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Study on Clinical Dental Hygiene in Korea Based on Analysis of Clinical Dental Hygiene Curriculum of Fones School in the United States (미국 폰즈스쿨의 임상치위생학 교육과정 분석을 통한 국내 임상치위생학 교육과정에 관한 고찰)

  • Choi, Yong-Keum;Lim, Keun-Ok;Han, Yang-Keum;Bae, Soo-Myoung;Shin, Bo-Mi;Ahn, Se-Youn;Jeon, Hyun-Sun;Kim, Jin;Jang, Sun-Ok;Kim, Hye-Jin;Park, Ji-Eun;Lim, Hee Jung;Jang, Yun-Jung;Jung, Jin-Ah;Lee, Hyo-Jin
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.123-133
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    • 2017
  • The aim of this study was to analyze in depth the standardized Clinical dental hygiene curriculum of the Fones School in the United States. We investigated the clinical dental hygiene curriculum in 2015~2016 including title, credit, hours, contents, goals, competencies, and evaluation. We obtained the course syllabus and data related to each subject, for each grade, from the professors and students at the university. The goals and competencies, of the clinical dental hygiene program, which were based on the goals of the Fones School and the mission of the University of Bridgeport, were developed in accordance with the dental hygienist practice standards proposed by the American Dental Hygienists Association. The curriculum consisted of theory to teach proper dental hygiene care procedures and incorporated practical exercises that modeled an actual clinical setting. The students had to document the procedures performed for each client/patient and improve their clinical competency through discussion with the professors. Dental hygiene care should be provided for children, adolescents, adults, elderly, and patients, which includes patients with moderate or severe periodontal status. Students were evaluated by a paper test or case study presentation and their clinical evaluation was based on their clinical competency. In particular, professors evaluated students on a rotational basis, so they could evaluate the level of achievement of clinical competency of all students and find ways to improve any weaknesses. Therefore, the current study suggested that clinical dental hygiene program in Korea could be improved if based on the curriculum of Fones School in the United States.

The Mediating Effect of Experiential Value on Customers' Perceived Value of Digital Content: China's Anti-virus Program Market (경험개치대소비자대전자내용적인지개치적중개영향(经验价值对消费者对电子内容的认知价值的中介影响): 중국살독연건시장(中国杀毒软件市场))

  • Jia, Weiwei;Kim, Sae-Bum
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.219-230
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    • 2010
  • Digital content makes big changes to our daily lives while bringing opportunities and challenges for companies. Creative firms integrate pictures, texts, videos, audios, and data by digitalization to develop new products or services and create digital experiences to promote their brands. Most articles on digital content contribute to the basic concept or development of marketing it in literature. Actually, compared with traditional value chains for common products or services, the digital content industry seems to have more potential value. Because quite a bit of digital content is free to the consumer, price is not necessarily perceived as an indicator of the quality or value of information (Rowley 2008). It becomes evident that a current theme in digital content is the issue of "value," and research on customers' perceived value of digital content is a necessity. This article argues that experiential value has an advantage in customers' evaluations of digital content. Two different but related contributions to the understanding of "value" of digital content are made here. First, based on the comparison of digital content with products and services, the article proposes two key characteristics that make experiential strategy available for digital content: intangibility and near-zero reproduction cost. On top of that, based on the discussion of the gap between company's idealized value and customer's perceived value, this article emphasizes that digital content prices and pricing of digital content is different from products and services. As a result of intangibility, prices may not reflect customer value. Moreover, the cost of digital content in the development stage may be very high while reproduction costs shrink dramatically. Moreover, because of the value gap mentioned before, the pricing polices vary for different digital contents. For example, flat price policy is generally used for movies and music (Magiera 2001; Netherby 2002), while for continuous demand, digital content such as online games and anti-virus programs involves a more complicated matter of utility and competitive price levels. Digital content companies have to explore various kinds of strategies to overcome this gap. Rethinking marketing solutions such as advertisements, images, and word-of-mouth and their effect on customers' perceived value becomes essential. China's digital content industry is becoming more and more globalized and drawing special attention from different countries and regions that have respective competitive advantages. The 2008-2009 Annual Report on the Development of China's Digital Content Industry (CCIDConsulting 2009) indicates that, with the driven power of domestic demand and governmental policy support, the country's digital content industry maintained a fast growth of some 30 percent in 2008, obviously indicating the initial stage of industry expansion. In China, anti-virus programs and other software programs which need to be updated use a quarter-based pricing policy. Customers can download a trial version for free and use it for six months or a year. If they want to use it longer, continuous payment is needed. They examine the excellence of the digital content during this trial period and decide whether to pay for continued usage. For China’s music and movie industries, as a result of initial development, experiential strategy has not been much applied, even though firms in other countries find the trial experience and explore important strategies(such as customers listening to music for several seconds for free before downloading it). For the above reasons, anti-virus program may be a representative for digital content industry in China and an exploratory study of the advantage of experiential value in customer's perceived value of digital content is done in the anti-virus market of China. In order to enhance the reliability of the survey data, this study focused on people who were experienced users of anti-virus programs. The empirical results revealed that experiential value has a positive effect on customers' perceived value of digital content. In other words, because digital content is intangible and the reproduction costs are nearly zero, customers' evaluations are based heavily on their experience. Moreover, image and word-of-mouth do not have a positive effect on perceived value, only on experiential value. That is to say, a digital content value chain is different from that of a general product or service. Experiential value has a notable advantage and mediates the effect of image and word-of-mouth on perceived value. The results of this study help provide an understanding of why free digital content downloads exist in developing countries. Customers can perceive the value of digital content only by using and experiencing it. This is also why such governments support the development of digital content. Other developing countries whose digital content business is also in the beginning stage can make use of the suggestions here. Moreover, based on the advantage of experiential strategy, companies should make more of an effort to invest in customers' experience. As a result of the characteristics and value gap of digital content, customers perceive more value in the intangible digital content only by experiencing what they really want. Moreover, because of the near-zero reproduction costs, companies can perhaps use experiential strategy to enhance customer understanding of digital content.

