• 제목/요약/키워드: 장애 관리

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Analysis on Factors Influencing Welfare Spending of Local Authority : Implementing the Detailed Data Extracted from the Social Security Information System (지방자치단체 자체 복지사업 지출 영향요인 분석 : 사회보장정보시스템을 통한 접근)

  • Kim, Kyoung-June;Ham, Young-Jin;Lee, Ki-Dong
    • Journal of Intelligence and Information Systems
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    • 제19권2호
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    • pp.141-156
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    • 2013
  • Researchers in welfare services of local government in Korea have rather been on isolated issues as disables, childcare, aging phenomenon, etc. (Kang, 2004; Jung et al., 2009). Lately, local officials, yet, realize that they need more comprehensive welfare services for all residents, not just for above-mentioned focused groups. Still cases dealt with focused group approach have been a main research stream due to various reason(Jung et al., 2009; Lee, 2009; Jang, 2011). Social Security Information System is an information system that comprehensively manages 292 welfare benefits provided by 17 ministries and 40 thousand welfare services provided by 230 local authorities in Korea. The purpose of the system is to improve efficiency of social welfare delivery process. The study of local government expenditure has been on the rise over the last few decades after the restarting the local autonomy, but these studies have limitations on data collection. Measurement of a local government's welfare efforts(spending) has been primarily on expenditures or budget for an individual, set aside for welfare. This practice of using monetary value for an individual as a "proxy value" for welfare effort(spending) is based on the assumption that expenditure is directly linked to welfare efforts(Lee et al., 2007). This expenditure/budget approach commonly uses total welfare amount or percentage figure as dependent variables (Wildavsky, 1985; Lee et al., 2007; Kang, 2000). However, current practice of using actual amount being used or percentage figure as a dependent variable may have some limitation; since budget or expenditure is greatly influenced by the total budget of a local government, relying on such monetary value may create inflate or deflate the true "welfare effort" (Jang, 2012). In addition, government budget usually contain a large amount of administrative cost, i.e., salary, for local officials, which is highly unrelated to the actual welfare expenditure (Jang, 2011). This paper used local government welfare service data from the detailed data sets linked to the Social Security Information System. The purpose of this paper is to analyze the factors that affect social welfare spending of 230 local authorities in 2012. The paper applied multiple regression based model to analyze the pooled financial data from the system. Based on the regression analysis, the following factors affecting self-funded welfare spending were identified. In our research model, we use the welfare budget/total budget(%) of a local government as a true measurement for a local government's welfare effort(spending). Doing so, we exclude central government subsidies or support being used for local welfare service. It is because central government welfare support does not truly reflect the welfare efforts(spending) of a local. The dependent variable of this paper is the volume of the welfare spending and the independent variables of the model are comprised of three categories, in terms of socio-demographic perspectives, the local economy and the financial capacity of local government. This paper categorized local authorities into 3 groups, districts, and cities and suburb areas. The model used a dummy variable as the control variable (local political factor). This paper demonstrated that the volume of the welfare spending for the welfare services is commonly influenced by the ratio of welfare budget to total local budget, the population of infants, self-reliance ratio and the level of unemployment factor. Interestingly, the influential factors are different by the size of local government. Analysis of determinants of local government self-welfare spending, we found a significant effect of local Gov. Finance characteristic in degree of the local government's financial independence, financial independence rate, rate of social welfare budget, and regional economic in opening-to-application ratio, and sociology of population in rate of infants. The result means that local authorities should have differentiated welfare strategies according to their conditions and circumstances. There is a meaning that this paper has successfully proven the significant factors influencing welfare spending of local government in Korea.

