• Journal of Korean Critical Care Nursing
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• v.4 no.2
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• pp.27-38
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• 2011

Purpose: The purpose of this study was to examine the effect of tooth-brushing oral care on oral health and ventilator-associated pneumonia of patients in Intensive Care Unit (ICU). Methods: A total of 74 participants were recruited from a medical, surgical, or neurosurgical ICU at S Hospital in Seoul, Korea, from September of 2010 to January of 2011. An experimental group (n= 36) received oral care with tooth-brushing while a control group (n=38) received oral care with cotton ball and gauze. In both group, the oral care was done three times a day at least one minute for 7 days. Oral health was examined by the Modified Oral Assessment Guide before the intervention and each night. Results: There is no difference between the groups in aspect of passage of time (p = .603), interaction between time and intervention (p =.300), the performance intervention (p = .766), and the incidence of VAP (p = .486). Conclusion: The effect of oral care with tooth-brushing on oral health and VAP was not different from that of usual oral care in ICU. However, further study is necessary due to high attrition in this study.

• Journal of Korean Academy of Nursing
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• v.36 no.6
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• pp.1042-1054
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• 2006

Purpose: Previous evaluation studies of the visiting nursing program explained an average change of the participants' health status, without considering socio-ecological characteristics and their impacts. However, these factors must affect individual health problems and lifestyles. For effective and appropriate community based programs, the Geographical Information System(GIS) can be utilized. GIS is a computer-based tool for mapping and analyzing things that happen on earth, and integrates statistical analysis with unique visualization. The purpose of this study was to evaluate visiting nursing care and to advocate the usefulness of planning and evaluating visiting nursing programs using Exploratory Spatial Data Analysis(ESDA) with GIS technology. Methods: One hundred eighty-four elderly participants with cerebrovascular risk factors who lived in 13 areas of one community received visiting nursing care. The data analyzed characteristics of pre-post change and autocorrelation by ESDA using GIS technology. Results: Visiting nursing care showed an improvement in the participants' lifestyle habits, and family management ability and stress level, while the improvements were different depending on the regions. The change of family management ability and stress level correlated with neighborhoods (Morgan's I=0.1841, 0.1675). Conclusions: Community health providers need to consider the individual participant's health status as well as socio-ecological factors. Analysis using GIS technology will contribute to the effective monitoring, evaluation and design of a visiting nursing program.

• Journal of The Korea Institute of Healthcare Architecture
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• v.26 no.3
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• pp.27-35
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• 2020

Purpose: A solid system in the process of establishing guidelines can increase social acceptance and utilization. The paper aims to comparatively analyze the system in which guidelines for health care facilities in the US, Australia, and the UK and suggest implications for Korea. Method: It conducted literature analysis of the system in the framework of composition, governance, and procedure for the Facility Guidelines Institute's Guideline for US, Australia's Australasian Health Facility Guidelines for Australia, and Health Building Notes for UK. Results and Implications: First, in terms of composition, the guidelines for health care facilities can be divided into composition by space and composition by issue. It is proposed to establish a system that space and issues are clearly separated, such as Australia's AusHGF, and complete it step by step. Second, in terms of governance, despite the fact that the medical supply is privately oriented, the medical system is controlled by the government in Korea. Therefore, it is suggested to form a separate organization in the public sector that establishes, researches, and revises the guideline that will serve as a focal point for experts in various fields to participate. Third, in terms of procedure, it is suggested to establish a guideline that reflects the experiences and demands of consumers by clearly organizing procedures including collecting opinions.

• Korea Journal of Hospital Management
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• v.9 no.3
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• pp.18-48
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• 2004

Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.

• Health Policy and Management
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• v.28 no.3
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• pp.202-209
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• 2018

Health care has two different facets. One is commodity and another is a right of human being. Health care as a commodity is utilized by demand approach in market. Demand is determined by economic factors such as price and income. From the last third of the 19th century until the early 1920s, priority of sickness insurance was replacing the income that workers lost as a result of illness and injury. By the 1920s, the capacity of applied biological and medical science was remarkably developed. Development of medical science stimulated the cost of medical care, and the burden of increased medical care cost required new role of medical care security system. In 1942, Beveridge report was published in United Kingdom, and health care was considered as a right of human being. In 1948, United Nations declared heath care as a right in the Universal Declaration of Human Right. In most countries introduced new medical care security policy based on health care as a right. The viewing health care as a commodity must be shifted toward need based care as a right. Need were understood to rest on demographic, epidemiological, scientific, and medical knowledge factors. Bring needed care to the population could best be achieved institutionally by a hierarchy of provider organizations, guided by planning bodies, which would provide comprehensive benefits. In Korea, health care in social health insurance (SHI) is considered as a commodity not a right. However, health policies under SHI must be need approach based on health care as a right. Mismatch between health policies and ideology of SHI made big troubles. It is important to realize ideology of SHI for good health policies.