Rural Migration and Changes of Agricultural Population (농민이촌(農民離村)과 농업인구(農業人口)의 변화(變化))

  • Wu, Tsong-Shien;Kim, Kuong-Ho
    • Korean Journal of Agricultural Science
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    • v.1 no.1
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    • pp.91-116
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    • 1974
  • Taiwan agricultural development in the last decade has not been changed much since the accomplishment of land reform program. This is mainly due to the rapid development taken place within industry that agricultural development can not keep pace with. The increasing gap of rural-urban income discrepancy has caused socio-psychological unstability among rural people and inspire wants of out-migration. From 1961 to 1970, population of the ten largest cities showed an annual growth rate of 4.05%, while the population of the remainder of Taiwan showed 2.06%. Assuming the natural increase rate of these two population sections are similar, the difference of rural and urban annual growth rate can be at tributed to the flow of people from rural to urban sectors. The main objective of this paper is to identify the amount of agricultural out-migration and its impact on agricultural development and agricultural extension programs. Specifically, the objectives are to examine (1) rural-urban population composition (2) rural out-migration estimation (3) changes of agricultural population, and (4) implications for agricultural development and extension programs Some of the important findings are listed below; (1) The average agricultural out migration of the period 1960-1969 is estimated at around 60,000 per year. Take Tainan prefecture for example, the Male-Female Migration Ratio is 0.39 for age 20-24, 0.55 for age 25-29, 0.90 for 30-34. It is understood between age 20 and 34, the rural female migration rate is higher than the rural male. (2) Based on the population growth rate of 1950-1969, agricultural population is projected for the period of 1953 to 1989. By 1978, the agricultural population will reach its peak and begin to dedaine from 1980. The projected agricultural population in 1989 is 5,847,566 which occupies 29% of the Taiwan total population. (3) Assuming area of cultivated land keep unchanged as 905,263 ha. in 1970, and tif we can eliminate all 72% of part-time farms, then the average farm acreage for hose full-time farms will be increased to 3.6 hactares. This is unlikely to happen before 1989 without the government interference. (4) Less than 10% of adult farmer s of age 25-64 in 1969 enrolled in Farm Discussion Club, only 5% of adult farm women enrolled in Home Economics Club, and 5% of rural youth enrolled in 4-H Club. These statistics show a fact that only few farmers are reached by extension workers. Based on findings in this paper, some important suggestions are listed for future agricultural development. (1) Improve agricultural structure by decreasing agricultural population (a) Encourage farmers with less than 0.5 ha. of land to seek jobs outside of agriculture (b) Encourage joint cultivation and farm mechanization (c) Discourage rural migrants to Keep farm land (d) Provide occupational guidance program through extension education programs (2) Establish future farmers settlement project to assure rural youth have enough resources for farming. (3) An optimum Population policy should be integrated into rural socio-economic development and national development programs.

