• Quality Improvement in Health Care
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• v.26 no.2
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• pp.86-94
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• 2020

Purpose: This study aimed to identify current quality control (QC) practices of primary care clinics participating in the National Cancer Screening Program (NCSP) in Korea. Methods: A nationwide survey using a structured questionnaire was conducted among the primary care clinics participating in the NCSP, which were selected by a proportionate stratified sampling. The questionnaire consisted of general information about the responding clinics and the scope of QC activities undertaken. A total of 360 clinics responded and the set of data was then analyzed with Chi-square test and multivariable logistic regression analysis. Results: Among 360 respondents, 332 (92%) reported that they were involved in the QC activities. Most frequently performed QC activities were 'maintenance of facility and instruments' (89%) and 'staff training' (85%). The analysis revealed, with statistical significance (p<.05), that there was an association between certain characteristics of the clinics and the scope of QC activities. These findings also indicated that the diversity of QC practices varies according to the size of the clinics. The clinics screening more types of cancer, those with more screenees, and those with more employees were more likely to implement various QC activities including 'maintenance of facility and instruments', 'external quality control', and 'management of screening data'. Conclusion: To our knowledge, this is the first study to investigate the current status of QC activities conducted among primary care clinics participating in the NCSP. The results of this survey can be used as a basis for further development of policies on quality management of small- and medium-sized primary care clinics in Korea. However, further studies encompassing various aspects of QC activities and management of primary care clinics are needed to assess the current situation in a concise manner.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.131-160
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• 2023

An amendment to Medical Law allowing permanent face-to-face treatment has been proposed in the 21st National Assembly, with five different bills introduced. However, each proposed amendment focuses on different aspects, and the issue is currently in a state of 'ongoing review' due to factors such as opposition from the medical profession and political considerations. However, from the perspective that the introduction of non-face-to-face treatment should be institutionalized and legislated prioritizing patient safety, certain directions are proposed. These include focusing on returning patients as the primary target, chronic diseases as the focal conditions, outpatient medical institutions as the implementing agencies, restricting non-face-to-face means primarily to video systems, and legally exempting healthcare professionals from responsibility for incidents beyond their control. The proposed directions also emphasize establishing the right to demand face-to-face treatment. It is suggested to legislate initial standards that ensure a minimum level of safety and gradually expand the scope of non-face-to-face treatment through future research, evaluation, and similar step-by-step approaches.

• Journal of Teachers' Pension
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• v.3
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• pp.207-252
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• 2018

현행 사학연금법은 공무원연금법 제46조 제1항 제4호 "정원 감소로 퇴직한 때부터 연금 지급" 조항을 준용함에 따라 정원감축 및 폐교에 따른 퇴직을 할 경우 법에 명시된 연금지급 개시연령이 아닌 퇴직 후 5년 이후에 조기연금을 지급하도록 하고 있다. 본 연구의 목적은 현행 지급개시연령 규정의 타당성을 검토하고 개선방안을 제시하는데 있다. 이를 위해 사학연금 지급개시연령 현황 및 사립학교 폐교 현황과 사학연금이 공무원연금법을 준용함으로써 발생하는 문제점 및 현행 규정에 따른 연금지급 시 사학연금재정에 미치는 영향을 분석하고 법 개정의 타당성을 검토하여 개선방안을 모색하였다. 주요 연구결과는 다음과 같다. 65세 정년이 되어 은퇴하지 않고 중도에 퇴직하거나 고용이 취소되어 지급개시연령 보다 훨씬 일찍 조기연금을 지급하게 될 경우에는 퇴직연금 자체가 노후소득보장제도이기 보다는 실업급여의 성격으로 전락하게 되는 측면이 있다. 또한, 폐교에 재직 중인 교직원은 근로가 가능한 연령과 건강상태임에도 불구하고 즉시 연금을 수급하게 됨으로써 재취업을 하지 않을 경우 연금에 대한 의존성이 높아지고 근로유인을 저해할 수 있다. 그리고 최근 잦은 폐교로 인한 연금수급자 과다 발생 및 재정적 지속가능성의 문제가 있다. 또한 사학연금 가입자와 공무원연금 가입자의 특성을 비교하면 중요한 차이점이 발견된다. 국공립학교의 경우에는 해당 학교가 폐교 또는 정원이 감소될 경우 다른 지역 학교로 해당 재직 교직원을 이동 배치하는 등의 대처 방안을 시행하기 때문에 사실상 퇴직하는 사례가 거의 없는 반면, 사학연금 가입자의 경우 공무원연금 가입자에 비해 상대적으로 고용불안에 노출되어 있고, 학령인구 감소 등으로 인해 사립학교 폐교 가능성이 상존하므로 이들에 대한 생활안정대책이 필요하다. 또한 공무원 조직의 개폐 및 정원 감소는 법령으로 정하고 있지만, 사립학교 교직원의 개폐 및 정원의 감소는 사학기관의 특성에 따라 차이가 있다. 그리고 공무원의 경우 공무원연금의 대상이면서도 고용형태의 상대적 취약점을 감안하여 임기제 공무원의 경우 고용보험의 가입이 일부 허용되나, 사학연금 가입자의 경우에는 전면적으로 가입이 제한되어 직역연금 간 형평성 문제가 발생하고 있다. 그리고 국민연금과 비교할 때 다음과 같은 차이점이 있다. 국민연금법의 경우 사업장가입자로 적용받고 있다 하더라도 준용법과 같은 사립학교 폐교 시 조기연금 수급 규정이 없으며, 고용보험법의 적용으로 실직 시 실업급여 등의 대응책이 있긴 하나 연금 수급을 통한 소득보장 수준에는 못 미치는 제도적 보완책을 갖추고 있다. 또한, 국민연금 가입자는 고용보험에 적용되나, 사학연금 가입자는 실업상태에 놓였을 경우 고용보험의 적용을 받지 못한다는 점에서 차이가 존재한다. 이에 다음과 같은 개선방안을 제시하였다. 폐교 시 사학연금 가입자의 생활안정을 위해 고용보험 가입을 검토할 필요가 있고, 재정안정화를 위해 연금을 전액지급하기 보다는 퇴직일부터 지급개시연령까지의 잔여기간에 따라 차등지급하는 방안을 모색해 볼 수 있으며, 고용보험법상의 실업급여 제도를 원용하고 소정의 연금지급기간을 설정하여 연금을 지급하는 방안을 고려할 필요가 있다. 이에 더하여 사학연금제도 내에서 별도의 고용보험기금을 마련하는 방안도 모색해볼 필요가 있다.

