• Journal of agricultural medicine and community health
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• v.36 no.1
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• pp.36-46
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• 2011

Objectives: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. Methods: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. Results: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. Conclusions: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.

• Journal of agricultural medicine and community health
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• v.35 no.4
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• pp.395-404
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• 2010

Objectives: This study was conducted to investigate the relationship between vertical trust in the healthcare system and participation in routine health examinations. Method: Data from the 2008 Pusan Health Survey were analyzed for this study. Multiple logistic regression analyses were performed to investigate the influence of possible confounders (sex, age, education, monthly mean household income, horizontal trust) on participation in routine health examinations according to trust in the healthcare system. Result: In a total sample of 7,683 participants, 3,756 (48.9%) were classified as health examination participants. Respondents with high trust in the healthcare system had significantly higher odds ratios of participation, 1.17 (95% CI 1.03-1.33), after multiple adjustments. Conclusion: Vertical trust in the healthcare system was significantly associated with higher odds of participation in routine health examinations. Improvements to the healthcare system have potential for increasing participation in routine health examinations.

• Journal of agricultural medicine and community health
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• v.35 no.3
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• pp.301-313
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• 2010

Objectives: The purpose of this research is to provide foundational data for reeducation concerning prehospital emergency care in order to improve the performance of emergency medical technicians (EMTs) working at 119 fire safety centers. Methods: Data were collected using a mail-in questionnaire developed by researchers from 288 subjects, who were EMTs working at 119 fire safety centers and local units in the Gwangju Metropolitan City and South Jeolla Province, from March 1, 2009 to April 31, 2009. Results: The mean score for EMTs' knowledge on drug intoxication was7.04 out of a total of 10 points. The mean score for EMT's attitude of emergency treatment performance on drug intoxication was 2.96 out of a total of 4 points. The level of EMT's knowledge is relatively high regarding prehospital care for drug intoxication. The EMT's attitude of performances demonstrated an understanding of the patients' conditions. However EMTs did not actively explain the prognosis and medical conditions for their patients. Conclusions: This research will contribute to making plans for reeducating emergency crew working at 119 fire centers so that can they have a more active attitude towards prehospital emergency medical care.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.369-385
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• 1999

This is carried out to study on the general consciousness for medical ethics of Korean local and hospital clinicians from March to May, 1999. The subjects are 288 respondents out of 1,500 those who selected by systemic random sampling method from the list of physicians published on 1997. An adequate questionnaire with 21 questions made by author was distributed through mail for those. The characteristics of respondents are as follows. Women are 15%. For like this questionnaire, those who were graduated from. The national universities were more actively concerned than those graduated from the private universities. Christian was 35.4%, Catholic was 28.5% and buddhist was 14.9% and 17.4% had no religion. Now a day in generally, it is clearly confusing status between an ideal thinking and actuality in medical ethical aspects in Korea. They want more developed medical delivery system. The most of physicians are improving on four mind-sets, the mind of love, pity, joy and abandonment as much as they are cognizing that the pains of patients are themselves pains. But they do not want to be the ministry. On the problems of the easy to die, it seems that they have somewhat different opinions according to their religions, respectively;- christians are more responsible than others to keep to the terminal point of life of patients.

• Journal of Korean Society for Atmospheric Environment
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• v.4 no.1
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• pp.58-70
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• 1988

