• 보건행정학회지
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• 제30권3호
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• 한국융합학회논문지
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• 제11권4호
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• pp.265-275
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• 2020

본 연구는 내러티브 탐구를 활용하여 정신과 낮병원 이용 환자들의 경험을 연구하였다. 연구자들은 낮병원 이용경험이 있는 정신과 환자 4명을 대상으로 3회 이상 심층면담을 실시하였으며 낮병원 퇴원 후 외래 진료 과정에서 추가 면담을 실시하여 자료를 수집했다. 연구 참여자들의 낮병원 이용 경험의 의미는 '세상과 끊어진 줄을 다시 묶다.', '힘이 되는 마음의 안식처.', '삶에 대한 방향성을 찾다.' 세 가지 주제로 나타났다. 본 연구는 정신과 낮병원 이용 당사자들의 이야기를 깊이 있게 다루었다는 점에서 의의가 있다. 연구 결과를 바탕으로 정신과 환자의 고립 해소를 위한 제도적 지원, 다양한 지지체계 활성화 노력, 프로그램 개발 활성화의 정책적 제안을 한다.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.67-73
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• 2019

Objective: The purpose of this study was to compare the differences in the length of hospital stay between hemorrhage stroke survivors with health insurance and those with medical care after controlling all factors except for the type of medical insurance by using the propensity score matching (PSM) method. Design: Retrospective cohort study. Methods: Data from the Korean National Centers for Disease Control and Prevention's In-Depth Discharge Injury Survey between the years 2006 and 2012 were used for analysis. A total of 4,538 cases were defined as persons with hemorrhagic stroke (I60-I62) based on the block of categories in the International Classification of Diseases (10th). In order to analyze the inpatient period differences depending on the type of health care, which reflects one's socio-economic level, the chi-square and t-test was conducted. Results: Frequency and percentage were presented, and regression analysis was used to determine the factors affecting the inpatient period. Age, severity of disease, treatment outcome, and post-discharge status were no longer statistically significant after matching. The inpatient period of the persons receiving medical aid benefits was found to be significantly longer than those with national health insurance (p<0.05). Conclusions: The factors influencing the inpatient period of hemorrhagic stroke survivors were treatment outcomes, severity of disease, hospital admission process, and the type of health care. It is necessary for systematic and comprehensive governmental management for persons with hemorrhagic stroke to be transferred to long-term care facilities.

• 보건행정학회지
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• 제25권1호
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• pp.11-21
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• 2015

Background: The objective of this research is to investigate and provide analysis of the economic participatory change affecting the unmet needs of health care in Korean adults. Methods: We used Korea health panel 4th and 5th data of 10,261 adults. The method of investigation is threefold. First, We identified the regional factors affecting unmet needs of health care. Second, we analyzed the effect of economic participatory change as it affects the unmet needs of health care. Third, we also investigated whether there were discernable differences between the age subgroups. Results: It was determined that influencing factors included sex, education, economic level, and health status. And after the subgroup analysis of age, we found that the economic participatory change was associated with the economical unmet needs of health care especially for those over 40 years of age. Also the population are facing unemployment enduring particular economic hardship in meeting their medical needs. Conclusion: This study finds that there are some policy recommendations for the sake of medical service equality. Medical welfare policy for those 40 years of age and older has been identified as an area that needs improvement. And considering that those 40 years of age and older are facing unemployment enduring particular economic hardship in meeting their medical needs, this study finds a need for government sponsored medical stipends or subsidizing of medical premiums, co-payment, and other fees.

• International Journal of Contents
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• 제13권2호
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• pp.1-5
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• 2017

Residents under hazard and disaster conditions should be evacuating to the pre-assigned nearest safety facilities, community hall, local schools, friend's houses, etc. in a safety zone, quickly as soon as possible. The small percentage of evacuees shows serious economy class syndrome after the quake, because those people are forced to a stressful dairy evacuee-life in scattered homes and/or in-vehicle, for instance. Then, we consider on supporting evacuees using heart rate variability, Geospatial Positioning System (GPS) and WiFi functions of a smartphone, and Web-server on the Internet to keep their health in good conditions.