Evaluation of Puretone Threshold Using Periodic Health Examination Data on Noise-exposed Workers in Korea (소음 특수건강진단 자료를 이용한 순음청력검사 평가)

  • Kim, Yang-Ho;Choi, Jung-Keun;Park, Jung-Sun;Moon, Young-Han;Kim, Kyoo-Sang
    • Journal of Preventive Medicine and Public Health
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    • 제32권1호
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    • pp.30-39
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    • 1999
  • Objectives. This study was carried out to evaluate hearing impairment judgement and to investigate the differences in various diagnostic criteria for noise-induced hearing loss (NIHL) among workers who required for close observation (C). Methods. Out of 731,029 workers who had taken the specific periodic health examination in 1994, we used the audiometric data on 37,999 workers (C) eliminating the employees who had previous otologic problems. Many investigators have being using different criteria for the evaluation of hearing impairment. In this study, we used the criteria of early (1989-1994), current, compensation for NIHL in Korea, 2-, 3-, 4-divided classification and hearing loss at 4,000 Hz and compared the evaluation results. Results. The prevalences of C and workers who had occupational disease $(D_1)$ diagnosed for NIHL were 11.1 % and 0.44 %. There were significant difference in the prevalences of C and $D_1$, depending on different province of Korea. Pure tone averages (PTAs) were not appropriately applied in their evaluation 97% of workers whom we studied on were below the level of mild hearing loss judged by ISO standard. However, there were wide variations in the prevalence rate of mild hearing loss by diagnostic criteria. Thus, there were different judgements in determining the degree of NIHL depending on which diagnostic criteria were utilized. PTAs were found 20.54 (Rt) and 20.74 (Lt) when the method of 3-divided classification was applied for audiometric data. The degree of hearing impairment of the left ear was more severe than that of right ear. The prevalence of normal hearing threshold below 20 dB was 75.4% and the range of difference in both ear was below 10 dB. Right sided hearing threshold levels were 21.08 dB (500 Hz), 18.44 dB (1,000 Hz), 22.09 (2,000 Hz) and 52.36 dB (4,000 Hz). There was typical high frequency loss (C5-dip at 4,000 Hz) above 30 - 40 dB in normal hearing level. The increasing trend in hearing threshold level was gradually decreased by the increase of PTAs. The difference between PTAs and threshold at 4,000 Hz was about 10 dB. Conclusions. We could found that PTAs in the previous examination were not appropriately evaluated. This study revealed that they did not use unique criteria for managing the workers of NIHL. For the prevention of NIHL, it was found that the quality control on diagnosis and comprehensive management program were required, especially for those of hearing loss (C).

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Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • 제8권2호
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

A Study on Farmer's Syndrome and Its Risk Factors of Vinyl House Worker and Farmer in a Rural Area (일부 농촌지역 비닐하우스 재배자들의 농부증 실태와 관련요인)

  • Lee, In-Bae;Lee, Yeon-Kyeong;Chang, Sung-Sil;Lee, Sok-Goo;Cho, Young-Che;Lee, Dong-Bae;Lee, Tae-Yong
    • Journal of agricultural medicine and community health
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    • 제24권1호
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    • pp.13-33
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    • 1999
  • The aim of this study was to investigate fatigue scores, physical complaints, farmer's syndrome and to find out its risk factors among farmers. The questionnaire survey was conducted to 177 vinyl house workers and 213 farmers who lived in Chongyang gun of Chungnam province from February 24 to March 15, 1998. The obtained main results were followings; 1. The fatigue scores were not significantly different between vinyl house workers and farmers. The fatigue scores were higher in female group, lower education group, shorter sleep hours group(under 8 hours), nonsmoker, nondrinker group than otherwise groups. There was not statistically significant difference between the mean fatigue scores and age, eating habit and body mass index. Duration of farming years in vinyl house and farming area and number of farming workers in farmers family showed a slight relationship with the fatigue score. 2. Health scores were not different between vinyl house workers and farmers. The health states was poorer in female group, lower education group, shorter sleep hours group(under 8 hours), nonsmoker group, and nondrinker group than otherwise groups by health scores. Health scores were not related with age, eating habit and body mass index. 3. The proportion of farmer's syndrome was 49.1% in vinyl house workers and 52.1% in farmers. That was higher in female than in male and the higher proportion was found in the lower education group of vinyl house workers and farmers. The proportion of farmer's syndrome was higher in the group of smoker, alcohol drinkers and over or under weight in vinyl house workers, but did not differ in those of farmers. 4. By multiple logistic regression, sex and sleep hours were risk factors affecting to farmer's syndrome. Odds ration for female group was 2.53 (reference group was male) and that for over 8 sleep hours group was 0.74 (reference group was under 8 sleep hours group). 5. The chief complaints by CMI were "I am difficult to work due to aching the back and the limbs", "I feel prickle pain in the limbs", "I sometimes have a twinge in the limbs", "I am not quite well as having a pain in the limbs", "I feel weaker grasping power than before" in both of vinyl house workers and farmers. Vinyl house workers more frequently pointed out skin darkening, skin disease and hemorrhoids than farmers. 6. According to correspondence analysis, skin disease of vinyl house workers was related to vinyl house farmers and digestive and general symptom was associated with male and endocrinological and muscular symptom was associated with female in vinyl house workers. And it revealed that farmer's syndrome was highly related with female and farmers relatively. By the above results, the fatigue scores, perceive health and farmer's syndrome did not much differ in two groups, but aged female farmers should be considered as female farmers represented higher fatigue score, farmers syndrome and poorer perceive health than male farmers in addition to farmer's syndrome was increased with ageing process. Also feeble but distinguished symptoms which might be due to working environment were observed especially in vinyl house workers and that should be considered and investigated continuously.

