• The Korean Journal of Pain
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• v.6 no.2
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• pp.192-198
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• 1993

In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

• Phonetics and Speech Sciences
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• v.11 no.3
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• pp.69-76
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• 2019

This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.

• Journal of Nutrition and Health
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• v.6 no.1
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• pp.71-76
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• 1973

1. This survey is somewhat different from that conducted by Yonsei University, although being in many respects, very similar. We found the average per capita caloric intake to be 7 or 8% of what it should be. Of that caloric intake, 84.5% in the model village here and 82.2% in the compared village Bupyong, by and large depends on cereal grains. Since such grains tend to distend the stomach, the farmers, it seems,should substitute fat for a part of their diet so as to dimish digestive pain and still receive the necessary calories. 2. Protein is the most important nutrient for the development of physical strength and improvement of health, but the average daily intake is only 68.3% of the necessary amount. It is desirable that the ratio of vegetable protein to that of animal be one to three for maintaining one's health. Most of the villager's protein, however, comes from plants: the intake of animal protein, at a level of only 13.6 g, is far below such a one to three ratio. 3. In the model village, 497.6 mg, of inorganic calcium is the daily intake level. In the compared village it is 505.5 mg, making a difference of only 8mg. This, however, is 35% less than the recommended intake. More than 50% of this calcium comes from cereals and other plants. Moreover, plant calcium which has much oxakuc acud us not as nutritional as animal calcium, so their calcium diet is less than it would appear. We must, therefore, make efforts to receive as good nutritional calcium as possible. 4. Among the vitamin group, the daily average intake of vitamin A and vitamin $B_{2}$ are respectively 40% and 32% less than the desired intake, while vitamin $B_{1}$ happens to be taken in sufficient quantities and more niacin is taken than which is even necessary. The intake of vitamin C is much more than the necessary quantity. However, this figure was calculated from uncooked food; if the loss from cooking were to be considered, the real intake might well be a little less. Also, as this survey was carried out in May, some of these results were influenced by the fact that lettuce and spinach are seasonally popular. In conclusion, except for a few nutrients which are in abundance, the normal food intake in a day is, on the whole, less than the average recommended. Furthermore despite the fact that both of these places are model villages in the development of nutrition, it seems that they have not gotten out of such conventional eating habiys as the almost dependancy on cereal grains. Cow's milk, sheep's milk, eggs and so on produced by each farmhouse are not used for their own families but are taken to the market for the purpose of making money. Accordingly, I think from now we must seek to improve, guide and enlighten the farmers as to how to correct their eating habits and implement changes in their lives so that our firm purpose may be achieved.

• The Korean Journal of Mycology
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• v.7 no.1
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• pp.13-73
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• 1979