대기오염이 건강에 미치는 영향의 유무를 알아보고 그 영향의 정도를 반영해 줄 수 있는 지표의 개발을 목적으로 우리나라 전역을 서울, 대도시, 중소도시, 농어촌 등 4개 지역으로 구분하고 의료보험대상자 3,922,027명에 대한 호흡기질환 외래수진률을 지역별로 비교해 보았다. 조사대상 질환군으로서는 다음 7가지의 호흡기질환을 채택하기로 하였다. 1) 결핵성 질환 2) 호흡기 및 흉곽내장기의 악성신생물 3) 급성호흡기 감염 4) 폐염 및 인플루엔자 5) 만성폐색성 폐질환 및 유사증 6) 진폐증 및 외인성의 기타 폐질환 7) 상기도의 기타질환 상기 질환으로 인한 외래수진에 관한 정보는 1983년 1월 1일 부터 12월 31일 사이에 제출된 보험의료비 청구서에 나타난 자료를 이용하여 수집하였으며, 그 분석을 통해 다음과 같은 결론을 얻었다. 1) 지역별 연간종합외래수진률을 비교해 본 결과 농촌지역에서 가장 낮은 수준을 나타내고 있는 질환은 조사대상 7개 호흡기질환군중 다음 4개 질환군이 해당되고 있다. (1) 결핵질환 (2) 호흡기 및 흉곽내장기의 악성 신생물 (3) 상기도의 기타질환 (4) 진폐증 및 외인성의 기타 폐질환 한편 이 종합외래수진률이 가장 높은 지역은 대도시 지역으로서 5가지 호흡기질환군의 수진률이 다른 지역에 비해 훨씬 높게 나타나 있다. 이와같은 결과는 의료보험환자들의 "외래수진률"을 이용하여 대기오염과 건강과의 관련도를 측정할 수 있는 "대기오염 - 건강" 지표의 개발이 가능할 것임을 뒷받침해 주고 있다. 그러나 가장 오염도가 높다고 예상되는 서울지역에서의 외래수진율이 대도시 지역보다 높지 않다는 것은 오염도와 외래수진률과의 관계에서 일관성있는 결과를 보여주지 못하고 있음을 뜻하는데 과거의 자료로서는 외래수진률만 가지고 대기오염과 건강과의 관계를 표시해주는 지표로 삼기에는 미흡함을 알 수 있다. 2) 월별 외래수진률의 경향을 보면 거의 모든 호흡기질환군에서 계절적인 특이성을 나타내지 못하고 있다. 단 이 경우도 농촌지역이 연중 계속 최하위를 유지하고 있는 질환군이 7개 대상질환군 중에 4개군에 달하고 있다. 3) 보험환자들의 "외래수진률"은 아직은 미흡한 점이 있으나 앞으로 "대기오염 - 건강" 지표로서 개발 활용할 가치는 있다고 볼 수 있으며 서울, 대도시, 중소도시, 농어촌 등 4개 지역에 대한 월별 외래 수진률을 다음 4가지 질환군에 대하여 계속 관측하여 그 경향을 분석할 것을 권장한다. (1) 호흡기 및 흉곽내장기의 악성 신생물 (ICD. 160-165) (2) 급성호흡기 감영 (ICD. 460-466) (3) 폐염 및 인플루엔자 (ICD. 480-487) (4) 만성폐색성 폐질환 및 유사증 (ICD. 490-496) 4) 외래수진률은 진료방식 즉, 투약기간의 장단등으로 인한 통원 (通院) 빈도 차이의 영향을 받게 되므로 지역별 병 $\cdot$ 의원의 보험환자 진료방식에 대한 비교검토가 요구된다.

• Journal of agricultural medicine and community health
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• v.45 no.4
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• pp.194-207
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• 2020

Purpose: The purpose of this study is to develop and evaluate the curriculum, that was the continuing professional development program, for cultivating physician's competencies in public health. Methods: This study was conducted through in-depth interview and survey in the frame of ADDIE, from 2 May to 30 June in 2019. Participants were 7 physicians by in-depth interview and Respondents were 46 physicians worked in public health by survey. Results: The results were analyzed and described in the frame of ADDIE model. In the stage of Analysis, physician's core competencies in public health was presented to practical education, management of organization and labor force, communication with community, and director' role of public health center in the community as core competencies by in-depth interview. The skill - knowledge-attitude competencies were highest in order in the survey for placing priority (by Borich score) of 29 core competencies. In design stage, the educational objective of curriculum was established, that is to develop the competencies of knowledge, skills, and attitude needed for physician of public health in 21th century. In development and implementation stage, it is important to decide to lecturer, to get in advance educational materials to do the maintenance and management of curriculum. In the stage of evaluation, the educational satisfaction was high on the whole and educational effect was statistically significant. Conclusions: This study was an initial study of Korean doctors, and it aims to pursue competency-based education as a continuing professional development (CPD) beyond continuing medical education (CME) including knowledge, skills, and attitudes.

