• 보건행정학회지
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• 제23권1호
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• pp.3-18
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• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.211-217
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• 2014

Objective : In Korea, early vertebroplasty (EVP) or delayed vertebroplasty (DVP, which is performed at least 2 weeks after diagnosis) were performed for the treatment of acute osteoporotic compression fracture (OCF) of the spine. The present study compared the outcomes of two surgical strategies for the treatment of single-level acute OCF in the thoracolumbar junction (T12-L2). Methods : From 2004 to 2010, 23 patients were allocated to the EVP group (EVPG) and 27 patients to the DVP group (DVPG). Overall mean age was $68.3{\pm}7.9$ and minimum follow-up period was 1.0 year. Retrospective study of clinical and radiological results was conducted. Results : No significant differences in baseline characteristics were observed between the two groups. As expected, mean duration from onset to vertebroplasty and mean duration of hospital stay were significantly longer in the DVPG ($17.1{\pm}2.1$ and $17.5{\pm}4.2$) than in the EVPG ($3.8{\pm}3.3$ and $10.8{\pm}5.1$, p=0.001). Final clinical outcome including visual analogue scale (VAS), Oswestry Disability Index, and Odom's criteria did not differ between the two groups. However, immediate improvement of the VAS after vertebroplasty was greater in the EVPG ($5.1{\pm}1.3$) than in the DVPG ($4.0{\pm}1.0$, p=0.002). The proportion of cement leakage was lower in the EVPG (30.4%) than in the DVPG (59.3%, p=0.039). In addition, semiquantitative grade of cement interdigitation was significantly more favorable in the EVPG than in the DVPG (p=0.003). Final vertebral body collapse and segmental kyphosis did not differ significantly between the two groups. Conclusion : Our findings suggest that EVP achieves a better immediate surgical effect with more favorable cost-effectiveness.

• 한국보건간호학회지
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• 제26권1호
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• pp.158-173
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• 2012

Purpose: This study was conducted in order to investigate factors related to depression of elderly women in a Metropolitan city. Methods: Subjects included 118 elderly women older than 65 years of age. Structured questionnaires were used for data collection, and descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and hierarchical regression analysis were performed for data analysis. Results: A significant difference in depression was observed according to number of chronic diseases(F=4.963, p=.001). Significant factors influencing depression included number of chronic diseases (${\beta}$=.265, p<.01), cognitive function (${\beta}$=.290, p<.01), quality of sleep(${\beta}$=.212, p<.01), and nutritional state (${\beta}$=.161, p<.05). These factors explained 54.2% of the variance. Conclusion: Findings of this study suggest the need for development of nursing strategies to decrease the incidence of depression in elderly women.

• 한국의류학회지
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• 제33권1호
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• pp.22-32
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• 2009

The purpose of this study was to suggest the appropriate marketing strategies for Korean fashion companies wishing to enter the US market. In-depth-interview with documentary research were performed to investigate the seven Korean fashion companies launching in the US market as wholesalers or retailers. The interviews were executed from May to July 2007. The results of the study were summarized in accordance with Marketing Mix(4P's). In most cases, the brand targets are female customers of 20's to early 30's. The products carried by the companies are trendy with a tint of vintage and oriental feelings. The price ranges from middle to high level. Most brands are engaged in wholesaling through trade shows to sell the merchandise for department stores or specialty stores, but recently are trying to convert to retailing. Trade shows and show rooms are used as one of the promotion tools, but celebrity marketing has also been active for the promotions. Most companies suggested their superior qualities of the products as their strength, and the lack of experience and information as their weakness. Most companies forecast that the influence of FTA between Korea and the US may be limited because of Korea companies' overseas outsourcing system.

• 대한간호학회지
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• 제26권4호
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• pp.808-819
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• 1996

The purpose of this study was to examine the stressors and coping strategies of school -age children and to explore the relationship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjects consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35 (SD=.86). The Feel Bad Scale(FBS), Schoolager's Coping Strategy Inventory(SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire (HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from .81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov.25 to Dec.19, 1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows : 1. The mean score for the FBS was 204.79(range : 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range : 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range : 0-81) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms ( r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56.78%. The study revealed that stressful life events correlated with health symptoms in school-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

• Journal of Korean Biological Nursing Science
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• 제18권4호
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• pp.213-220
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• 2016

Purpose: The aim of this study was to identify the influence of knowledge, attitude and preventive health behavior of cancer on nicotine dependency in male college students who have a habit of smoking. Methods: In this study, a cross-sectional survey design was adopted for the 254 male college students who smoke in D and S city. The data was analyzed for descriptive statistics, t-test, Pearson's correlation coefficient and multiple regression analysis using the SPSS 20.0 program. Results: Knowledge about lung cancer (${\beta}=-.407$, p<.001), preventive health behaviors about cancer (${\beta}=-.223$, p<.001) and the smoking period ($5years{\leq}$) (${\beta}=.198$, p=.001) were identified as the factors influencing nicotine dependency of the subjects. The model explained 33% of variance in nicotine dependency (F=20.49, p<.001). Conclusion: The results suggest that anti-smoking educators should include the strategies to increase knowledge about lung cancer and preventive health behaviors of cancer, and to reduce the smoking period in their smoking cessation program.

