• Title/Summary/Keyword: Health service area

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The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization

  • Kim, Agnus M.;Park, Jong Heon;Kang, Sungchan;Hwang, Kyosang;Lee, Taesik;Kim, Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.4
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    • pp.230-239
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    • 2016
  • Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

A Study on the Effects of Perceived Oral Symptoms and Masticatory Performance on the Quality of Life for the Elderly in an Urban Area (대도시 노인의 주관적 구강증상과 저작능력이 삶의 질에 미치는 영향)

  • Ryu, Hwang-Gun;Lim, Hyun-Ju;Kim, Hye-Sook;Kang, Hyun-Kyung
    • The Korean Journal of Health Service Management
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    • v.6 no.1
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    • pp.15-25
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    • 2012
  • The purpose of this study is to examine relations among the subjective oral symptoms, masticatory performance and life quality of aged people residing in some regions of a large city, ultimately providing basic information needed to develop and implement programs oral health project and oral health education programs for the oral health promotion of those people. For the above purpose, this researcher conducted a questionnaire survey of people aged 65 or over from July 14th to 30th, 2011. Among the copies of the questionnaire distributed to the subjects, 318 were recollected. Out the recollected forms, 18 which were deemed as in appropriately filled in were excluded, and the remaining 300 were finally analyzed. The results are as follows. Subjective oral symptoms and masticatory performance have correlation(p<0.001) with aged people's life quality. Factors of influencing life quality were indicated to be gender(p=0.046), age(p=0.008), appearance of living together(<0.001), masticatory performance(p<0.001), and temperature reaction(p=0.018). This study has limitation because of being information that was obtained just with questionnaire survey on subjective oral symptoms. It is considered that there is a need of surveying along with objective data on oral symptoms hereafter.

Incidence of ascarid eggs in sands of educational facilities and public playground in Seoul (서울지역 교육시설 및 공원 놀이터 모래에서 회충의 충란 조사)

  • Kwak, Jeong-Yeon;Seol, Chae-Hyeon;Seo, Hyeong-Su;Kim, Gyu-Hyeon;Kim, Neung-Hee;Chae, Hee-Sun;Son, Hong-Rak;Kang, Yong-Il
    • Korean Journal of Veterinary Service
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    • v.36 no.3
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    • pp.223-226
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    • 2013
  • To evaluate the potential risk associated with zoonotic ascarid eggs in educational facilities and public playground in Seoul city, the sand samples collected from April to December in 2011 were examined with a fecal flotation method. Of 5,066 sand samples from 1,367 playgrounds tested, 12 sands from 12 places (0.88%) had ascarid eggs. Sand samples in educational facilities were more contaminated (10/870, 1.15%) with the parasite eggs than those of public playground area (2/497, 0.4%). Fisher's exact tests were used to make pairwise comparisons between which locations were more or less similar with regard to levels of contamination. We didn't find significantly different from one another. Most ascarid eggs detected were found in the Spring. Through this study, we hope to raise awareness of contamination of playgrounds by potentially infectious ascarid ova.

Fatigue among Medical Technicians in Hospital and Actions to Control Fatigue (의료기술직 종사자의 피로도에 영향을 미치는 요인과 피로조절행위)

  • Park, Nam-Keun;Park, Jae-Yong;Han, Chang-Hyun
    • The Korean Journal of Health Service Management
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    • v.5 no.2
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    • pp.119-129
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    • 2011
  • A researcher examined 158 medical technologists and 140 radiologists who are working at 9 general hospitals in Gyeongsangbuk-do area using structured questionnaire to find out degree of fatigue of health professionals, the primary factors that have effect on them, and actions to control their fatigue on December 1 through December 20, 2008. The average complaining rate of fatigue subjective symptom by syndromes was overall 17.24 points, and medical technologists scored 16.48 points while radiologists scored 18.09 points. There were significant difference in the average fatigue complaining score of both medical technologists and radiologists such as when the younger their age is, when they are single, when the lower their monthly salary is, when the shorter their total working period is, and when the current status is staff at work. As a result of multiple regression analysis which sets fatigue score as dependent variable, there were significant difference on both syndromes such as satisfaction on work, work stress, and sleeping condition. It was the highest on relaxation, which was 76.6%, among the 15 questions on actions to control fatigue, and the next was enough sleep and controlling stress. And the lowest was help from medical professionals, which was 7.3%. It was the highest on enough sleep, which was 1.98 points, and next was relaxation and controlling stress, and the lowest points were help from medical professionals and taking medicine in the effective score of fatigue control action. In consequence of research, it is necessary to develop program and health education to control health professionals' various fatigue such as stress management and sleeping, and it is considered to find out the plan about effective work system.

