• 대한토목학회논문집
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• 제32권4D호
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• pp.397-406
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• 2012

기부채납은 본래의 공익과 사익의 합리적인 조정수단으로써 운영되는 것과 달리 효용성 및 사후관리의 문제 등의 많은 문제점이 제기되고 있는 실정이다. 이에 본 연구는 실제 기부채납이 된 공공시설의 현황분석을 통해 문제점을 살펴보았으며, 실질적으로 이용하는 주민들의 의식조사를 통해 개선방향을 도출하는 것을 목적으로 한다. 기부채납 공공시설 현황분석 및 이용자 의식조사분석에 따른 문제점은 자투리땅에 조성되는 위치 및 입지여건의 문제, 단지 내 시설로 인식 및 이용되는 문제, 거주자들의 이용 및 안전을 고려하지 않은 가로시설물 조성 및 사후관리의 문제, 주변지역현황을 고려하지 않은 효용성의 문제점을 도출하였다. 각 문제점에 따른 기부채납 공공시설의 효율적인 운영을 위한 개선방안으로는 첫째, 이용률 및 효율성을 높일 수 있도록 기부채납 공공시설의 위치 및 입지여건을 고려한 계획이 수립되어야하며 둘째, 기부채납 공공시설의 이용성 증진을 위한 각 지자체별 홍보가 필요하다. 셋째, 공공의 시설이라는 인지를 위한 표지 및 안내판 등의 기부채납 공공시설 인지의 의무화를 시행하며, 넷째, 효율적인 사후관리를 위한 공공시설의 운영을 주민, SH LH공사 등에게 위임하는 방안과, 마지막으로 해당 지역에 필요한 공공시설을 파악할 수 있는 공공시설서비스 지도를 작성하여 기부채납 시 활용될 수 있도록 제안하여야 한다고 사료된다.

• 한국IT서비스학회지
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• 제19권5호
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• pp.93-106
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• 2020

This study attempts to present specific technical measures and case models to meet the needs of caregivers and maximize the effectiveness of senior care facilities by utilizing Wellness IT Service. IT services for supporting elderly care need to go beyond productivity and efficiency and now require the new choice and standards to satisfy the Wellness concept of well-being and happiness. Therefore, this study explores to develop the existing human-based service into the Wellness IT Service by utilizing IT based Wellness in the elderly care facility and thereby to improve the quality of elderly care service. Therefore, this study analyzes the relevant research background and the various feasibility of technical applications of Wellness IT service, and review the new value creation in the elderly care facilities. Lastly this study provides a new foundation for Wellness architecture and a service model for using Wellness IT infrastructure of the elderly care facilities.

• 토지주택연구
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• 제14권2호
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• pp.83-95
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• 2023

본 연구의 목적은 도시 내 군 복지시설의 민간 활용방안을 모색하여 군의 복지 증진과 지역사회와의 상생 방안을 모색하는 데 있다. 군 복지시설 민간 활용의 개념은 민간이 군 복지시설을 활용해 추가적인 효용이나 부가가치를 창출하는 활동을 의미하며, 민간이 해당 시설을 이용하는 것과 민간의 개발행위로 시설의 고도화나 유휴부지의 개발을 모두 포함하는 개념이다. 군 복지시설은 군 장병들과 가족들의 복지 증진 차원에서 매우 중요한 시설이지만, 대부분의 서설이 노후화되어 건물의 리모델링을 통한 시설의 현대화가 필요한 실정이다. 도시 측면에서 군 복지시설은 주민 친화적인 시설로 인식되어 있어 지역사회와 함께 활용할 수 있는 좋은 도시 자원이기도 하다. 본 연구에서 시행한 주민 설문조사 결과 군 복지시설은 주민들에게 더 이상 기피 시설이 아니며, 민간 활용의 필요성에 대해 긍정적으로 응답하였다. 따라서 군 복지시설의 민간 활용은 활용은 군의 복지 증진과 지역사회에 필요한 시설을 제공할 수 있는 기최의 공간으로 그 활용방안을 모색할 필요가 있다. 본 연구에서는 군 복지시설 중 민간 활용이 가능한 시설을 도출하기 위해 전국 108개 복지시설 중 영외에 있는 시설 80개를 분석하였다. 그 결과 도시 내 9개 시설에 대해 민간 활용이 가능할 것으로 분석되었으며 민간 활용방식의 유형으로 3가지를 방안을 제시하였다. 정책제언으로는 군 복지 확대를 위한 민간 참여 활성화와 군과 지역이 상생할 수 있는 제도적 기반 마련 방안을 제시하였다, 또한 군 복지시설의 효율적인 개발방식과 다양한 주체 간의 거버넌스 구축방안 등 군의 복지 증진과 도시의 환경을 동시에 개선하기 위한 정책 방향을 제시하였다.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• 보건행정학회지
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• 제17권2호
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• pp.33-51
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• 2007

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

• 지역사회간호학회지
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• 제20권2호
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• pp.123-133
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• 2009