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Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

A Case Study on Center of Gravity Analysis when Performing Uchimata by Posture and Voluntary Resistance Levels of Uke in Judo[ll] (유도 허벅다리걸기 기술발휘 시 받기의 자세와 저항수준에 따른 중심변인 분석 사례연구[II])

  • Kim, Eui-Hwan;Kim, Sung-Sup;Chung, Chae-Wook
    • Korean Journal of Applied Biomechanics
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    • v.15 no.1
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    • pp.237-257
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    • 2005
  • It was to study as a following-research of "A Case Study on Center of Gravity(COG) Analysis when Performing Uchimata(inner thigh reaping throw) by Posture and Voluntary Resistance Levels(VRL) of Uke in Judo[I]". The purpose of this study was to analyze the COG variables when performing uchimata(inner thigh reaping throw) by two postures and voluntary resistance levels(VRL) of uke(reciver) in Judo. The subjects, who were one male judoka(YH) for 1992 Barcelona Olympic Games Olympian(silver medalist), and one male trainee; Y.I.University representative member (SDK), and were filmed on two S-VHS 16mm video cameras(60fields/sec.) through 3-dimensional motion analysis methods, that postures of uke were shizenhontai (straight natural posture) and jigohontai(straight defensive posture), VRL of uke were 0% and 100%, respectively. The kinematical variable was COG variable, distance of COG, and distance of resultant COG between uke and tori(the thrower), velocity and acceleration of COG. The data of this study collection were digitized by SIMI Motion Program computed the mean values and the standard deviation calculated for each variables. When performing uchinmata according to each posture and VRL of uke and classifying. From the data analysis and discussion, the conclusions were as follows : 1. Displacement of COG Subject YH, COG was the highest in kuzushi(balance -breaking), vertical COG was low when following in tsukuri(positioning; set-up), kake(application; execution), and COG was pattern of same character each postures and resistance, respectively. Subject SDK, COG was low from kumikata(engagement positioning) to kake, and COG was that each postures and resistance were same patterns, respectively. Subject YH, SDK, each individual, postures and resistance, vertical COG was the lowest in kake phase, when performing. 2. Distance of COG between uke and tori The distance of COG between uke and tori when performing, subject YH was $0.64{\sim}0.70cm$ in kumikata, $0.19{\sim}0.28cm$ in kake, and SDK was $0.68{\sim}0.72cm$ in kumikata, $0.30{\sim}0.42\;cm$ in kake. SDK was wider than YH. 3. Distance of resultant COG between uke and tori The distance of resultant COG between uke and tori when performing, subject YH was $0.27{\sim}0.73cm$ from kumikata to kake. and SDK was $0.14{\sim}0.34cm$ in kumikata, $0.28{\sim}0.65cm$ in kake. Jigohontai(YH:$0.43{\sim}0.73cm$,SDK:$0.59{\sim}0.65cm$) was more moved than shizenhontai(YH:$0.27{\sim}0.53cm$, SDK: $0.28{\sim}\;0.34cm$). 4. Velocity of COG The velocity of COG when performing uchimata, subject YH was fast anterior-posterior direction in kuzushi, ant.-post. and vertical direction fast in tsukuri and kake. SDK was lateral, ant.-post. and vertical direction in kuzushi, ant.-post. and vertical direction in tsukuri and ant.-post. direction in take, respectively. 5. Acceleration of COG The acceleration of COG when performing uchimata, The trend of subject YH was showed fast vertical direction in kuzushi and tsukuri, ant.-post. and vertical direction fast in kake. The trends of SDK showed lateral direction in kuzushi, lateral and ant.-post. direction in tsukuri and ant.-post. direction in kake, respectively.

The Effects of Sex Education on the Primary Schooler's Knowledge and Attitude about Sex (성교육이 국민학생의 성지식과 성태도에 미치는 효과)