These studies were conducted to investigate nutrient sources and supplementary materials of synthetic compost media for Agaricus bisporus culture. Investigation were carried out to establish the optimum composition for compost of Agaricus bisporus methods of out-door fermentation and peakheating with rice straw as the main substrate of the media. The incidence and flora of harmful organisms in rice straw compost and their control were also studied. 1. When rice straw was used as the main substrate in synthetic compost as a carbon source. yields were remarkably high. Fermentation was more rapid than that of barley straw or wheat straw, and the total nitrogen content was high in rice straw compost. 2. Since the morphological and physico-chemical nature of Japonica and Indica types of rice straw are greatly dissimilar. there were apparent differences in the process of compost fermentation. Fermentation of Indica type straw proceeded more rapidly with a shortening the compost period, reducing the water supply, and required adding of supplementary materials for producing stable physical conditions. 3. Use of barley straw compost resulted in a smaller crop compared with rice straw. but when a 50%, barley straw and 50% rice straw mixture was used, the yield was almost the same as that using only rice straw. 4. There were extremely high positive correlations between yield of Agaricus bisporus and the total nitrogen, organic nitrogen, amino acids, amides and amino sugar nitrogen content of compost. The mycerial growth and fruit body formation were severely inhibited by ammonium nitrogen. 5. When rice straw was used as the main substrate for compost media, urea was the most suitable source of nitrogen. Poor results were obtained with calcium cyanamide and ammonium sulfate. When urea was applied three separate times, nitrogen loss during composting was decreased and the total nitrogen content of compost was increased. 6. The supplementation of organic nutrient activated compost fermentation and increased yield of Agaricus bisporus. The best sources of organic nutrients were: perilla meal, sesame meal, wheat bran and poultry manure, etc. 7. Soybean meal, tobacco powder and glutamic acid fermentation by-products which were industrial wastes, could be substituted for perilla meal, sesame meal and wheat bran as organic nutrient sources for compost media. B. When gypsum and zeolite were added to rice straw. physical deterioration of compost due to excess moisture and caramelization was observed. The Indica type of straw was more remarkable in increase of yield of Agricus bisporus by addition of supplementing materials than Japonica straw. 9. For preparing rice straw compost, the best mixture was prepared by 10% poultry manure, 5% perilla meal, 1. 2 to 1. 5% urea and 1% gypsum. At spring cropping, it was good to add rice bran to accelerate heat generation of the compost heap. 10. There was significantly high positive correlation (r=0.97) between accumulated temperature and the decomposition degree of compost during outdoor composting. The yield was highest at accumulated temperatures between 900 and $1,000^{\circ}C$. 11. Prolonging the composting period brought about an increase in decomposition degree and total nitrogen content, but a decrease in ammonium nitrogen. In the spring the suitable period of composting was 20 to 25 days. and about 15 days in autumn. For those periods, the degree of decomposition was 19 to 24%. 12. Compactness of wet compost at filling caused an increase in the residual ammonium nitrogen. methane and organic acid during peak heating. There was negative correlation between methane content and yield (r=0.76)and the same was true between volatile organic acid and yield (r=0.73). 13. In compost with a moisture content range between 69 to 80% at filling. the higher the moisture content, the lower the yield (r=0.78). This result was attributed to a reduction in the porosity of compost at filling the beds. The optimum porosity for good fermentation was between 41 and 53%. 14. Peak heating of the compost was essential for the prevention of harmful microorganisms and insect pests. and for the removal of excess ammonia. It was necessary to continue fer mentatiion for four days after peak heating. 15. Ten species of fungi which are harmful or competitive to Agaricus bisporus were identified from the rice compost, including Diehliomyces microsporus, Trichoderma sp. and Stysanus stemoites. The frequency of occurrance was notably high with serious damage to Agaricus bisporus. 16. Diehliomyces microsporus could be controlled by temperature adjustment of the growing room and by fumigating the compost and the house with Basamid and Vapam. Trichoderma was prevented by the use of Bavistin and Benomyl. 17. Four species of nematodes and five species of mites occured in compost during out-door composting. These orgnanisms could be controlled through peakheating compost for 6 hours at $60^{\circ}C$.

• Journal of Preventive Medicine and Public Health
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• v.4 no.1
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• pp.41-64
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• 1971

