환경수중에 분포되어 있는 Legionella속 균은 대부분 L. pneumophila인 것으로 추정되며, 우리 나라에서는 계절 변화가 뚜렷하여 겨울철에는 냉각 시설을 가동하지 않는 관계로 냉각탑수 중에서의 Legionella의 검출율은 초 여름보다 늦 여름에 높은 것으로 생각된다.

• 한국의료질향상학회지
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• 제14권1호
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• pp.77-91
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• 2008

Objectives : The purpose of this study was to survey the opinion and attitude of hospital managers toward the hospital evaluation program. Method : Managers of 157 hospitals which had participated in the hospital evaluation program were requested to respond to structured self-administered questionnaire. The questionnaire was composed with five categories: the preparation for the hospital evaluation program, the expertise levels of surveyors, the process and contents of the hospital evaluation program, the applying strategies for the result of the hospital evaluation to manager's work at their hospitals, and the main points to improve the hospital evaluation program. Result : 135 out of the 157 subjects completed the questionnaire, and the overall response rate was 86%. The hospital managers answered that they didn't have enough information such as the scoring rule of the standards, the process of the evaluation, and how to ask and get an answer to prepare the hospital evaluation. Furthermore, they estimated that the surveyors weren't specialized enough and didn't give a chance of checking over the result of the evaluation. In addition, they experienced that the result and feedback of the evaluation weren't enough information to be used as a guideline to improve in hospital management. Managers of the hospitals responded that the standards and method of survey in the hospital evaluation system should be reformed. Conclusion : Most of the responded managers seemed to have negative opinion on the hospital evaluation system, even though they were pushed up for interest in quality. Further studies and extensive evaluation of the hospital evaluation program are needed to bring up various information such as receptiveness and effectiveness.

• 보건행정학회지
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• 제17권2호
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• pp.33-51
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• 2007

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

• 한국산업보건학회지
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• 제19권3호
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• pp.250-260
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• 2009

To improve work environment for health managers, it was investigated about effect of job stress, psychosocial stress and job satisfaction of health managers on job commitment. The sample used in this study consisted of 166 persons of industrial health managers. The data were collected with self-administered questionnaires between November 2007 and January 2008, and the results analyzed with ANOVA and multiple regression analysis. Job stress was evaluated by using a Korean Occupational Stress Scale(KOSS), and Psychosocial wellbeing index-Short Form(PWI-SF) was used for a psychosocial stress level evaluation. Organized commitment evaluated loyalty, compensation, welfare, job immersion, external employment opportunity, total agreement with employer and personal ability development. In path analyses, interpersonal conflict, lack of reward, psychosocial distress were associated with job satisfaction. And psychosocial distress, job demand, job insecurity, organizational system, occupational climate were associated with organizational commitment. In considering above findings, the health program for psychosocial distress, improvement of job demand, job insecurity, organizational system, occupational climate would be implemented to increase organizational commitment of Health manager.

• Journal of Preventive Medicine and Public Health
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• 제27권1호
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• pp.107-116
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• 1994

The United States adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses (1) The PPS decelerated the increase in the hospital expenditure (Part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (Part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the Part A expenditure were greater than losses in the Part B expenditure. The dependent variables are per capita hospital expenditure, per capita Part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows : (1) The annual increase in the per capita Part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significient (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita Part B expenditure was accelerated by $1.73 (t=1.91) after the implementation of the PPS. (3) The increase in the total Medicare expenditure per capita was reduced by $4.26 (t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.

• Journal of Preventive Medicine and Public Health
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• 제53권3호
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• pp.158-163
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• 2020

Objectives: In the current early phase of the coronavirus disease 2019 (COVID-19) outbreak, Bali needs to prepare to face the escalation of cases, with a particular focus on the readiness of healthcare services. We simulated the future trajectory of the epidemic under current conditions, projected the impact of policy interventions, and analyzed the implications for healthcare capacity. Methods: Our study was based on the first month of publicly accessible data on new confirmed daily cases. A susceptible, exposed, infected, recovered (SEIR) model for COVID-19 was employed to compare the current dynamics of the disease with those predicted under various scenarios. Results: The fitted model for the cumulative number of confirmed cases in Bali indicated an effective reproduction number of 1.4. Interventions have decreased the possible maximum number of cases from 71 125 on day 86 to 22 340 on day 119, and have prolonged the doubling time from about 9 days to 21 days. This corresponds to an approximately 30% reduction in transmissions from cases of mild infections. There will be 2780 available hospital beds, and at the peak (on day 132), the number of severe cases is estimated to be roughly 6105. Of these cases, 1831 will need intensive care unit (ICU) beds, whereas the number of currently available ICU beds is roughly 446. Conclusions: The healthcare system in Bali is in danger of collapse; thus, serious efforts are needed to improve COVID-19 interventions and to prepare the healthcare system in Bali to the greatest extent possible.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.282-291
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• 2004

Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.