• 대한간호학회지
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• 제37권1호
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• pp.105-113
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• 2007

Purpose: The purpose of this study was to identify the effects of a multi agent obesity control program in obese school children. This program was composed of strategies to modify diet and exercise habits and to change cognitive behavior variables(stress, coping, and self-efficacy). Method: The subjects were 40 obese school children who participated in our project voluntarily via homepage, TV, newspaper, public paper and school official documents. The program was implemented daily for 4 sessions per day for ten days from August 16 to 26, 2004. The daily program consisted of exercise therapy, dance therapy, cognitive behavior therapy and aroma therapy. The data was analyzed by paired t-test using the SPSSWIN program. Result: There was a significant decrease in children's waist-hip ratio(p=.04) and in children's stress(p=.00) after the program. There was a significant increase in children's self-confidence after the program(p=.02) and a significant decrease in children's diet habit after the program(p=.02). Conclusion: This study provides evidence that a multiagent obese control program is effective in changing waist-hip ratio, stress, self-confidence, and diet habits in obese school children.

• 한국의류학회지
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• 제30권5호
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• pp.663-673
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• 2006

The purpose of this study is to seek for a plan of marketing strategy in the businesses of Korean clothes, by examining the causality among marketing factors, which have influenced CRM(Customer Relationship Management) performance in Korean clothes. As for the research method, a research model was designed to include routes form 4P's(products, price, promotion, place) through endogenous variables to performance variables, and a questionnaire was developed on the basis of theoretical background. The research participants were male and female adults at their age from 20 to 60. The survey was conducted in March of 2003, and 672 questionnaires were used for the final analysis. In terms of data analysis, we carried out reliability analysis, exploratory and confirmatory factor analysis, correlation analysis, and Structural Equation Modeling by using SPSSWIN 10.0 and AMOS 4.0. As a result 4P's were indicated to have influence upon confidence, satisfaction and commitment of customers. Especially, sales promotion factor was found to have the biggest impact on them. also, the quality of relationship affected CRM performance. as sales promotion factor was identified as one of the integral elements of marketing strategies, a strategy that utilizes a role of salespeople and enhances the quality of service is needed.

• Journal of Korean Biological Nursing Science
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• 제21권4호
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• pp.308-317
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• 2019

Purpose: This study aimed to investigate the level and related factors related to health-promoting lifestyle in operating room nurses in Korea. Method: A cross-sectional descriptive survey design was employed. The data were collected using questionnaire for three weeks in December 2018 from 110 operating room nurses working for more than six months in a general hospital located in Seoul. The Health Promoting Lifestyle Profile-II, The Korean Version of the Practice Environment Scale of Nursing Work Index, and Operating nurse's Job stress Factor Scale were used. Results: Significant relationships were observed between health promoting lifestyle and educational level(p= .025), perceived economic status (p= .001) wearing a lead apron for protection from radiation during the operation(p< .001), work satisfaction(p= .016), and fatigue related to work(p= .006). Also significant correlations were identified between nursing work environment and health promoting lifestyle. However, the health promoting lifestyle was not statistically different based on occupational stress(p= .365). In multiple linear regression analyses, the level of health promoting lifestyle found to be higher in subjects who did not wear a lead apron for protection from radiation(p= .017), and who had more positive perception of the nursing work environment(p= .034). Conclusion: In order to increase health promoting lifestyle of operating nurses, the strategies to improve the nursing work environment are essential.

• 한국전문물리치료학회지
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• 제27권2호
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• pp.155-161
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• 2020

Background: The consequences of falls are often debilitating, and prevention is important. In theory, the lower the center of mass (COM), the greater postural stability during standing, and a weight belt at the waist level may help to lower the COM and improve the standing balance. Objects: We examined how the limit of stability (LOS) was affected by the lowered center of mass with the weight belt. Methods: Twenty healthy individuals participated in the LOS test. After calculating each participant's COM, a weight belt was fastened ten centimeters below the COM. Trials were acquired with five weight belt conditions: 0%, 2%, 4%, 6%, and 8% of body weight. Outcome measures included reaction time, movement velocity, endpoint excursion, maximum excursion, and directional control in 4 cardinal moving directions. Results: None of our outcome variables were associated with a weight belt (p > 0.075), but all of them were associated with moving direction (p < 0.01). On average, movement velocity of the COM and maximum excursion were 31% and 18% greater, respectively, in mediolateral than anteroposterior direction (5.4°/s vs. 4.1°/s; 97.5% vs. 82.6%). Conclusion: Our results suggest that postural stability was not affected by the weight-induced lowered COM, informing the development and improvement of balance training strategies.