  • Kim, Jin-Son
    • Women's Health Nursing
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    • v.1 no.2
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    • pp.200-221
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    • 1995
  • The confusion of the sense of value on sex is increasing because of the rapid change in social-cultural environment. Also due to a rise in the standard of living, the age of adolescence is getting lower, and so the second sexual marks appear to primary schoolers. At this time in the aspect of the education for the whole man, it's very important for primary schoolers to acquire right knowledge and desirable attitude on sex so that can overcome psychological instability caused by physical growth, be responsible for their behaviors and lead happy lives. This study was made to find out the effects of sex education for the primary schoolers' knowledge and attitude about sex. The study was designed as simulated control group pretest-posttest design, which only pretest was practiced to control group and after sex education only posttest was practiced to experimental group. The data was collected for 18 days from March 13, 1995 to March 31, 1995. The subjects of this study were 130 six-graders in a private primary school in seoul. The control group and experimental group were composed of 65 pupils, each. Sex education consisted of lecture and discussion and the materials were this researcher's own made, 'How do I grow? and related OHP film and video. This education was practiced 40 minutes at a time, at intervals of 2-4 days' six times during 3weeks. For sex knowledge tools, 20 item questionaries on the base of related reference books and contents of this study were used. For sex attitude tools, this researcher's own made 13 item questionaries were used which were revised and complemented and laying stress on the reference books. The data was analyzed through pc-SAS program. The homogeneity test in terms of the general characteristics of experimental and control group was analyzed through $x^2$-test and t-test. And the difference in the primary schoolers' score on knowledge and attitude about sex before and after the sex education was analyzed through t-test and ANCOVA. The results of this study are as follows : 1. The result of the homogeneity test in terms of the general characteristics of the experimental and control group showed that there were significant differences in economic standard($x^2$=2.92, P=0.052) and brotherly ties($x^2$=3.78, P=0.052). 2. Hypothesis 'After sex education, the score of primary schoolers' sex knowledge will be higher than before. 'showed statistically significant difference.(t=11.99, P=.0001) Sex education was practiced under control over subjective view of economic standard and brotherly ties which showed significant difference at the homogeneity test in terms of the general characteristics between the two groups. After this education, the results of comparing the score of primary schoolers' sex knowledge also showed significant difference between the two groups. So hypothesis I was supported since primary schoolers to have education showed noticeable results in the sex knowledge score. (F=16.52, P=.0001) 3. Hypothesis 'After sex education, primary schooler's sex attitude score will be higher than before' showed statistically significant(t=5.08, P=.0001) Sex education was practiced, too, under control over subjective view of economic standard and brotherly ties which showed significant difference at the homogeneity test in terms of the general characteristics between the two groups. Bat this time the results of comparing the primary schoolers' sex attitude showed no significant difference between the two groups. So hypothesis II was rejected since for primary schoolers to have sex education showed no noticeable results in sex attitude score. (F=3.52, P=.0628) These results of the study show that sex education gives affirmative change to the primary schooler's sex knowledge, bat short periods' sex education doesn't give any change to the sex attitude. For the establishment of the pupils' desirable sex attitude, systematic and concrete sex education fit for the pupils' developing stage should be practiced over a long period of time.

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Science Teachers' Diagnoses of Cooperative Learning in the Field (과학교사들이 진단한 과학과 협동학습의 실태)

  • Kwak, Young-Sun
    • Journal of the Korean earth science society
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    • v.22 no.5
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    • pp.360-376
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    • 2001
  • This qualitative research investigated in-service science teachers' perceptions about cooperative learning and their perceived barriers in implementing cooperative learning in their classrooms. The underlying premise for cooperative learning is founded in constructivist epistemology. Cooperative learning (CL) is presented as an alternative frame to the current educational system which emphasizes content memorization and individual student performance through competition. An in-depth interview was conducted with 18 in-service science teachers who enrolled in the first-class teacher certification program during 2001 summer vacation. These secondary school teachers's interview data were analyzed and categorized into three areas: teachers' definition of cooperative learning, issues with implementing cooperative learning in classrooms, and teachers' and students' responses towards cooperative learning. Each of these areas are further subdivided into 10 themes: teachers' perceived meaning of cooperative learning, the importance of talk in learning, when to use cooperative learning, how to end a cooperative class, how to group students for cooperative learning, obstacles to implementing cooperative learning, students' reactions to cooperative learning, teachers' reasons for choosing (not choosing) student-centered approaches to learning/teaching, characteristics of teachers who use cooperative learning methods, and teachers' reasons for resisting cooperative learning. Detailed descriptions of the teachers' responses and discussion on each category are provided. For the development and implementation of CL in more classrooms, there should be changes and supports in the following five areas: (1) teachers have to examine their pedagogical beliefs toward constructivist perspectives, (2) teacher (re)education programs have to provide teachers with cooperative learning opportunities in methods courses, (3) students' understanding of their changed roles (4) supports in light of curriculum materials and instructional resources, (5) supports in terms of facilities and administrators. It's important to remember that cooperative learning is not a panacea for all instructional problems. It's only one way of teaching and learning, useful for specific kinds of teaching goals and especially relevant for classrooms with a wide mix of student academic skills. Suggestions for further research are also provided.