• Health Policy and Management
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• v.6 no.1
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• pp.163-190
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• 1996

본 논문은 미국 농촌병원의 경영전략과 관련하여 몇가지 가설을 검증한 연구결과이다. 구체적으로 1987년부터 1991년 사이의 미국 농촌병원들의 기본적 경영전략 지향 형태와 변화 추세, 경영전략과 환경 및 병원특성과의 관계, 그리고 경영전략과 재정적 성과의 관계 등이 연구되었다. 본 연구의 자료수집은 미국 농촌지역의 모든 종교병원과 영리병원, 그리고 무작위 표본추출로 뽑힌 50%의 공공병원 및 기타 비영리 병원의 최고경영자를 대상으로 1989년에 우편설문조사를 통해 이루어졌으며 회수된 설문지 중 사용가능한 640개 병원 (응답율 43%)의 자료가 분석 이용되었다. 조사대상병원의 환경적 특성자료는 지역자원 파일(Area Resource File)에서 수집하였고, 병원특성 및 재정적 성과자료는 미국병원협회 연감(Annual Survey of Hospitals)에서 구하였다. 응답병원과 비응답병원간에 환경 및 병원특성에 유의한 차이는 없는 것으로 나타났다. 본 연구에서는 Miles와 Snow가 개발한 방어형(defender), 분석형(analyzer), 진보형(prospector), 반응형(reactor)의 네가지 경영전략지향 형태를 사용하여 분석하였다. 본 연구의 결과를 요약하면 다음과 같다. 1) 미국 농촌 병원들은 과거에는 방어형 및 분석형의 경영전략 지향을 보이다가 점차 반응형과 진보형으로 변화해 가고 있다. 2) 가장 뚜렷한 경영전략 지향의 변화추세는 방어형이 급격히 줄고 반응형이 크게 늘어나고 있다는 점이다. 이는 많은 병원들이 급격한 환경변화에 적응하기 위해 일관된 전략 지향보다 융통성 있고 탈력적인 경영전략을 선호하고 있음을 나타낸다. 3) 농촌병원들은 경영전략의 급격한 변화를 추구하지는 않을 것이라는 가설을 뒷받침할 근거는 없는 것으로 나타났다. 이는 급격한 의료환경의 변화로 인해 병원들이 다양한 경영전략의 변화를 모새하고 있는 것으로 볼 수 있다. 4) 대부분의 외부환경 및 병원특성은 병원의 전략지향의 선택에 큰 영향을 미치지 않는 것으로 나타났으나 인구 10,000명당 의사수, 병상규모, 위탁경영 여부, 병상점유율, 소유형태 등의 변수들이 경영전략 지향 형태에 따라 유의한 차이가 있는 것으로 나타났다. 5) 경영전략 지향이 상이한 병원들은 세부 실천전략에 있어서도 치이가 있을 것이라는 가설을 일부 전략에 있어서 사실인 것으로 나타났다. 즉 방어형 병원들은 진보형이나 반응형 병원들보다 내부관리전략, 다양화 전략, 의사유치전략, 직원복지전략 등에 있어서 소극적인 것으로 나타났다. 6) 비록 방어형 병원들이 다른 형태의 병원보다 낮은 재정적 성과를 보이고 있었지만 본 연구의 자료로는 경영전략지향과 재정적 성과간의 인과관계를 구명할 수 없었다. 또한 재정적성과에 따른 전략지향의 변화여부도 통계적으로 유의한 관계가 있지는 않은 것으로 나타났다. 이는 각각의 전략지향들이 환경에 따라 나름대로 장점을 가질 수 있으며 반드시 어느 한가지의 전략지향만이 최선은 아님을 시사해주고 있다. 7) 병원의 경영전략 변화는 환경의 변화와 더블어 그러한 변화에 적응할 수 있는 내부의 능력과도 관계가 있는 것으로 보인다. 이상의 연구결과에 따르면 미국의 농촌병원들은 급격한 환경변화에 적응하기 위하여 다수의 병원들이 환경 및 벼원특성에 관계없이 생존을 위한 전략적 노력을 기울이고 있음을 알 수 있다. 끝으로 이러한 연구결과는 최근 어려운 경영환경에 처한 한국의 농촌병원들도 합리적인 경영을 위해서는 병원이 처한 외부환경분석과 함께 내부의 능력에 적합한 경영전략의 방향을 설정하고 그에 따른 실천적 세부 경영전략을 수립해야만 한다는 것을 시사해 주고 있다.