• Quality Improvement in Health Care
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• v.12 no.2
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• pp.75-83
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• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.

• Korean Medical Education Review
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• v.18 no.1
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• pp.1-15
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• 2016

In preparing for the unification of North and South Korea, rather than unilaterally over-writing the North's human resource training system with the South's health care human resource development system, it is important to understand the North's system and its ecology and to achieve a balance by seeking out aspects of each of the systems that could be consolidated with each other. The training period in both the North and South's health care human resource development systems is specified to be 6 years, but there is no system for internships or residencies in the North. South Korea introduced a 6-year system for pharmacist education in 2009, but North Korea has been using such a system since the 1970s (currently 5.5 years). In North Korea, training of health care personnel is conducted at various levels: at universities, at vocational schools, and at institutes for training health officials. Various types of training (daytime training, online, and ad hoc programs) are carried out. Also of interest is the North's licensure examination system. Rather than a state examination system as in South Korea, the North favors a graduation exam given by a national graduation examination committee composed of university professors, which awards both graduation certificates and 'permits,' that is, licenses for doctors and pharmacists. In working out a plan for the integration of the two Koreas' systems based on the study and analysis of the North's educational and testing system for doctors and pharmacists, this paper does not place exclusive focus on the distinctions between the systems or cling to negative views. Rather than claim that unification/integration is a practical impossibility, the paper focuses on the similarities between the two systems and maximizes them to uncover an approach for arriving at solutions. It is hoped that the practical data offered in this paper can contribute to the design of a forward-minded unification/integration model.

• Journal of Korean Academy of Nursing
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• v.31 no.5
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• pp.932-947
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• 2001

The purpose of this study was 1) analyze the current state of Sanhojoriwon; and 2) to suggest the new model for the community based mother infants health care delivery system: strategies of TMIC are related to Public Health policy, cost-effectiveness, mother infant care provision of medical professionalism, and so on. Method: Forty-seven workers from seventeen Sanhojoriwon participated to analyze several aspects of Sanhojoriwon. Using a questionnaire developed at Korean Sanhojori Research Forum (KSARF), such as the traditional and medical concept of the Sanhojori, postpartum care, Korean traditional postpartum care, job description on women and infant care at Sanhojoriwon, professional management, health care policy and the educational need. Results: Based on the descriptive study results, the TMIC, the community based transitional mother infants care center was suggested as a new model for the cyclic public health care system related on the reproductive health, using an already existing related center, Sanhojoriwon. Also, several strategies were presented on the TMIC.

• Korean Journal of Health Education and Promotion
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• v.16 no.1
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• pp.101-126
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• 1999

As the WTO system launches through the agreement of Uruguay Round, the Government has to revise the office regulations or reform the system. Also, Integrating and Coordinating the like affair in health care (i. e., children's home, industry health, school health, health manpower, the administration of health center, the administration on food hygiene, health environmental education, and so on.) which is now scattered into some government departments like the Ministry of Labor, the Ministry of Education, the Ministry of Home Affairs, the Ministry of Agriculture, and the Ministry of Environment, the Government has to prevent unspecialty, inefficiency, inconsistency, and uneconomy. The Government has to review and adopt above suggested the Proposal 1),2),3),4) of the Health Centers on the basis of the local autonomy law and it will help the successive settlement of the local autonomy system in Korea. According to the suggested proposal, the Central Government mainly takes charge of the Macro affairs as hardware, and transfer the Micro affairs as software into the Local Governments to attempt the appropriate functional allocation. To achieve it successfully, the Central Government also has to do the financial support, manpower training and technical support, allocation of health care resources, direction and control, research and development and the health care plan on the macro level. Local Governments which divided into the wide local government and basic local government also have to do their best for health improvement of the community societies like plan of health care program, implementation of health care service program, taking charge of the affairs of health insurance, activation of community residents' participation and security of health care resources etc. To achieve this goal, the Government have to be more active and reformative, the related social and health agencies and educational agencies have to cooperate and support for the goals, and especially, the community residents have to participate actively and voluntarily, When all these conditions promote, local health care administration will be developed, and health level of community residents will be secured. And going one step forward, the country and people will be more healthy

• Health Policy and Management
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• v.18 no.4
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• pp.185-206
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• 2008

The National Health Insurance (NHI) has been the main body of health care system in Korea for the last 30 years since the NHI was founded. However, the inefficient management and strong regulations of the NHI have hindered the development of health care industry. The establishment of the MB government, whose interest lies on economic growth rather than equity, is expected to help the health care services gain a momentum. The essential measures that can step up public health care services overall are the following: the introduction of competition within NHI, the activation of private health care insurance, and the allowance of for-profit hospital. The private-public mix with market mechanism would level up the health care service for the public.