• Journal of Preventive Medicine and Public Health
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• 제39권3호
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• pp.263-269
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• 2006

Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.

• 한국병원경영학회지
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• 제8권1호
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• pp.112-134
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• 2003

The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.

• Perspectives in Nursing Science
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• 제11권2호
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• pp.132-143
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• 2014

Purpose: This study was designed to explore adolescents' experience with yoga class in South Korea. Methods: Qualitative data were collected by focus group interviews from February to March 2014. Eleven adolescents who experienced yoga class were recruited from two different schools. The interview questions investigated adolescents' experience with yoga regarding expectations before yoga class, positive changes after yoga, and advice for future yoga classes. Results: Three primary themes from the qualitative content analysis include 1) motivation to join a yoga class, 2) perceived benefits after class and 3) suggestions for school-based yoga. We found that high school students had intrinsic and extrinsic motivations to join yoga classes, and the perceived benefits included physical, psychological, cognitive and social aspects. The students also indicated the need for support by person, yoga with fun and information, yoga tailored by individual goal, simple and easy class. Conclusion: These results suggest that yoga could be an appropriate intervention for holistic health care, and school-based yoga should be applied by focusing on the various situational needs of adolescents'. Furthermore, when yoga leads to healthy habits compared to just simple exercise, a balanced development of adolescents can be achieved.

• 보건의료산업학회지
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• 제6권2호
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• pp.25-34
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• 2012

The purpose of this research is to evaluate the degree of transactions of the electronic commerce in the hospitals. We created well-organized questionnaire to achieve this goal. we did telephone interviews with the hospitals, and then we reached out to the hospitals by e-mail and postal mail. We interviewed 311 hospitals, and 104 hospitals participated in this study. We conducted cross tabulations. The results are following : Among the subjects, male was 77.9%(81) and female was 22.1%(23). 51.0% of the hospitals used electronic commerce in their work purpose. The proportion of the hospitals that started their electronic commerce before 2000 years was 30.2% and after 2000 years was 69.8%. In the major electronic commerce service providers, 30.4% of the hospitals had their contract with auction, 18.4% of the hospitals had their contract with public procurement services. which is running by Korean government, and 11.8% were with EZmedicom and 10.8% were working with Carecamp. Through electronic commerce, the most high usage was office supplies 41.0% and the send area was medical supplies 11.2%. The results of this study suggest that electronic commerce in health care field is a very new area compared to other industries. There may be lots of barriers in the aspects of a way of working and norms of health care field. Electronic commerce system and contracts with their electronic commerce service providing partners.

• 대한소아치과학회지
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• 제35권3호
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• pp.578-588
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• 2008

소아치과학이 목표로 하는 어린이와 청소년의 구강건강을 달성하기 위하여는 민간 치과의료기관에서 내원 환자를 대상으로 하는 진료만으로는 한계가 있으며 공공서비스(公共service)의 역할이 필요하다. 학교구강보건실이 설치된 초등학교는 전체의 7.2%이었고, 초등학교 중에서 불소용액양치사업을 수행한 비율은 57.5%, 급식 후 집단잇솔질을 한 비율은 46.9%이 었으며, 초등학생 중에서 구강보건교육을 받은 비율은 48.0%, 치아홈메우기를 받은 비율은 12.4%이었다(2006년). $0{\sim}6$세 영유아의 약 42%가 지난 1년간 구강검진, 불소도포, 치면세마, 치아홈메우기 중 하나 이상의 예방적 치과진료를 받았으며, 받은 장소는 교육시설이 약 18%, 보건소가 약 1%이었다(2005년). 불소농도가 조정된 수돗물을 마시는 인구 비율은 전국 평균이 5.7%이었다(2006년). 학교구강보건사업의 발전을 위해서 행정의 일원화, 보건교사에 대한 교육, 구강보건교사제도의 도입, 순회 학교치과의사와 학교치과병원을 통한 포괄적 진료서비스의 제공 등을 고려할 수 있을 것이다. 또한 아동.청소년 주치의제의 도입으로 민간기관을 통해 공공서비스를 강화하는 방안이 검토되고 있다.