During the period from July 1st to the end of November 1970, a survey on air pollution and noise level was made in Seoul, Pusan and Taegu, the three largest cities in Korea. Each city was divided into 4-6 areas; the industrial area, the semi-industrial area, the commercial area, the residential area, the park area and the downtown area. Thirty eight sites were selected from each area. A. Method of Measurement : Dustfall was measured by the Deposit Gauge Method, sulfur oxides by $PbO_2$ cylinder method, suspended particles by the Digital Dust Indicator, Sulfur dioxide ($SO_2$) and Carbon Monoxide (CO) by the MSA & Kitakawa Detector and the noise levels by Rion Sound Survey meter. B. Results: 1. The mean value of dustfall in 3 cities was $30.42ton/km^2/month$, ranging from 8.69 to 95.44. 2. The mean values of dustfall by city were $33.17ton/km^2/month$ in Seoul, 32.11 in Pusan and 25.97 in Taegu. 3. The mean values of dustfall showed a trend of decreasing order of semi-industrial area, downtown area, industrial area, commercial area, residential area, and park area. 4. The mean value of dustfall in Seoul by area were $52.32ton/km^2/month$ in downtown, 50.54 in semi-industrial area, 40.37 in industrial area, 24,19 in commercial area, 16.25 in park area and 15.39 in residential area in order of concentration. 5. The mean values of dustfall in Pusan by area were $48.27ton/km^2/month$ in semi-industrial area, 36.68 in industrial area 25.31 in commercial area, and 18.19 in residential area. 6. The mean values of dustfall in Taegu by area were $36.46ton/km^2/month$ in downtown area, 33.52 in industrial area, 20.37 in commercial area and 13.55 in residential area. 7. The mean values of sulfur oxides in 3 cities were $1.52mg\;SO_3/day/100cm^2\;PbO_2$, ranging from 0.32 to 4.72. 8. The mean values of sulfur oxides by city were $1.89mg\;SO_3/day/100cm^2\;PbO_2$ in Pusan, 1.64 in Seoul and 1.21 in Taegu. 9. The mean values of sulfur oxides by area in 3 cities were $2.16mg\;SO_3/day/100cm^2\;PbO_2$ in industrial area, 1.69 in semi-industrial area, 1.50 in commercial area, 1.48 in downtown area, 1.32 in residential area and 0.94 in the park area, respectively. 10. The monthly mean values of sulfur oxides contents showed a steady increase from July reaching a peak in November. 11. The mean values of suspended particles was $2.89mg/m^3$, ranging from 1.15 to 5.27. 12. The mean values of suspended particles by city were $3.14mg/m^3$ in Seoul, 2.79 in Taegu and 2.25 in Pusan. 13. The mean values of noise level in 3 cities was 71.3 phon, ranging from 49 to 99 phon. 14. The mean values of noise level by city were 73 phon in Seoul, 72 in Pusan, and 69 in Taegu in that order. 15. The mean values of noise level by area in 3 cities showed a decrease in the order of the downtown area, commercial area, industrial area and semi-industrial area, park area and residential area. 16. The comparison of the noise levels by area in 3 cities indicated that the highest level was detected in the downtown area in Seoul and Taegu and in the industrial area in Pusan. 17. The daily average concentration of sulfur dioxides ($SO_2$) in 3 cities was 0.081 ppm, ranging from 0.004 to 0.196. 18. The daily average concentrations of sulfur dioxides by city were 0.092 ppm in Seoul, 0.089 in Pusan and 0.062 in Taegu in that order. 19. The weekly average concentration of carbon monoxides(CO) was 27.59 ppm. 20. The daily average concentrations of carbon monoxides by city were 33.37 ppm. in Seoul, 25.76 in Pusan and 23.65 in Taegu in that order. 21. The concentration of $SO_2$ and CO reaches a peak from 6 p. m. to 8 p. m. 22. About 3 times probably the daily average concentration of CO could be detected in the downtown area probably due to heavy traffic emission in comparison with that in the industial area. 23. As for daily variation of the concentration of $SO_2$ and CO it was found that the concentration maintains relatively higher value during weekdays in the industrial area and on the first part of the week in the downtown area.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.76-84
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• 2002

Objectives：This study was conducted to investigate the effect of oxygen on attention and memory functions in healthy adolescents. Methods：The participant subjects were recruited from local advertisement. All subjects are students attending ordinary middle and high school. Their degree of achievement was average or below average. Before the study, its nature and purpose were fully explained to the patients and their parents, and a written informed consent was obtained from each child's parent and a written assent from each child for entire the procedure. The Ethics Committee and Clinical Research Committee of Gyeongsang National University Hospital approved the protocol. For baseline assessment, all subjects received tests for attention and memory. All tests were conducted by a certified psychologist. Stroop test, continuous performance test and trail making test A and B were used for evaluation of attention. As memory tests, we used memory assessment scale(MAS), standardized memory assessment tools. Ten to fourteen days after initial assessments, same tests was applied to the same subjects after prior 5 minute oxygen inhalation. Results：1) Attention test：Improved performances in trail making part B, and stroop test were found in normobaric oxygen inhalation group compared to air inhalation group. Improved reaction time in those tests seemed to reflect the enhanced executive prefrontal activity. 2) Memory test：More words and digits memorization were found in short-term memory subscale score in MAS in oxygen inhalation group compared to air inhalation group. This finding suggested the improved working memory function after oxygen inhalation. Conclusion：Though interpreted cautiously, these results suggested that normobaric oxygen inhalation could enhance executive function and working memory of prefrontal lobe. Further study, however, should be performed to investigate the mechanism of effects of oxygen on cognitive enhancement.

