• Korean Journal of Social Welfare
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• v.56 no.3
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• pp.113-133
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• 2004

Although National Health Insurance(NHI) in the South Korea has guaranteed access to health insurance coverage to virtually all the people, a significant portion of out-of-pocket spending can create substantial financial burdens for some beneficiaries, particularly those with low incomes. Previous studies have estimated the magnitude of out-of-pocket spending by types of chronic illness or in- and out-patients. Prior estimates, however, have not given a complete picture of the impact of health care costs on lower-income populations. The result from this study shows that 20 percent of beneficiaries in the lowest-income quintile spent more than twelve percent of their household equivalent income out-of-pocket health services, whether they were enrolled in a Health care services or not. In comparison, the beneficiaries in the highest-income quintile level spent only 2 percent of their income out-of-pocket on health care. Also, the regression analysis suggests that age, household income, number of chronic illness, type of hospital in addition to the number of usage may affect the size of out-of-pocket spending.

• Journal of muscle and joint health
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• v.20 no.1
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• pp.10-21
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• 2013

Purpose: This study was conducted to describe the meaning units of the teaching experience of Tai Chi instructor with nursing background, consequently to expand areas where nurses can work. Methods: Participants were four nurses who have worked as Tai Chi instructors for 5 to 8 years. An in-depth interview was conducted from June, 2010 to February, 2011. Each interview took 40 min to 4 hours. The data were analyzed with qualitative content analysis, by repeatedly listening to the tapes and reading the transcription to find the emerged meaningful words, phrases, and sentences. Results: Through the content analysis, 19 theme clusters were emerged and grouped together into seven categories: 'establishing my identity as an instructor', 'enjoying myself practicing Tai Chi', 'being confident about teaching Tai Chi with nursing background', 'exploring better ways to teach and motivate the class', 'feeling good about helping people to be healthy', 'accepting teaching Tai Chi as a lifetime job', 'contributing to health promotion with Tai Chi." Conclusion: Teaching and helping others to promote health were parts of nursing. Tai Chi can be used to promote health in the low-income population with limited access to health care system.

• Journal of Preventive Medicine and Public Health
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• v.42 no.6
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• pp.416-423
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• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• Journal of Digital Contents Society
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• v.18 no.3
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• pp.485-497
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• 2017

People can access to their vital signs easy through portable devices and wearable devices. The vital signs are used only for the purpose of health care, and can not be found when they are used for purposes other than health care. In this paper, we propose a web site to judge the emotional state of a viewer by using vital signs provided by smart bands. On the proposed web sites, user can see the overall trend of a person's vital signs and the vital signs of a person's best scenes and specific scenes. In this paper, we recognized the necessity to utilize the vital signs as an aspect other than existing health care. In this study, we analyzed the emotional state of people with vital signs and implemented them as a web site. In this paper, we store vital signs in a database, apply algorithms based on stored data, and draw graphs to provide user - specific graphs and graphs of all users on the Web site.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9427-9432
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• 2014

Background: Delayed presentation of symptomatic breast cancer is a public health issue in Iran, making a major contribution to low survival. Despite the importance of this problem, current knowledge is insufficient to inform interventions to shorten patient delay. The aim of this study was to explore factors influencing patient delay in Iranian women with self-discovered breast cancer symptom. Materials and Methods: This qualitative study was conducted during 2012-2013. Purposeful sampling was used to recruit 20 Iranian women with self-discovered symptoms of breast cancer who attended the Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. Data were collected through semi-structured in-depth audiotaped interviews, which were transcribed and analyzed using conventional content analysis with MAXqda software version 10. Findings: Content analysis of the data revealed four main themes related to the delay in seeking medical help including: 1) attributing symptoms to the benign conditions; 2) conditional health behavior; 3) inhibiting emotional expression; and 4) barriers to access to health care systems. Conclusions: These results suggest that patient delay is influenced by complex and multiple factors. Effective intervention to reduce patient delay for breast cancer should be developed by focusing on improvement of women's medical knowledge, managing patients' emotional expression and reform of the referral system.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.1
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• pp.181-195
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• 1999

