• Journal of Korean Academy of Nursing
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• v.16 no.2
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• pp.44-52
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• 1986

Maternal and child health(MCH) status is considered as an important indicator of the level of health and civilization of a community and a country. MCH services for the rural population in the remote ar deserves priority by the government, since more than half(52.9%) of the delivery was occured at home and almost half (45.5%) of the delivery was assited by family members or neighbors. The purpose of the study was to analyse the health fare behavior related to pregnancy and delivery, which can be contributed maternal health care policy mating for the rural people. Specifically, it was intended to analyze the variables which affect the health care behavior in selecting birth places and birth attendants. This study utilized the data which had been already collected for an experimental study on primary health program model in Korean rural communities, funded by the USAID. 184 sample households with women who had delivered a baby during March 1982 to February 1983 were selected. Discriminant Analysis was employed for statistical analysis by utilizing SPSS computer package program. Birth places and birth attendants were considered as dependent variables. Among 12 independent variables in 5 groups considered, 7 independent variables were found statistically significant to affect the selection of birth place. Significant variables by the order of importance are mother's age, order of baby, number of prenatal care, accessibility of emergency medical care, coverage of medical insurance, mother's membership in community organization and husband's educational level. The degree of correct classification of the grouped cases by employing a discriminant . analysis was significantly improved to 78.2％ in comparison to Cmax（56%) and Cpro(51%). Policy implications for each significant variable were discussed to improve the maternal and child health. in Korean ruralarea.

• Korea Journal of Hospital Management
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• no.spc
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• pp.39-50
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• 2016

This paper discusses the strategic concepts applied to integrated delivery system(IDS). IDS is rooted in vertical integration(VI) and strategic alliance(SA), but only few knows about the theoretical backbone of the IDS. The paper explains how VI and SA applies to IDS, then provides cases of IDS rooted in strategic concepts; Kaiser Permanante Model, Mayo Clinic Model, and ACO(Accountable Care Organizations). Finally the paper provides the implication of IDS on Korean healthcare delivery system.

• Korean Parent-Child Health Journal
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• v.3 no.2
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• pp.67-80
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• 2000

This study was described as midwife's role and obstacle of midwife's role expansion. Midwife as primary medical personal who practices for a mother and infant health care and promotion of mother infant interaction. As the trend of increasing natural childbirth, midwifery has to provide childbearing care those who want delivery in a midwifery center. This study conducted to survey for 44 midwives who work at the midwifery center. The results of the study as fellows. 1. Most of the midwives role was care of pregnancy, delivery, postpartum women and babies. Another role was conducted educational classes childbirth, breast feeding, contraception and sexual education. 2. Some midwives role perform breech, vaccum delivery, episiotomy and suture, pitocin induction and augmentation, ultrasonogram, giving medication, anesthesia, collecting specimen from Pap smear and vaginal discharge. Midwife perform these roles without medical law support. 3. Most of the obstacles of the midwife role was the medical law limitation. Midwives want revise medical law to perform simple treatment for childbearing women and babies. 4. Half of the midwives refer cases to medical doctor in case of complication of women and newborns. 5. Current frequency of home birth rate is slightly higher than before and me cases like to have delivery under water. Finally, midwife and midwifery have to prepare to meet childbearing woman, baby and family's need. For activation and expansion of midwife's role, every midwife has to be aware of medical law accurately and they must know what practice they can do and what practice they can not do.

• 한국IT서비스학회:학술대회논문집
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• 2006.11a
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• pp.240-247
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• 2006

We assess service delivery system for outpatients of general hospital(A) using. service blueprint. Service blueprint for outpatients' service process currently being implemented in general hospital(A) is analysed to improve hospital services and define hospital service delivery system more accurately. In addition, comparative analysis of service blueprint before and after improvement was conducted to find that health care services is now more customer-oriented and hospital employees can link their duties with service delivery system. The analysis of service blueprint of outpatients' service process suggested in this study are useful for setting strategies for health care service. It also helps service process design and service digitalization of other general hospitals in the future.

• Journal of Digital Convergence
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• v.16 no.8
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• pp.57-69
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• 2018

The purpose of this study is to investigate the influence of the social welfare service delivery system of Namyangju City on the satisfaction degree of the elderly with welfare services and on their quality of life. This study conducted a survey of the elderly aged 65 and over who were either service users or nonusers of the public-private partnership welfare service delivery system called Hope Care Center. A total of 324 copies including 205 copies of Hope Care Center users and 119 copies of nonusers were analyzed. The analysis shows that the four key elements of welfare service delivery system are statistically significant to the service users of Hope Care Center than the nonusers with the users' higher level of satisfaction with the services. However, in terms of quality of life, there was no meaningful distinction between the two groups. This indicates that services of Hope Care Center increased the satisfaction with welfare services, thereby improving users' quality of life to the level of nonusers. Further studies for the same subjects are expected to be deeper if they compare and analyze the before and after of using Hope Care Center with more comprehensive independent variables.

• The Korean Nurse
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• v.12 no.4 s.66
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• pp.52-53
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• 1973

• Health Policy and Management
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• v.21 no.1
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Restorative Dentistry and Endodontics
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• v.24 no.4
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• pp.639-646
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• 1999

The dental care delivery system and the dental specialty system have a very close relationship each other. Compared to Korea. Western European countries with predominant public sector in dental service have recognized merely 2 or 3 dental specialties, while North American countries with predominant private sector, 8 or 9 ones. It is desirable to adopt the dental specialty system as soon as possible in Korea to encourage scientific development in various dental specialties and qualitative advance in dental service. We, however, have to establish equitable dental care delivery system which can use limited dental resources efficiently as follows. 1. clarifying the different roles in assignments between general dentists and specialists by the amendment of the related laws such as the Medical Act and establishing the organic patient-referral system. 2. adopting the dental specialty system and expanding personnel and equipments so that the dental college hospitals, especially dental divisions of general hospitals, night function as secondary care facilities with specialties. 3. determining the size of dental specialists according to the national needs for dental specialized service's, whose number is to be not more than 10% of the total dentists. 4. transferring the function of accredating dental specialists to the efficient, self-controlled professional organization such as the Korean Dental Association rather than putting it under the governmental control. 5. conducting a comprehensive review of specialty education and practice for re-recognition, and maintaining competence of specialists by re-accredating them periodically. I expect this article to contribute to further discussion about the dental specialty system in Korea in productive and practical way. I am sure that we can Establish this system in the near future when people in every walks of life-the academic circle, the press, the authority concerned, consumer groups and the Korean Dental Association-take part in the discussion with special concern.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.235-262
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• 2019

While traditionally threatening human infectious diseases are decreasing, chronic diseases such as cancer and diabetes, including cardiovascular diseases, are spreading rapidly. Reflecting the characteristics of chronic diseases that are difficult to treat, the management of risk factors and the preparation of health promotion policies corresponding to them have emerged as important concerns around the world. Providing so-called multi-sector approach such as health promotion and disease prevention policy and solution for community response, The value of primary care is once again highlighted in the changed medical environment. As the existing medical delivery system has become difficult to cope with the people's desire for rapid aging, disease paradigm change, and quality of life improvement, European Union countries have made various efforts to improve the quality of their primary medical system, which provides continuous, com- prehensive and coordinated management. This paper examines the current status and problems of the healthcare delivery system in Korea, draws implications from the European Union examples related to the strengthening of primary care, and discusses the plans for establishing a patient-centered future medical delivery system.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.