• The Journal of the Korean dental association
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• v.53 no.11
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• pp.789-794
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• 2015

Swallowing disorders or dysphagia, which are difficulties with the act of swallowing, can occur at different phases such as oral, pharyngeal, and esophageal phase in the swallowing process. These disorders can be caused by structural, functional abnormalities or psychological problems. Dentists can actively provide patients suffering from dysphagia with comprehensive professional care, especially from the cognitive stage of food to the pharyngeal stage of the swallow. Many cases of dysphagia can be improved with careful managements based on dental professionals' knowledge, including meticulous evaluation of masticatory and swallowing functions, training on eating and swallowing, and fabrication of palatal or lingual augmentation prosthesis. The important thing is that prevention of these disorders through the oral health care instruction and planned follow-up dental visit at periodic intervals in order to manage the problems caused by anatomical, functional, and psychological reason.

• Journal of Korean society of Dental Hygiene
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• v.14 no.4
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• pp.463-470
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• 2014

Objectives : The purpose of this study was to investigate the association factors of infection control practice based on health belief model in the dental hygienists in dental clinics. Methods : A self-reported questionnaire was filled out by 278 dental hygienists in 160 dental clinics in Gwangju by a proportional stratified sampling method from September 13 to October 7, 2013. Data were analyzed by t-test, ANOVA, correlation analysis, and multiple regression analysis using SPSS version 12.0. Results : In multiple regression analysis, practice scores were significantly higher in aged dental hygienists and those who took infectious disease history from the patients before treatment. With regard to health belief model, perceived barrier was negatively associated with the practice(${\beta}$=-.16, p<.001), importance of infection control in hand hygiene(${\beta}$=.14, p=.026), and use of personal protective equipment(${\beta}$=.17, p=.043). The intention of action was positively associated with the practice(${\beta}$=.13, p=.002). Conclusions : This study will provide the basic evidence for the quality improvement of infection control and prevention. So the dental hygienists will be able to put into practice in infection control management.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.227-237
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• 2011

Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.25-32
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• 2011

The number of patients requesting services of pediatric dental clinics has been steadily increasing in South Korea. The pediatric dental clinics are comprised of hospital-based clinics and local clinics. The purpose of this study was to analyze new-patient distribution and to survey the motives for visiting the department of pediatric dentistry at Seoul National University Dental Hospital(SNUDH), utilizing questionnaires for parents from May to July 2010. The results are as follows: 1. Age distribution showed that 0-3 year-olds formed the largest group of 29.3%. The average age of patients was 6.2 years old. 2. In the surveys for the parents, the major reason for visiting SNUDH was the referral from other clinics(30.6%). 3. The 75% of patients previously visited other clinics before visiting SNUDH. 1) The greater number of patients(52%) visited general practitioner's clinic than pediatric specialists(48%). 2) More than 90% of the patients visited SNUDH after visiting other clinics for reassuring diagnosis and referrals. 3) The crucial deterring factor of being treated at SNUDH was difficult accessibility.

