• Health Policy and Management
• /
• v.26 no.2
• /
• pp.135-147
• /
• 2016

Background: The voluntary diagnosis-related groups (DRG)-based payment system was introduced in 2002 and the government mandated participation in the DRG for all hospitals from July 2013. The main purpose of this study is to examine the independent effect of mandatory participation in DRG on various outcomes of patients. Methods: This study collected 1,809,948 inpatient DRG data from the Health Insurance Review and Assessment database which contains medical information for all patients for the period 2007 to 2014 and examined patient outcomes such as length of stay (LOS), total medical cost, spillover, and readmission rate according to hospital size. Results: LOS of patients decreased after DRGs (large hospitals: adjusted odds ratio [aOR], 0.87; 95% confidence interval [CI], 0.78-0.97; small hospitals: aOR, 0.91; 95% CI, 0.91-0.92). The total medical cost of patients increased after DRGs (large hospitals: aOR, 1.22; 95% CI, 1.14-1.30; small hospitals: aOR, 1.22; 95% CI, 1.21-1.23). The results reveals that spillover of patients increased after DRGs (large hospitals: aOR, 1.27; 95% CI, 0.70-2.33; small hospitals: aOR, 1.18; 95% CI, 1.16-1.20). Finally, we found that readmission rates of patients decreased significantly after DRGs (large hospitals: aOR, 0.28; 95% CI, 0.26-0.29; small hospitals: aOR, 0.59; 95% CI, 0.56-0.63). Conclusion: The DRG payment system compared to fee-for-service payment in South Korea may be an alternative medical price policy which can reduce the LOS. However, government need to monitor inappropriate changes such as spillover increase. Since this study also is the results based on relatively simple surgery, insurer needs to compare or review bundled payment like new DRG for expansion of various inpatient-related diseases including internal medicine.

• Korean Journal of Environmental Biology
• /
• v.21 no.2
• /
• pp.87-100
• /
• 2003

It is important to understand the potential human health implications of exposure to environmental chemicals that may act as hormonally active agents. It is necessary to have an understanding of how pharmaceutical and personal care products and other chemicals affect the ecosystem of our planet as well as human health. Endocrine disruption is defined as the ability of a chemical contaminating the workplace or the environment to interfere with homeostasis, development, reproduction, and/or behavior in a living organism or it's offspring. Certain classes of environmentally persistent chemicals such as polychlorinated biphenyls (PCBs), dioxins, furans, and some pesticides can adversely effect the endocrine systems of aquatic life and terrestrial wildlife. Research continues to support the theory of endocrine disruption. However, endocrine disruption researches have been applied to proteomics poorly. Proteomics can be defined as the systematic analysis of proteins for their identity, quantity and function. It could increase the predictability of early drug development and identify non-invasive biomarkers of tonicity or efficacy. Proteome analysis is most commonly accomplished by the combination of two-dimensional gel electrophoresis (2D/E) and MALDI-TOF mass spectrometry (MS) sr protein chip array and SELDI-TOF MS. Proteomics have an opportunity to play an important role in resolving the question of what role endocrine disruptors play in initiating human disease. Proteomics can also play an imfortant role in the evaluation of the risk assessment and use of risk management and risk communication tools required to address public health concerns related to notions of endocrine disruptors. Understanding the need for the proteomics and possessing knowledge of the developing biomakers used to abbess endocrine activity potential will he essential components relevant to the topic of endocrine disruptors.

• Journal of Environmental Impact Assessment
• /
• v.24 no.4
• /
• pp.332-343
• /
• 2015

It would be the most effective way to have government take care of social problems and hazardous material danger due to odor. It is also well known that odor acceptance and their willingness to pay for resolving the odor problem vary person by person. This is why public sector's intervention is required to get ride of any possibility of market failure resulted from negative external effect of human. This paper has tried to do empirical research based on survey of residents who are currently living in the area of Ochang industrial complex in North Chong-chung province. According to the empirical research results, first of all, it was proven residents' perception of legal regulation has a negative effect on odor acceptance. That is, the more residents are aware of law and regulation, the less they tend to accept odor. In addition, resident's perception on need to improve odor regulation has a positive impact on their odor acceptance. Finally, residents' satisfaction on the legal complaints to local government has an interaction effect to causative relationship between the perception of improving odor regulation and odor acceptance.

