• Korean Journal of Health Education and Promotion
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• v.33 no.4
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• pp.67-77
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• 2016

Objectives: The study was to propose strategies and directions how to manage the hypertension and diabetes in communities. Methods: The survey data from 606 patients with hypertension or diabetes based on Community Health Survey, 2013 were analyzed and the hypertension and diabetes projects in communities for last 10 years were reviewed. Results: The patients visiting the primary clinics had statistically significant lower rates than those of teaching hospitals in physician's recommendation experience, perception level of attention from doctors, self-efficacy and health habit practice level. Since the Hypertension and diabetes registration and management system in 2007, there have been several trials for management of hypertension and diabetes such as Chronic diseases management system on the primary clinics, Community based primary medical care pilot projects, Post-national health screening management, and Pilot project on reimbursement for chronic diseases care services. Conclusions: The upmost urgent task might be to have a support system for patients' self care affiliated with primary clinics. To achieve it, it is necessary to expand the current Hypertension and diabetes registration and management system into nation and to find a way to attract the active participation from primary clinics.

• Korean Journal of Occupational Health Nursing
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• v.25 no.4
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• pp.259-267
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• 2016

Purpose: This study examined the effect of job stress, depression and perceived health status on job satisfaction among child care teachers. Methods: Data were from a convenient sample of 169 child care teachers with self-administered questionnaires from January 5th to 30th, 2015. Collected data were analysed using SPSS/WIN 18.0. Results: Child care teachers had upper-medium level of perceived health status, lower level of depression and job stress and above medium level of job satisfaction. Affecting factors of job satisfaction among child care teachers included depression, and job stress ($Adj.R^2=.58$, F=78.60, p<.001). Conclusion: These results suggest that development of emotional supportive program and supportive system are needed to increase the job satisfaction among child care teachers. Exploration of strategies to reduce the depression and job stress will be necessary in order to increase the job satisfaction.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.16-25
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• 2019

Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

• The Journal of the Korean dental association
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• v.48 no.1
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• pp.6-11
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• 2010

Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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• pp.576-590
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• 1996

Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-highways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.77-107
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• 2008

In Republic of Chaina (Taiwan), Natural Death Act named "Anning Huauhe Yiliao Tiaoli" which means palliative and hospice care act was enacted in year of 2000. And enforced in the same year. Many scholars say that Taiwan's Act took Many U.S.A.'s acts such as 'Federal Patient Self-Determination Act 1990', 'California Natural Death Act 1976' and 'Washington Natural Death Act 1979' for a model. Taiwan's Act adopts a few outstanding systems - 'advance declarations' including 'living will' and 'durable power of attorney for health care', 'family-determination system' for a patient who is in a persistent unconscious state. This paper disusses this Act. 'The content is as follow: 1. A background of legislation. 2. The purpose of legislation. 3. The concept of terms. 4. Patient's self-determination. 5. Subrogated determination by family. 6. Keeping documents. 7. Punitive provision. 8. The relationship with euthanasia. 9. Controversial issues.

• 한국노년학
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• v.39 no.1
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• pp.1-20
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• 2019

Recently, the Ministry of Health and Welfare has emphasized the necessity to build community care, and the interest of health care- long-term care-social welfare system continues. In order to examine the future vision of long-term care for elderly people, which can be a core system in establishing community models for elderly people in the future, we will implement aging in place as a national policy project. It is meaningful to analyze in depth the case of Japan's policy implementation through the amendment process of long-term care insurance system. The purpose of this study is to examine the concept definition, operating system, and major promotion process of the Integrated Care System in Japan and to suggest policy implications for the future Korea long-term care insurance system. As a result of reviewing the operation status and revision process of the long-term care insurance system for establishing the Integrated care system in Japan, it is necessary to clarify the basic principles and construction of community care system, diversification of residence type and upgrading work, establishment of linkage network of health care-long term care-social welfare, expansion of support for family and self-mind.

• Health Policy and Management
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• v.11 no.4
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• pp.1-20
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• 2001

Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.

• Women's Health Nursing
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• v.4 no.2
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• pp.145-161
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• 1998

This correlational study sought to find the relationship among women's health status and the level of importance & performance of postpartal care. One hundred thirty three women who live in Seoul and rural area including hospitalized in a general hospital and midwifery clinic were studied from 1st April, 1998 to 25th April, 1998 for 25 days. Data analysis consisted of frequency, percentage, Pearson Correlation Coefficiency, t-test, ANOVA and Sheffe test as a post hoc, using SPSS. The results of analysis were as follows ; mean age of respondents was 31.9 years and mean number of children was 1.8. The most of family type was nuclear family and lived int apartment. Mean frequency of pregnancy was 2.7 times and most women delivered at local clinic, general or University hospital. Mean period of after delivery was 53.7 month. The level of importance and performance of traditional postpartal care (Sanhujori) was more higher than hospital postpartal care. The level of importance, performance of postpartum care and health status had significant relationship. The higher level of importance was, & the higher level of performance was higher, and the higher degree of health status. The factors related to health status were postabortal sahujori period after abortion, nuclear family, the evaluation of sahujori, whether women and followed the caregiver's advice well or not and whether they have physical symptoms or not, at the level of $5{\sim}0.1%$ of significance statistically. The factors related to the level of importance of postpartal care were the number of child, present health status and health status of pre-post of delivery, deliver place and the opinion of effective postpartum care method at the level of $5{\sim}0.1%$ of significance statistically. The factors related to the level of performance of postpartal care were delivery place, the opinion of whether they can do at the hospital or not and whether they have physical symptom or not at the level of $1{\sim}0.1%$ of significance statistically. In conclusion, this finding reconfirmed the relationship among women's health status and the postpartal care. It provides a challenge to the health professional caregivers to research continually and repeatedly and confirm the conceptual model of Sanhujori, reestablish effective and integrative postpartal caring system which contains oriental and western paradigm for women's life long health toward the 21C.

• Journal of Korean Public Health Nursing
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• v.6 no.1
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• pp.5-14
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• 1992

The role of Community Health Practitioner(CHP) should be continuously adapted to the social changes and the needs for health care services. That is the reason CHP needs to be retrained through the continuing education program. This paper showed CHP's roles to be reinforced by analyzing his present . task performance and ability in seven task areas as well as the changes of the social environment. In addition, this paper presented retraining areas needed for the reinforcement of the CHP's role in the future, and the development strategy of related continuing education package. The major results are as follows: 1. CHP's main practice area is health care services and management & guidance, whereas the development of health information system is neglected. 2. As a result, CHP plays a role mainly as a health care supplier, a consultant and a health instructor. Therefore CHP's roles to be reinforced are management of the community health system, act as a spokesman and a team member, promotion, assessment, collection & maintenance of information, coordination and research. 3. The areas to be reinforced in CHP's continuing education are (]) aged people's health, (2)?drinking & smoking, (3)?young people's health(including drug and sexualissues), (4) rehabilitation, (5)?administration and management for community health, (6)?partnership & membership, (7) local residents' participation and community development, (8) collection & treatment of health information and (9) environmental issues for community health. 4. The priority in developing continuing education package should be given to the area, which is encountered often in rural area but important, and has a good opportunity to be resolved. The health management of aged people was selected as a top priority by members of the Community Nursing Academic Society. 5. It is recommended that the instruction materials be accommodated to the small scale workshop or seminar in order that CHPs can participate actively in the continuing education program.