This study was done to develope a computer program for the evaluation of quality of nurisng care. Because the professional nursing care should be evaluated consistantly, computer program for the measurement of quality of nursing care is necessary for the effective and efficient management of nursing quality. In this study, a computer program for gastrointestinal surgery patients was developed as a module. Visual basic 4.0 was used as a basic program for the development of this program, and Access 7.0 was used for the data base construction of the program. The systems of evaluation criteria were hierarchical. and the titles of the hierarchical criteria were evaluation area-evaluation item-indicator. Each evaluation area contained several items and each evaluation item contained several indicators. The numbers of the evaluation criteria for gastrointestinal surgery patients were 7 evaluation areas, 32 evaluation items. and 71 indicators. Content validity of the evaluation criteria(in this case, 32 evaluation items) was .95. Scoring could be possible with the evaluation items. For the scoring types of this program were two. norm-referenced type(option 1) and criterion-referenced type(option 2), the user can choose the type according to the purpose of the evaluation. With this computer program. accurate and consistant evaluation of the quality of nursing care could be expected. Also. by the rapid feedback to nursing care practice. quality of nursing practice could be improved rapidly. and the systems of the evaluation criteria developed in this study could be used for the development of other moduls for various kinds of patient groups. Because this computer program was developed only for the purpose of research, it is necessary to be refined commercially to be used in real nursing situation.

• Journal of Korean Academy of Nursing
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• v.36 no.8
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• pp.1324-1330
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• 2006

Purpose. This study developed a web-based wound care course for undergraduate nursing students and evaluated the course's content, system, and student-satisfaction. Methods. This study was done in three stages, the development of the web-based wound care course, the implementation and evaluation of the course. The course was developed based on the ARCS model. 80 under-graduate nursing students to Y University in Korea used the web-based wound care program during four weeks. After that, they completed questionnaires, evaluating the contents, system, and their satisfaction. Results. Eighteen learning objectives were used to create the web-based wound care course and the course was developed with 7 chapters and 20 subsections. The analysis of the questionnaires showed a mean score for content and system-related items of 3.04 each, out of a possible 4 points. Student satisfaction items had a mean score of 2.89. Conclusions. The web-based course allowed students access to the course anytime and anywhere, and according to their own learning abilities. However this advantage would only be possible when nurse educators develop qualitative web-based course to meet the demand of a complex health care system as well as the needs of the students and the effectively incorporate it into traditional lectures.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.23 no.2
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• pp.95-104
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• 2014

This study is about the basis of satisfactions by patients : One is 'what factors of the marketing by dental medical service have an effect on consumers dental clinic' The other is 'what is the most important part when consumers choose the dental medical ser Seoul and Gyeonggi area unintentionally. Finally 446 people were analyzed. 6 general questions, 5 selective form questions when consumers choose the dental service, 11 satisfactions questions after treating and thought of reuse the dental service 6 (Likert scale) questions. Whether the choice of hospital dental marketing by dental analysis, both male and female hospital medical marketing and use of selected highly suggests that it does not respond. The resulting satisfaction analysis using the Hospital Dental Marketing consumer access to medical care, and then, a full explanation, comfort, quality and level, health care costs, treatment management, and symptom improvement were higher satisfaction with the item, select the dental healthcare after the analysis of the marketing of recycled doctors are otherwise subject the person selected from all entries equal to or higher than the average consumer satisfaction showed a higher medical doctor also higher reuse. Consequently, Through the use of marketing to choose the best dental healthcare need to providing quality care.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10121-10128
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• 2015

Background: Cancers impose an increasing burden on health of the populations and individuals, but little is known about cancer patient satisfaction with care. The aim of this study was to assess the psychometric properties of the Persian version of European Organisation for Research and Treatment of Cancer (EORTC) In-Patsat32, as a recently developed questionnaire to assess cancer patient satisfaction with care and information provided during hospital admission. Materials and Methods: Complying with EORTC protocols, the Persian version of Inpatsat32 was translated and piloted in a small group of patients, then applied to 380 cancer patients admitted to different oncology wards in Tehran. Validity (convergent, discriminant, and divergent) and reliability of the tool was assessed through using multitrait analysis, factor analysis, intraclass correlations, Chronbach's alpha and test-retest (on a sample of 70 patients). Results: Good acceptance and high sensitivity of the questionnaire with low floor and ceiling effects were recognized, indicating power of the instrument to detect differences between groups with heterogeneous levels of satisfaction. Multitrait scaling analyses supported the convergent validity of the majority of scales (correlation coefficient >0.4) and favorable discriminant validity (item own scale correlation >0.8). There was no correlation between In-patsat32 scales and the EORTC-C30, which measures different concepts, confirming divergent validity of the tool. Internal consistency for all domains was high (${\alpha}$ >0.70) except for the hospital access score and the test-retest reliability was excellent (r=0.86-0.96). There was a weak responsiveness to change except for nurses technical skills. Principle component analysis confirmed five domains with much improved internal consistency (${\alpha}$ >0.9). Conclusions: The Persian version of the EORTC-in-patsat32 module is a reliable and valid instrument to measure cancer patient satisfaction with care received during their hospitalization period and can be utilized in clinical cancer research.

• Journal of Preventive Medicine and Public Health
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• v.57 no.3
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• pp.260-268
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• 2024

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.