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A Study on Relationship between Degree of Stress and Dyspepsia, Sleeping, Satisfaction of Adult Women in Rural Area (성인 여성들의 스트레스와 소화불량 및 수면장애와의 관련성)

  • Kim, Yeong-Hee;Cho, Soo-Yeul;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Kang, Young-Ah;Hwang, Young-Lork
    • Journal of agricultural medicine and community health
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    • 제25권1호
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    • pp.51-63
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    • 2000
  • Ten Dongs were selected according to the systematic cluster sampling in Koryong Gun, and the survey was conducted on 571 women in the age between 30-69 years. The first survey was performed for 6 days between August 27 to September 1, 1999 with the investigation rate of 60.3%, and the second survey was performed in November with the investigation rate of 91.8%. The contents of survey included demographic characteristics, health behaviors, dyspepsia symptom score, sleeping induction time and the degree of sleep satisfaction, and degree of stress in the subjects. The dyspepsia symptom score was in the average 13.4 points out of a total 44 points and was the highest in the 50-59 year-old age group with 13.9 points. The sleep induction time was in the average of 35 minutes and was the highest in the 50-59 year-old age group with 40.9 minutes; the degree of sleep satisfaction was in the average of 7.9 points and was the lowest in the 50-59 year-old age group with 7.5 points. The stress score was in the average of 18.3 points and was highest in those subjects in their 40's and 50's with 18.7 points. When the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was analyzed, the results showed that he stress score and the degree of sleep satisfaction showed a significant negative correlation and that the stress score and dyspepsia symptom score showed a significant positive correlation. Also, a significant negative correlation was found between the degree of sleep satisfaction and dyspepsia symptom score. According to each age group, a significant correlation was revealed among the stress score, dyspepsia symptom score and the degree of sleep satisfaction in those subjects over 40 years of age compared to those subjects who were younger than 40 years of age. As for educational level, the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was higher in those subjects with less than middle school education compared to those subjects with more than high school education. When those factors that effects on the dyspepsia symptom score were analyzed with multiple regression, the results showed that the level of stress and chronic diseases were selected as significant variables. When those factors that affected on the degree of sleep satisfaction were analyzed, the sleep induction time and presence of chronic diseases and stress were selected as significant variables. Those women in their 50's who live in rural areas showed the highest level of stress, lowest the degree of sleep satisfaction, and highest level of dyspepsia, indicating that they need stress management. Also, since stress was showed to be a significant variable effecting on dyspepsia or the degree of sleep satisfaction, it is concluded that health promotion is possible through stress management. More studies are needed in the future on coping resources that would strengthen coping against stress, and by conducting studies on stress and related factors on community people, the measures of mental health promotion need to be developed.