• Journal of dental hygiene science
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• v.7 no.4
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• pp.225-233
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• 2007

This study, to investigate the job burnout and coping behaviors that clinical dental hygienists feel in the work process, has collected 322 clinical dental hygienists working in Daegu, Kyungbuk province, and Ulsan and had a conclusion as follows. 1. The average of area job burnout and coping behaviors were as follows; emotional burnout, 3.26, cynical manners, 2.63, the declination of job efficiency, 2.58, the total average, 2.82. 2. The average of area were as follows; active coping, 3.36, passive coping, 2.95, and the total average, 3.19. 3. The difference of job burnout relating to general characteristics was shown that the lower education level and age they were in, the significantly higher the declination of job efficiency and burnout area were. The unmarried had significantly higher points at cynical manners, the declination of job efficiency and burnout. Besides, the introspective had significantly higher points at emotional exhaustion, cynical manners, and burnout area. 4. The difference of job burnout related to working circumstance was shown that those with short working experience and those in charge of the general treatment showed significantly high points at the declination of job efficiency. And the less annual salary, the significantly higher points at cynical manners, the declination of job efficiency and burnout area. 5. In the correlation between job burnout and coping method, burnout area has a significantly normal correlation with active coping and coping area, whereas, it has significantly abnormal correlation with passive coping. 6. As for the difference of area burnout relating to coping behaviors, in coping area A group(under average) had significantly higher points than B group(over average) at the declination of job efficiency and burnout area. From the above results, it was proved that the clinical dental hygienists in younger age, with shorter work experience and less annual salary, no marital spouse had higher points at burnout and passive coping.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.635-641
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• 2003

Purpose : To investigate the success rate and factors that influence breast-feeding among women having antenatal breast-feeding plans. Methods : Questionnaires included items on success in breast-feeding, reasons for failure and perinatal factors. It was done by telephone calls to 152 randomly selected women having antenatal breast-feeding plans at 4 months after delivery. The questionnaires were analysed by bivariate ${\chi}^2$-analysis. Results : The breast-feeding rate for the first four months among women having antenatal breast-feeding plans was 37.5%. The major reason for breast-feeding failure was insufficient amount of breast milk(66.3%). The breast-feeding rate was 2.3(95% CI 1.15-4.62) times higher in women having antenatal breast-feeding plans for longer than 4 months(P<0.05), but maternal age, breast-feeding for previous baby, person advocating breast-feeding, and family size were not significant factors of success in breast-feeding. The breast-feeding rate of graduates of college was 0.43(95% CI 0.21-0.86) times lower than that of graduates of high school. The breast-feeding rate of employed mothers was 0.37(95% CI 0.17-0.83) times lower than that of housewives(P<0.05). Maternal disease, smoking, alcohol drinking, and understanding and knowledge about breast-feeding were not significant determinant factors of success in breast-feeding. Breast-feeding rate of infant born at local obstetric clinics was 3.97(95% CI 11-14.23) times higher than that of infant at general hospital(P<0.05). Conclusion : To increase the breast-feeding, medical personnel should educate mothers on problems during breast-feeding. Hospital polices that facilitate breast-feeding such as rooming-in must be promoted. For employed mothers, strategies for breast-feeding within companies must be encouraged.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.143-152
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• 2010

Purpose: This study aimed to evaluate the current status of hospice palliative care facilities in Korea. Based on the result, we attempted to suggest activation plans of hospice palliative in Korea. Methods: To conduct a survey, we obtained a list of hospice palliative care facilities from related agencies and academic societies. A survey was conducted from February, 2009 to March, 2009. The survey was consisted of general characteristics of organizations, manpower, facilities & equipments, and so on. In addition, we used data from Statistics Korea to estimate the number of beds required and the bed occupancy rate. Results: Total number of facilities responded to the questionnaire were 53. Forty-two facilities were general hospitals and 6 facilities were clinics among the total 53 facilities, and 18.8% of facilities were located in Seoul, Incheon and Gyeonggido. Overall bed occupancy rate was rather low as 21.9%, and there were 4 provinces where bed occupancy rates were 0%. Deaths in hospice palliative care facilities during 2008 were 6.3% of total deaths from cancers. As for the questions about the financial status of facilities, 86% of facilities were answered financial insufficiency. Also more than half of the facilities gave financial insufficiency as the reason for shortage of human resource supplies and inability to achieve the standard for authorization by the government. Facilities answered in order to activate the hospice palliative care, governmental support is needed, mostly in financial support (71.2%), donation tax deduction (43.1%), and setting up a public utility foundation (23.5%). Conclusion: This study showed low rates of hospice palliative care use and bed occupancy in Korea. Regional variance in bed occupancy rate was significantly high. As a roadblock for these problems, most of the facilities cited financial insufficiency. Therefore, there must be some action plans to boost financial support to activate hospice palliative care in Korea. Finally, efforts to improve these circumstances including lack of understanding about hospice and palliative care, are needed as well.