• Journal of the Korea Organic Resources Recycling Association
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• v.8 no.3
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• pp.131-140
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• 2000

Compostable household wastes(mainly food residues) were composted in a small bin for 30 days, in which compostable household wastes were fed every day and mixed thoroughly under aerobic conditions. Three small bins were employed. In the first bin only recycled compost was composted, in the second, compostable household wastes with recycled compost, and in the third compostable household wastes with recycled compost and vermiculture. The correct decomposition rate of each composting material was calculated during composting. Total reduced rate of the weight after 30 days was 57.32% when composting the compostable household wastes with recycled compost, and 64.71% when composting them with recycled compost and vermiculite. In the case of composting the compostable household wastes with the recycled compost, the total weight reduction rate for a day was 6.81% and the total decomposition rate 6.81%. Their difference was not great. But in the case calculated with only compostable household wastes the total weight reduction rate was 56.34% and the decomposition 6.79%. When compostable household wastes were composted with the recycled compost and vermiculite, the total weight reduction rate was 64.99% and the decomposition rate 1.48%, but the total weight reduction 4.36% and the decomposition rate 35.46% when calculated with only compostable household wastes. MgO, $K_2O$ and Cr concentrations in the composting mixture during the early composting time were higher when composted with vermiculite than without it, but organic matter, CaO, NaCl, and $P_2O_5$ concentrations were contrarily diluted because of their lower concentration of vermiculite when compostable household wastes were composted with vermiculite.

• Journal of muscle and joint health
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• v.5 no.2
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• pp.238-252
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• 1998

Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking Place In one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression and psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, In addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree of compliance was measured by the data collected from documents in addition to the results of the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the variables following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables affecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1 : 3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and IS years, with 70% less than years. 2. The average figure In relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an "r" value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease ; if they become able to manage themselves thanks to the training ; and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.

• The korean journal of orthodontics
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• v.10 no.1
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• pp.71-79
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• 1980

The purpose of this study was (1) to determine the prevalence of some causes by which dental occlusion might be affected , (2) to determine the prevalence of malocclusion, and types of molar, vertical incisor and horizontal incisor relationships, and (3) to examine the sex difference in the prevalence ratios, and (4) to determine the between-examiner differences in assessing types of dental occlusion. The material consisted of 1281 males and 811 females, total 2091 persons, aged 17 to 21 years. Two examiners who were graduate students in the orthodontic course, examined independently dental occlusion of the material. Before calculating the statistics, the subjects consisted of 156 mates and 164 females, total 320 persons, haying any one or more causes suspected to affect dental occlusion, was eliminated. Then the remained subjects, 1124 males and 647 females, total 1771 persons, were assessed. The results were as follows 1. The prevalence of some causes by which dental occlusion might be affected was 15.32 per cent. The missing rate of any one or more first molars was 8.85 percent, that of any one or more teeth positioned anterior to the first molar was 3.83 per cent. The prevalence of crossbite of the first molar was 0.48 per cent, that of retained primary teeth was 0.77 percent, and that of orthodontic treatment was 0.43 per cent. 8. The rate of between-examiner difference was 12.53 per cent in assessing the types of molar relationship, 18.86 percent in assessing the types of horizontal incisor relationship, and 26.37 percent in assessing the types of horizontal incisor relationship. 3. There was no sex difference in the prevalence ratios of the types of molar relationship. The prevalence of Class I molar relationship was 80.91 percent, that of Class II was 5,03, that of Class II subdivision was 4.01, Percent, that of Class III was 5.99 percent and that of Class III subdivision was 4.07 percent. 4. In the prevalence of the types of horizontal incisor relationship, there were no sex differences except that of Class II division 2. The prevalence of Class I horizontal incisor relationship was 73.12 percent, that of Class II division t was 12.03 percent, that of Class II division 2 was 6.58 percent in male and 4.33 percent in female, and that of Class III was 9.09 percent. 5. In the prevalence of the types of vertical incisor relationship, there were no sex differences except that of deep bite, The prevalence of open bite was 2.20 per cent, that of edge-to-edge bite was 9.15 percent, that of normal bite was 76,34 percent, and that of deep bite was 14.15 percent in male and 9.12 percent in female. 6. There was no sex difference in the prevalence of malocclusion the prevalence of malocclusion was 82.67 percent and that of normal occlusion was 17.33 percent. 7. There was a tendency that when Class I molar relationship changed to Class II, incisor relationships were to be larger overjet or upright upper incisors and deep bite, but when that changed to Class III molar relationship, these were to be cross bite and openbite.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.