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Clinical Applications and Efficacy of Korean Ginseng (고려인삼의 주요 효능과 그 임상적 응용)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • 제26권3호
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    • pp.111-131
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    • 2002
  • Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

The Effect of Oral Health Behavior by Oral Health Belief of Student in Dental Hygiene Department of College Students in Seoul (서울지역 일부대학 치위생과 학생의 구강건강신념이 구강보건행태에 미치는 영향)

  • Park, Mi-Sook
    • Journal of dental hygiene science
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    • 제11권2호
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    • pp.107-119
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    • 2011
  • The purpose of this study was to examine the effects of oral health behavior by oral health belief from the students in the dental hygienics department who take charge of oral health office, and therefore to lead a clear oral health care, to complete desirable oral health belief, and finally to utilize them for oral health field. The survey was conducted using structured self-administered questionnaires based on oral health belief model targeting 163 students in the dental hygienics department of one of the college in Seoul, and collected data were statistically analyzed using the SPSS 18.0 program. As a result of analysis to determine that the oral health belief significantly affects on the oral heal behavior, the personal variables such as age, economic status and occupation, and the seriousness for the oral health belief were indicated to be significant variables(p<0.05), and as a result of analysis that effects on the number of the oral health behavior, the susceptibility and the seriousness were indicated to be significant variables for oral health belief(P<0.05). As a conclusion, oral health belief was identified as a factor of salience through understanding that oral health belief of the students in the dental hygienics department effects on oral health behavior based on an oral health belief model, and it can be concluded that the necessity of oral health belief investigation should be discussed as a crucial issue to provide a more effective oral health promotion plan.

A Study on the Investigation into Dental Hygienists' Awareness of Health Impairment Factors by Occupational Diseases (치과위생사의 직업병에 의한 건강장애요인 인식도 조사)

  • Yoon, Mi-Sook;Song, Gui-Sook;Ko, Mi-Hee
    • Journal of dental hygiene science
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    • 제3권2호
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    • pp.59-66
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    • 2003
  • As a basic research material to make more efficient healthcare and health promotion for dental hygienists, this study intends to determine which factors may affect their awareness of occupational diseases. For this sake, this study attempted to investigate into a variety of literatures and data, and applied a questionnaire survey to 160 dental hygienists for about 5 months(from June to October 2003), who were all employed in domestic dental clinics or offices. As a result of analysis, this study can be concluded as follows: (1) The result of analyzing how dental hygienists recognized their occupational diseases showed that 'stiffness in muscle, neck or shoulder due to intensive use of specific physical regions' and 'stress resulting from the attributes of each task' reached the highest awareness(90.6%) of all, which was followed by 'lower eyesight due to detailed or even sophisticated tasks for many hours(65%)' and 'symptoms of ruptured disk due to standing tasks as dental hygienists do for many hours(62.5%).' (2) The result of analyzing how dental hygienists recognize their occupational diseases showed that their awareness averaged 7.28 points out of 14 points, which implies that their awareness of occupational diseases is not very high. Meanwhile, the result of examining how they recognize detrimental or harmful properties of given materials against human body showed that a majority of total respondents(74.4%) regarded given materials as detrimental to human body. (3) The result of examining how dental hygienists recognize their occupational diseases showed that a majority of total respondents(91.9%) identified their own occupational diseases. Many of total respondents(41.9%) pointed out that environmental improvement around workshop in each clinic or office should be foremost prerequisite to health and welfare for dental hygienists. Next, 34.4% of total respondents pointed out the necessity to perform in-house health diagnosis and examination on a regular basis, and 13.1% of total respondents thought it necessary to carry on healthcare education into harmful properties in the aspect of dental materiology, respectively.

