• 대한치과보철학회지
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• 제46권1호
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• pp.83-91
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• 2008

문제제기 : 2007년 4월 '노인장기요양보험법'이 국회를 통과하였고 노인수발행위에 치과의사의 참여가 확정되어 2008년 7월부터 법이 시행되면서, 고령화가 급속이 진행되고 있는 한국사회에서 치과분야가 담당해야 할 역할은 커질 수밖에 없다. 목적 : 본 논문은 한국의 두 노인시설에 대한 설문조사를 바탕으로 일본의 노인요양보험법과 비교를 통해 앞으로 시행되는 노인장기요양법의 구강위생서비스의 역할 및 방향을 수립하는데 기여하고자 한다. 연구재료 및 방법 : 2005년 한국의 두 노인요양시설에서 책임 있는 직무자 또는 실제 간호의 내용을 파악하고 있는 분을 대상으로 15개 항목의 설문조사를 시행하였다. 결과 : 두 시설 모두 각각의 특징을 살려 매우 기능을 잘 하고 있었으나, 구강위생 및 이에 대한 직원의 인지도는 낮았으며 정기적인 진료나 관리는 소홀했다. 고찰 : 일본에서는 2000년 노인요양보험이 도입 후 체계화된 방법론을 기초로 시행되고 있다. 현재 '노인장기요양' 법안에 치과의사 참여가 보장된 것과 관련하여 앞으로 치과의사의 적극적인 참여가 필요하고, 시설 및 재택 방문 진료가 가능하도록 하는 법정비용을 통해 치과분야의 진료영역을 넓힐 수 있는 움직임이 필요하다고 볼 수 있다.

• 지역사회간호학회지
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• 제9권1호
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• pp.89-103
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• 1998

The elderly population will increase from 5.8% in 1996 to 12.5% in 2020. The related problems of health will also become a very important issue in the future. Therefore it is important to address the problems of geriatric nursing and geriatric health. 87.6% of the aged were ill with chronic degenerative diseases in 1994. In 1995, hospital admission rates (86.8) for those aged 60 or older were higher than that (56.3) of the total age group. Such high medical utilization will increase national health costs. For the development of geriatric nursing, active nursing intervention in various settings combined with education and research should be developed. Considering the health and welfare of the aged and the present status and views in Korea, I suggest the following: First, the health needs of the elderly in the institution, must be met by a plan that fosters geriatric nurses and programmed service development. Second, health service for the residential elderly must be provided in day care centers, short stays, nursing homes and geriatric hospitals. Geriatric nursing services should be provided in home residential areas, public health centers, public health subcenters as well as having, community health practitioners in primary health care posts and home health nurses. Third, geriatric nursing curriculum must be developed adjust to situations and culture of Korea and be included in the nursing curriculum. And gerontological nurse practitioner or geriatric specialist must be fosteraged to provide the professional care for the aged. Geriatric nursing research should be also achived for geriatric nursing improvements.

• 대한한의정보학회지
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• 제15권1호
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• pp.67-76
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• 2009

Quality management is a recent phenomenon. Advanced civilizations that supported the arts and crafts allowed clients to choose goods meeting higher quality standards than normal goods. There are many methods for quality improvement. Health care, refers to the treatment and management of illness, and the preservation of health through services offered by the medical, dental, complementary and alternative medicine, pharmaceutical, clinical laboratory sciences (in vitro diagnostics), nursing, and allied health professions. Health care embraces all the goods and services designed to promote health, including "preventive, curative and palliative interventions, whether directed to individuals or to populations. The overall impact of managed care remains widely debated. Proponents argue that it has increased efficiency, improved overall standards, and led to a better understanding of the relationship between costs and quality. Practices can solicit feedback from patients in a variety of ways: phone surveys, written surveys, focus groups or personal interviews. What do I do with the results? While you don't have to act on every suggestion that your patients give you, you should take action on the key items that are causing dissatisfaction.

• Journal of Korean Biological Nursing Science
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• 제18권3호
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• pp.144-152
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• 2016

Purpose: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. Methods: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents' perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. Results: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. Conclusion: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.

• 한방재활의학과학회지
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• 제26권3호
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• pp.129-141
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• 2016

Objectives As awareness of the public about Korean medicine health care and the social demand about improvement for quality of health care service is constantly rising, the quality evaluation of Korean medicine health care service is needed to improve the quality. Through trial of Delphi method, we tried to set the priority in short, medium, long term among the disease which is the subject of quality assessment. Methods Carrying out the delphi survey to 50 experts of korean medicine who were recommended by the 41 member societies of Korean medicine and related organizations, we selected final candidates for quality assessment. It is composed with total 2 rounds, and we investigated the priority in three aspects; the importance of the matter, possibility quality assessment, potential about if there's any chance of improvement. Results By delphi method, we set the priority of quality assessment. Base on the result of the second round, we classified importance of the questions into above average, average, below average, and categorized items as short, medium, long term according on the final priority. We classified of musculoskeletal diseases and diseases of connective tissues and musculoskeletal injury as short term and cerebrovascular disease and disease of nerve system and malignant neoplasm as medium term, disease of digestive organs and diseases, symptoms and abnormal findings in clinical field or inspections which are not categorized as long term. Conclusions We set the subjects of quality assessment by delphi survey by experts, and classified into short, medium, long term. Further research is necessary for execution the Quality Assessment to each of the candidate. Also, we can send feedback to medical institution base on the result of Quality Assessment. then it would be able to induce the improvement in quality of medical institution by itself.