• The Korean Society of Law and Medicine
• /
• v.16 no.1
• /
• pp.221-254
• /
• 2015

The amendment of the Korea Civil Code will take place July 1, 2013. One of the most import issues related to adult guardianship system is a part. Though more than 100 new provisions, the revised Civil Code fundamentally reformed the guardianship system to establish a system to meet the diverse and complex needs of those who need a guardian and ensure due process. The new adult guardianship system intended to respect dignity and human right of mentally incapacitated adults, to guaranee their autunomy and to minimize the public interventions for assisting them. The new guardianship system for vulnerable adult has three kinds of legal guardianship system (adult guardianship, limited guardianship and specific guardianship). Mental patients forced the hospitalization of the mental health code and will be treated as an agreement incapable person. In principle an agreement incapable person has capacity of consent. The consent of the mental patients are admitted first. It is advisable to medical care only by the consent of the guardian when the the mental patient do not agree ability. If the mental patient do not agree with the mentally ill, but there should be a supervisory capacity for a guardianship of the couple guardian supervision. In conclusion, it not lost the capacity to consent to inpatient mental illness called. Therefore, we must discuss in detail the scope of the agreement for the mental patients. Mental Health Act amendments are necessary in accordance with the amended Civil Code.

• Journal of Trauma and Injury
• /
• v.19 no.1
• /
• pp.54-58
• /
• 2006

Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (${\geq}3m$, <6 m), and group C (${\geq}6m$). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients' ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall.

• Korean Journal of Social Welfare
• /
• v.37
• /
• pp.119-141
• /
• 1999

Korea paid attention to the work injury insurance in the early economic development stage as other developed countries did. Thus "The industrial Accident Compensation Insurance Law" was legislated in 1963 and it is now expanded to apply to the workplace with five or more employees. Beside the low coverage of the number of employees, the scope of benefits are the problem of work injury insurance. The work injury insurance's main benefits are for the loss of income and the medical cost caused by occupational accidents. On the other hand, the investment on the prevention accident and the medical, social and employment rehabilitation is very low, even though the occupational accident pension is higher than that in other OECD countries. Practically lay-off benefits and survivor' benefit for some special workers are paid more than they need, therefore they want to remain under the benefit condition and the medical care days are longer. This paper indicates the problems of work injury insurance and suggest how to improve the functions of it.

• The Journal of the Institute of Internet, Broadcasting and Communication
• /
• v.16 no.3
• /
• pp.187-201
• /
• 2016

The purpose of this study was to analyze the smart phone usage experience structure for college students. The phenomenology approach was used by conducting 4 times in-depth interviews with the 7 college students age between 20~23. Collected Data was analyzed by Giorgi's phenomenological method. There were 4 general structure descriptions and 28 themes. General structure descriptions were 'Dependence on smart phone', 'Phenomenon of smart phone usage', 'Results of smart phone usage' and 'Relationship between stress and smart phone'. Themes consisted of 'Ambivalence', 'Positive feelings for smart phones', 'Separation anxiety', 'Negative feelings for smart phones'. 'Dependent feelings for smart phones', 'A sense of unity with smart phones', 'Helpful for my life', 'Deeply involved with my life', 'Useful tool in my life', 'Study, communication, relaxation and health care', 'Maintain personal relationship', 'The most important thing in my life', 'Shallow relationship stress', 'Interference with personal relationship', 'Forming a negative relationship', 'Invasion of privacy', 'Forming a Incorrect relationship', 'Unwanted participation', 'No effort to improve relationship', 'Poor concentration', 'Interference with academic study', 'Study assistance', 'Limited help for study in depth', 'Shelter from the stress', 'Amplification of the stress', 'Obsessive focus', 'Feel separation for the reality' and 'Waste of time'. Smart phone usage make college students dependent on smart phones and had negative influence on both personal relationship and academic results. Usage of smart phone also amplified stress. Therefore we need fundamental principles on usage of smart phone and propose to build cultural etiquette that provides reasonable way to use smartphone.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.24 no.1
• /
• pp.36-43
• /
• 2013