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A Study on a Effect of Product Design and a Primary factor of Qualify Competitiveness (제품 디자인의 파급효과와 품질경쟁력의 결정요인에 관한 연구)

  • Lim, Chae-Suk;Yoon, Jong-Young
    • Archives of design research
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    • 제18권4호
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    • pp.95-104
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    • 2005
  • The purpose of this study is to estimate the determinants of product design and analyze the impacts of product design on quality competitiveness, product reliability, and consumer satisfaction in an attempt to provide a foundation for the theory of design management. For this empirical analysis, this study has derived the relevant measurement variables from a survey on 400 Korean manufacturing firms during the period of $August{\sim}October$ 2003. The empirical findings are summarized as follows: First, the determinants of product design are very significantly (at p<0.001) estimated to be the R&D capability, the level of R&D expenditure, the level of innovative activities(5S, TQM, 6Sigma, QC, etc.). This empirical result can support Pawar and Driva(1999)'s two principles by which the performance of product design and product development can be simultaneously evaluated in the context of CE(concurrent engineering) of NPD(newly product development) activities. Second, the hypothesis on the causality: product design${\rightarrow}$quality competitiveness${\rightarrow}$customer satisfaction${\rightarrow}$customer loyalty is very significantly (at p<0.001) accepted. This implies that product design positively affects consumer satisfaction, not directly but indirectly, by influencing quality competitiveness. This empirical result of this study can also support the studies of for example Flynn et al.(1994), Ahire et at.(1996), Afire and Dreyfus(2000) which conclude that design management is a significant determinant of product quality. The aforementioned empirical results are important in the following sense: the empirical result that quality competitiveness plays a bridging role between product design and consumer satisfaction can reconcile the traditional debate between QFD(quality function development) approach asserted by product developers and conjoint analysis maintained by marketers. The first empirical result is related to QFD approach whereas the second empirical result is related to conjoint analysis. At the same time, the empirical results of this study can support the rationale of design integration(DI) of Ettlie(1997), i.e., the coordination of the timing and substance of product development activities performed by the various disciplines and organizational functions of a product's life cycle. Finally, the policy implication (at the corporate level) from the empirical results is that successful design management(DM) requires not only the support of top management but also the removal of communication barriers, (i.e. the adoption of cross-functional teams) so that concurrent engineering(CE), the simultaneous development of product and process designs can assure product development speed, design quality, and market success.

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Functional MRI of Visual cortex in the Patients with Occipital Lobe Ischemia (후두엽의 허혈성 뇌졸중 환자에서 시각피질의 기능적 자기공명영상)

  • 이영준;정태섭;윤영수;한승한;조영재;배준호
    • Investigative Magnetic Resonance Imaging
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    • 제3권2호
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    • pp.173-178
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    • 1999
  • Purpose : To evaluate the usefulness of functional MRI (fMRI) of visual cortex in patients with ischemic infarction in the occipital lobe. Materials and Methods : Four patients with the symptoms and signs of visual cortical ischemia were included. Functional MRI was performed by 2D-FLASH technique with the parameter of 90/56msec TR/TE, $40^{\circ}$ flip angle, $240{\times}240{\;}FOV,{\;}64{\times}128$ matrix number, 8.32 seconds acquisition time, 8mm slice thickness. An axial slice including both visual cortices was selected and alternative activation and resting of the visual cortex was performed using red color photostimulator. all patients undertook visual field test, and vascular abnormality was examined by MRA (n=4) and DSA (n=2). fMRI results were compared with the results of a visual field test, conventional MRI and cerebral angiography. Results : On fMRI, decreased activity of the visual cortex was found in the occipital lobe corresponding to stenosis of the posterior cerebral artery or its branch noted on angiogram. However, 2 of 4 patients showed no abnormal findings on conventional MRI. Visual field defect was noted in 3 patients, one and of whom showed no abnormality on conventional MRI and diffusion-weighted image, but revealed decreased activity in the corresponding visual cortex on fMRI. Conclusion : fMRI may be a sensitive method for detection of the status of decreased blood flow or vascular reserve which other methods can not.

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