• Journal of agricultural medicine and community health
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• v.44 no.3
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• pp.115-123
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• 2019

Objective: This study was conducted to examine the effects of a health promotion program on the health condition of rural elderly women implemented at primary health care posts using Korean Frailty Index. Methods: The research was designed a nonequivalent control group pretest-posttest setting. The participants in this study were 50 residents (intervention group: 25, control group: 25) selected from 4 villages 2 primary health care posts in J city Gyeongsangnam-do. The health promotion program was conducted at the primary health care posts twice a week for 12 weeks. This program consisted of basic exercises(Gukseondo + Theraband muscle strength training) and additional activities(including modified Theraband activity, rubber ball exercise, ball massage, nutrition class, singing class). Collected data were analyzed by descriptive statistics, paired t-test, and repeated measures ANOVA with SPSS 21.0. Results: Results of the health promotion program showed that the health conditions(measured by perceived health status, frailty score, upper/lower flexibility, maximum grip strength, dynamic balance test Timed Up and Go) of the experimental group(25) all statistical significantly improved. Conclusion: Study findings indicate that the health promotion program implemented at primary health care posts on rural elderly women is effective and can contribute to a developed health promotion program for local residents in the future.

• Journal of agricultural medicine and community health
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• v.11 no.1
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• pp.55-63
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• 1986

In general, patients' health seeking behaviours can be affected by three factors ; psychological factor, economic factor and health delivery system. This study was focused on how the psychological factor affect to health seeking behaviour influenced by the various attitude of residents toward medical resources in their community. A total of 306 households were sampled for the investigation among residents of Banwol-Eup which was an industrial city newly developed. The data has been collected by interview method using close ended questionnaire. The major findings are ; 1) the respondents' attitude toward medical institutions in their community has shown negative responses (rate of negative attitude (a) 81.3%- facilities (b) 40.7% medical expenses (c) 21.1%-kindness of employees of medical facilities (d)59.0%- the degree of thorough explanation to patient on medical examination (e) 58.2%-doctors' practical competency). Above all, they have shown negative response on doctors explanation on results of medical examination and doctors' practical competency. 2) The study indicated a significant difference in health seeking behaviour between the group of positive attitude and that of negative attitude. 3) A big difference between the above mentioned two groups was identified as the attitude toward sub dimension of practical competency.

• Journal of agricultural medicine and community health
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• v.8 no.1
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• pp.35-43
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• 1983

Health institutions in Korea include a wide range of traditions, most notable of which are hospitals, clinics, pharmacies and health centers as foci for the dispension of western medicine care ; and herb clinics and shamans acting as centers for traditional medicine. Health consumers have pluralistic conceptions of illness(or disease) and act accordingly, using what they consider as appropriate medical practices. The research conducted surveyed residents of Jeomdong-Myon(a rural farming district), Guro 6-Dong(an urban district) and the Banwol(a semiurban district) area on attitudes about health institutions and their utilization of them. The results indicate that the hospital is considered the most reliable health institution, however, the most widely known and commonly used institution was the pharmacy. Hospitals and clinics were found to be utilized more frequently by those residents who were familiar with them than by others less familiar with them. In addition respondents with higher education, those with medical insurance, and those living in urban areas tended to utilize hospitals and clinics more frequently than their less educated, uninsured, or rural counterparts. Converse to the ranking of western medical institutions, traditional health institutions were rated low with regards to reliability, familiarity and utilization. This indicates that western medical care has pervaded the Korean medical system.