• 보건행정학회지
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• 제19권1호
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• pp.49-61
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• 2009

Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.

• 의료법학
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• 제8권1호
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• pp.215-234
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• 2007

The mission of the doctors is to take care of human life, body and health through the medical behaviors such as diagnosis and treatment. Under this job propensity, the doctors have care duty to take the best actions required to prevent the risk according to the patients' specific disease status. Such care duty of the doctor may be evaluated based on the medical behavior level at the medical institution and clinical medical study field. Such medical level should be understood in the normative level, considering the treatment environment, condition and specialty of the behavior, because it means the medical common sense known and acknowledged to the normal doctors. While the criminal suit requires the evidence for no doubt conviction, the civil suit requires more eased different standard. The results between the criminal and civil sentence may be different, because the confirmed former case may lead to long-term imprisonment and even death penalty, while the latter case puts only monetary penalty on the defeated party.

• 농촌의학ㆍ지역보건
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• 제22권1호
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• pp.75-83
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• 1997

The medical insurance system has been adopted in 1989. Since then, the utilization of medical care services has increased rapidly. It appears that the medical institution needs more nursing manpower such as nurses and nurse aides to meet an increased demand for medical care for the residents. However, the medical care clinics run by a medical practitioners has a more shortage of nursing manpower than hospitals. The purpose of this survey was to analyze the current employment status and to obtain an opinion on the improvement of utilization such as recruitment and retention of nursing manpower. The questionnaire sent to the private physician and the response rate was 28.7% ; 87 out of 300 physicians. 82.6% of the respondents employed nurses aides rather than nurses and an average number of employees per clinic was 2.5 persons. Most physicians had difficulties in recruiting nursing manpower. It took more than one month for replacement on average, therefore, they were suffering from giving good continual care for the patient and also high resignation of nursing personnel. The low wage, long working hours, hard work and lack of incentives are the biggest reasons for the difficulty in recruiting and retaining of the nursing personnel obtained for the clinics survey. The above mentioned problems would be solved in the near future by changing those difficulties. In the meantime, the private physicians are marking an effort to retain the nursing personnel by keeping a relationship of the private physician's cooperatives.

• 가정∙방문간호학회지
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• 제27권2호
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• pp.198-209
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• 2020

Purpose: This study sought to develop a scale to evaluate patient-centered healthcare services at hospitals and verify its reliability and validity. Methods: We conducted a literature review and interviewed medical personnel and practitioners in medical institutions. We also conducted a content validation and preliminary survey of experts, including 40 preliminary items. We conducted the main survey among 240 medical institution workers to assess the validity and reliability of the preliminary measurement tool. Results: The validity and reliability of the scale were assessed by 29 items underlying six factors: ease of communication, continuity and extension of the hospital's role, stable environment, emotional support, respect for patients' values, and offer of information. Cronbach's α of the whole tool was .91, while the value of each factor ranged from .82 to .74, thereby verifying its reliability. Conclusion: The patient-centered healthcare services scale was identified as a tool appropriate for healthcare professionals. This tool will be useful in a diverse range of research on the development of educational programs for patient-centered healthcare services and the promotion of patient-centered causes.

• 대한예방한의학회지
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• 제16권2호
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• pp.83-94
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• 2012

Objectives : This study aimed to investigate the use and patterns of health care resources of local patients and to analyze the health seeking behaviors focusing on shopping around phenomenon. Methods : Questionnaires on the use of health institution were developed and administered to the residents in Yangsan city, Korea. We selected patients who were suffering from any diseases two months and over. Patients' health seeking behaviors were categorized, and the factors for selecting health institutions in each visiting stages were analyzed. Results : 139 local patients participated in the survey, and 130 completed questionnaires were analyzed. We found that there were sixty eight different types of medical utilization paths. The most frequent path was 'western clinics ${\rightarrow}$ Korean medicine hospitals or clinics ${\rightarrow}$ western clinics'. Only 6 patients started at Korean medicine, however, 16 patients(12.3%) finalized their treatment at Korean medicine hospitals or clinics. In most health seeking stages, patients tended to select health resources by their own decisions, and the geographic factor was the key reason to select health resources. Conclusions : Patients had not any stable forms to treat with their diseases, and we observed diversified patterns in the health seeking behaviors of patients, a typical shopping around phenomenon.