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Exploring the Theoretical Trends of an Integrated Environmental Design (통합적 환경설계 이론 기초 연구)

  • Ahn, Myung-June;Pae, Jeong-Hann
    • Journal of the Korean Institute of Landscape Architecture
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    • v.37 no.2
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    • pp.14-25
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    • 2009
  • We live in an age which is exponentially growing as the knowledge paradigm is changing. New sites are subject to contemporary landscape architecture function as "fields" in which this hybrid aspect is both actively practiced and becoming a catalyst for change in the area of landscape architecture. With this as its background, this study attempts to deal with how the aspect of integration in environmental design is manifested. For this purpose, the tendencies for the discussion of integration in various fields of practice were examined: planning theories, urban theories, architecture, public environment, engineering, and landscape architecture. As yet, the discussions of interdisciplinary integration, which occur in practice in these respective fields, mainly tend to be oriented toward the effective implementation of the merits of other related fields. Seen from these examples of practice, integrated design approaches can be found in the following three aspects: design objects, respective professional areas, and methodologies of approaches and design. In terms of design objects, the positions of individual design subjects present themselves as most obvious, and integration or combination of the physical targets that come to exist through design can be easily seen. Most examples of integration turn out to be this, in almost every case of which the theme and the target of expression are integrated via a small number of certain methods. In terms of professional areas, what can be mainly evidenced is how the individual subject acts when the subject designs. The strong points of professionals from each field seem to create synergy, achieving through integration optimum results. In terms of methodologies of approaches and design, there are attempts to create integrated approaches as ways of effective decision-making, in which case the integration of all of the interest parties is of primary concern. As yet, few instances have been found in which integrated design has had enough strength to be seen as a concrete design methodology based on practical examples. However, it is encouraging that theoretical approaches and the necessity for integrated design have been identified from multiple perspectives, and that a practical movement such as landscape urbanism has come into active being. The authors of this study find this point in time to be ripe for discussions on integrated practices in terms of environmental design, on the basis of the synthetic approaches mentioned above.

A Study of the Value of Contemporary Urban Agriculture as Represented by the Saekgyeong(穡經) by Seogye Park Se-dang(西溪 朴世堂) (서계 박세당(西溪 朴世堂) 색경(穡經)에 표방된 현대 도시농업적 가치에 관한 연구)

  • Lim, Jung-Eon;Sung, Jong-Sang
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.1
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    • pp.76-87
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    • 2015
  • The present study examines the Saekgyeong (Classic of Husbandry; 1676), an agricultural manual dating from the Joseon Dynasty (1392-1910), and the agricultural thought of its author by Park Se-dang (pen name: Seogye; 1629-1703), a scholar. Its purpose lies in exploring the value of contemporary urban agriculture based on an examination of the attitudes toward agriculture, the values pursued through agriculture, and the ways of dealing with and using land as evinced by the classic and its author. Confirmed through an examination of Park's agricultural philosophy and the Saekgyeong, the results of the present study are as follow. First, there is the socioeconomic value of pursuing the stability of and promoting the economic independence of indigent petty peasants through productivity improvement. Second, there is the experiential value of exploration through experience and agricultural field practice for study. Third, there is the environmental value of endeavoring to overcome an infertile natural environment through agricultural methods that sought to accommodate the land by reading the flow and phenomena of nature. Fourth, there is the practical value of compiling the Saekgyeong and seeking to broaden its use as a guidebook containing agricultural methods appropriate to the land and the wisdom for life.8) When examined in terms of contemporary urban agriculture, the significance of the four values above is as follows: the socioeconomic effect of encouraging urban agricultural activities as a means of welfare for socially alienated classes and promoting the creation of jobs; the enhancement of the significance of study through hands-on activities from an educational perspective; the recycling and recovery of resources and the enhancement of environmental consciousness for the recovery of urban ecology; and a practical spirit that seeks to contribute directly to society through academic research that contributes to practical life and approaches familiar to the populace. The present study sought to find the value of urban agriculture, under discussion in diverse ways in recent years, in the thoughts of our ancestors, who pondered on agriculture. Despite differences in the periodic background, the significance of the present study lies in its in-depth reexamination of the fundamental significance of diverse agricultural values that are being pursued today.

A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance - (병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구)

  • Lee, Sook-Ja;Lee, Jin-Kyung;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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