Purpose: This study aimed to classify nursing interventions by developing a list of interventions for family nursing care. Methods: A new intervention list was confirmed after the researchers' discussion and professional consult. All possible interventions were re-organized. Results: Five grand categories were identified, which include health education, providing direct nursing care, utilization and referral of community resources, reinforcing family resources, and stress management. The category of health education consists of anticipatory guidance, training and education, providing information, and consult and motivation. The category of providing direct nursing care consists of identifying problem, providing technical nursing, providing family tailored nursing care, family contract, monitoring or evaluation, and collaboration with experts. The utilization and referral of community services includes utilization of health care facilities, utilization of social welfare facilities, use of neighbors, friends, and relatives, connecting to professionals or supporting groups, and utilization of other sources. Reinforcing family resources includes reinforcing economic resources, reinforcing physical resources, and reinforcing human resources. Stress management includes reorganization of perception, resolving conflicts, division of role, preparing communication strategies, time management, creating familiarity, supporting spirituality, and developing sense of humor. Conclusion: This study provides useful resources to promote nursing activities by identifying possible family nursing interventions.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권2호
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• pp.71-79
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• 2020

Purpose: The purpose of this study is to derive basic data for desirable location and functions of the integrated care center. Methods: Survey, Questionaire and statistical analysis are the main research method of this study. In order to collect data related to utilization pattern and favorite functions of the senior people, researchers have visited 4 social welfare facilities located in Southern Gyeonggi Province. 403 questionaires have been gathered from 4 facilities and they have been analyzed by using Excel Program of MS. Results: First, compared to other services, healthcare services have been preferred by many older people in Social welfare Facilities. This means that integrated care centers providing healthcare services for older people rather than services for children or disabilities is desirable. Second, Integrated Care Centers had better be established within the walk distance of elderly people. If it is not easy, the introduction of shuttle bus for older people is desirable. Especially, in case of large Care Center. Implications: This study shows that small facility with community care rather than big facility is desirable for small community in the point of friendliness, convenience, economy, etc.. However it is necessary to combine welfare service and healthcare service even in small centers.

• 보건행정학회지
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• 제1권1호
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• pp.116-135
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• 1991

Few studies have been conducted on the detailed routes of medical care utilization under the National Health Insurance. This study was undertaken to identify the utilization patte군 of health care facilities among industrial workers and their dependents. One of the largest health insurance association was purposively chosen for this objective. The association had 345, 757 members as of 31 December, 1990. The study sample of 297, 948 subjects have been drawn from the membership pool on the basis of their continuous membership status during 1 January through 31 December 1990. This study has tried to identify differential utilization patterns between acute and chronic conditions, and among standard income classes. All the diagnoses were recoded in a manner to achieve the objective of this study. As for acute diseases, most age group had used one medical facility as much as by 60% except the age group of 1-4, This young age group had used over three different health facilities as much as by 10.9-15.8%. The finding suggests that some policy measures by sought for remedying the excessive/inappropriate use of services. In addition, mid-income classes(between 17 and 48) were more likely to use multiple sources of care than lower income classes(between 1 and 16) and upper income classes(above 49). This study has revealed that chronic cases are more likely to pursue multiple sources of care, however those with chronic conditions tend to use single health facility more than those with acute conditions(67.9% versus 52.4%). As many as 12.2% have visited more than three health facilities in chronic conditions, but 5.9% for acute conditions. The most likely source of care was primary clinics for both acute and chronic conditions. Compared with the role of general hospital, small-size hospitals found to play a minimal role in the care and referral of patients. This indicates the need of strengthening the function of small-size hospitals. While a minor cross utilization of western medicine and pharmacy was noted, no significant boundary crossing was identified between western medicine and oriental medicine, or between pharmacy and oriental medicine. It is too early to confirm that whether there is substitutability or cross utilization among these alternative sources of care. A further study is needed to identify these relationship.

• 한국병원경영학회지
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• 제12권4호
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• pp.1-21
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• 2007

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

• 한국토양비료학회지
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• 제46권5호
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• pp.399-407
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• 2013

Organic grape was generally produced in rainshield or plastic greenhouse culture while most of fruits were produced in open field. But little attention has been given to soil properties with different culture facilities in organic grape cultivation. This study was conducted to investigate soil physico-chemical properties of organic grapes farms with different culture facilities and soil management practices. Organic fertilizer was main resource to manage soil at organic grapes farms. Organic grapes farms were applied with total amount of organic fertilizer at one time, either at basal or additional fertilization, whereas conventional grapes farms applied with split fertilization. Bulk density and penetration resistance of soil were lower at both rainshield and green manure-applied plastic greenhouse cultures than those at clean plastic greenhouse culture. Especially, in plastic greenhouse, sod culture with natural weed after green manure application was more effective than general sod culture in improving physical properties of the rhizosphere. The contents of organic matter, available phosphate and exchangeable potassium tended to increase in the soils applied with green manure, and the difference of soil chemical properties were significant between rainshield and plastic greenhouse cultures. The optimum soil management was required in plastic greenhouse because pH, available phosphate and exchangeable cations reached over optimum range. Consequently, the ground cover management is the key factor to affect the chemical properties as well as soil physical properties extensively in plastic greenhouse. It is found that sod culture with natural weed after green manure application resulted in enhancement of utilization efficiency of nitrogen, phosphoric acid and potassium in soil in comparison with general sod culture.