Objectives : The aim of this study was to investigate correlation of childhood trauma experience and parent-adolescents' assessment reports on problem behavior through comparison of delinquent and general adolescents. Methods : First, delinquent adolescents and general adolescents were asked to complete the Childhood Trauma Questionnaire (CTQ). Then, 71 pairs of delinquent adolescents and their parents and 133 pairs of general adolescents and their parents were asked to complete the Korean Youth Self-Report (K-YSR) and the Korean Child Behavior Checklist (K-CBCL). Finally, responses from 410 people were used for the analysis. Results : First, childhood trauma experience score was significantly higher for delinquent adolescents, compared to general adolescents. Second, t-test showed a greater difference between K-YRS and K-CBCL for general adolescents than for delinquent adolescents. Third, in the case of delinquent adolescents, the correlation analysis of K-YSR filled out by adolescents and K-CBCL filled out by parents showed significant correlation in certain areas, including social immaturity, delinquent behaviors, internalization issues, and externalization issues. On the other hand, the correlation analysis of K-YSR and K-CBCL of general adolescents showed significant correlation in all sub-categories. Fourth, the correlation analysis of delinquent adolescents' CTQ and K-YSR showed minimal yet significant correlation in social adaptation, withdrawing, depression/anxiety, and delinquent/aggressive behaviors, however, no correlation was observed between CTQ and K-CBCL. The correlation analysis of general adolescents' CTQ and K-YSR, and CTQ and K-CBCL showed significant correlation in all sub-categories, although the degree of correlation varied. Conclusion : Delinquent adolescents had more childhood traumatic experiences. However, general adolescents' childhood traumatic experiences showed minimal yet significant correlation with various adaptation indicators and their parents responded in a similar way, indicating that general adolescents with childhood traumatic experiences need close care and attention even if they have not shown prominent delinquent behaviors.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.11 no.7
• /
• pp.707-716
• /
• 2016

The current research focused on the needs for discharge education and the educational performance of nurses perceived by mothers of premature infants. The subjects for the current research were 54 mothers of premature infants hospitalized in the neonatal intensive care unit at K general hospital in G metropolitan city. The data was collected between June 9, 2014 and September 30, 2014 through self-recording surveys. The needs for discharge education were $4.21{\pm}0.60$ and the perceived educational performance of nurses was $3.95{\pm}0.73$. There was a significant difference between the needs for discharge education and the perceived educational performance in abnormal symptom monitoring and management ($0.55{\pm}0.97$, p=0.001), excrement management ($0.45{\pm}1.11$, p=0.004) and growth development ($0.41{\pm}1.08$, p=0.007). The needs for discharge education was significantly different according to delivery type (vaginal delivery: $4.41{\pm}0.47$, caesarean section: $4.03{\pm}0.47$, p=0.040) and birth order (first: $4.37{\pm}0.53$, second: $4.25{\pm}0.51$, over third: $3.75{\pm}0.72$, p=0.031). Perceived educational performance of nurses was significantly different according to baby sitter (yes: $4.15{\pm}0.66$, no: $3.48{\pm}0.67$, p=0.002). ]

• Journal of Families and Better Life
• /
• v.25 no.1 s.85
• /
• pp.127-144
• /
• 2007

This study was conducted for the purpose of analyzing volunteer workers' perceptions of and attitudes toward the behavior problems of the elderly residents after caring for the residents voluntarily at low-income nursing homes. Eleven male and female volunteers ranging from age 19 to 52 were asked how they felt about the elderly residents' behavior problems and what kind of behavioral problems they had experienced after doing volunteer works in the three chosen facilities. In particular, they were expected to explain what emotional changes they experienced during their volunteer service. In this study, it was observed that most of the elderly subjects experienced three categories of behavior problems: habitual, repetitious and unreasonable activities caused by the elderly residents' life span backgrounds, unexpected and/or abrupt behaviors resulting from gradual cognitive impairments, and physiological, awkward activities caused from gradual senility. The volunteers tend to believe that the elderly residents are naturally expected to act positively, since they have been provided with well- planned, regular care services such as bathing, counseling, activity programs, and religious guidances. On the other hand, some respondents stated that their experiences at the nursing homes caused them to form negative images of the elderly; they feel that the elderly are not helpful for giving advices on critical decisions, guiding and encouraging their daily lives, and offering any positive influences toward their own lives. Rather, they find themselves getting too much stressed as a result of their intimate contacts with demented or senile residents. Overall, in this study, it is proposed that education for confronting sudden abrupt behavior problems should be intensified more for female volunteers, since they tend to be more susceptible to emotional harassment resulting from the problem behaviors. It is also proposed that young volunteers who have not been systematically trained for confronting aggressive behaviors need to be separately assigned their roles in order to minimize the potential of confronting unseemly situations resulting from male residents whose mental health has deteriorated. Furthermore, it is also suggested that the combination of leisure-related activities for healthy residents and stressful intimate services for the frail residents be systematically planned and implanted for the volunteer program so that the volunteers can lessen the chances of suddenly finding themselves confronted with extremely abrupt agitations.