An Estimation on the Need and Supply for Visiting Nursing Services of Health Center in Seoul (서울시 보건소 방문간호 수요.공급 추계)

  • Myoung, Jae-Il;Hwang, Rah-Il;Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.14 no.4
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    • pp.587-597
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    • 2003
  • Purpose: The purpose of this study was to estimate the demand and supply of visiting nursing services provided by health centers in urban area, aiming at strengthening infrastructure, which may improved the quality of life and health status of vulnerable population in the community. Methods: This study was conducted through nominal group discussion, focus group study. The demand and supply of visiting nursing were estimated by health economists based on the secondary analysis data from 25 health centers in Seoul. Result: Primary targets for the visiting nursing must be people who are homebound in the community. They can be classified into: a group of Level I: chronic patients who need visiting nursing care at least once a week: and a group of Level II: vulnerable families that need management periodically e. g. twice a month. Based on the estimation of demand for visiting nursing services in the community, the estimated supply required was $651{\sim}770$ visiting nurses including home health nurses in visiting nursing programs based on health centers in Seoul. Conclusions: The estimated demand and supply of visiting nursing are expected to provide basic data for establishing alternative policies on visiting nursing infrastructure that might be accomplished through demand-based visiting nursing programs by districts.

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Lessons from the Development of Rural Health Nursing in Australia, Canada, and the United States (외국의 농촌간호에 관한 고찰 - 호주, 캐나다, 미국을 중심으로-)

  • June, Kyung-Ja;Park, Ji-Yeon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.4 no.1
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    • pp.51-57
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    • 2009
  • Purpose: This study was done to learn from the development of rural health nursing in developed countries. Method: A literature search was done using keywords such as "rural and nursing" or "rural and health" from the database CHINAL and website of institutions related to rural health and nursing. Results: In Australia, the type of rural health institution was categorized according to the population size and nursing service was done differently according to area. It is unique to Canada to have the Canadian Association of Rural and Remote Nursing, which published the survey report "the Nature of Nursing Practice in Rural and Remote Canada". In the U.S., the role of nurse practitioners in rural communities was relatively well developed and a diverse nursing care model was demonstrated. To improve health care access in rural communities, financial and political support by the governments has been part of long-term plans in the three countries. Conclusion: It is very informative to identity the difference and similarity in rural health nursing in three developed countries. For the future development of Korean rural nursing, suggestion can be made in terms of research, education and policy development.

Formulating Regional Relevance Index through Covariance Structure Modeling (공분산구조분석을 이용한 자체충족률 모형 검증)

  • 장혜정;김창엽
    • Health Policy and Management
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    • v.11 no.2
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    • pp.123-140
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    • 2001
  • Hypotheses In health services research are becoming increasingly more complex and specific. As a result, health services research studies often include multiple independent, intervening, and dependent variables in a single hypothesis. Nevertheless, the statistical models adopted by health services researchers have failed to keep pace with the increasing complexity and specificity of hypotheses and research designs. This article introduces a statistical model well suited for complex and specific hypotheses tests in health services research studies. The covariance structure modeling(CSM) methodology is especially applied to regional relevance indices(RIs) to assess the impact of health resources and healthcare utilization. Data on secondary statistics and health insurance claims were collected by each catchment area. The model for RI was justified by direct and indirect effects of three latent variables measured by seven observed variables, using ten structural equations. The resulting structural model revealed significant direct effects of the structure of health resources but indirect effects of the quantity on RIs, and explained 82% of correlation matrix of measurement variables. Two variables, the number of beds and the portion of specialists among medical doctors, became to have significant effects on RIs by being analyzed using the CSM methodology, while they were insignificant in the regression model. Recommendations for the CSM methodology on health service research data are provided.

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Regional Variance of Late Preterm Birth in Seven Metropolitan Cities of Korea: 2008-2012 (우리나라 대도시의 지역별 후기조기분만 발생에 관한 연구: 2008-2012)

  • Lim, Dar-Oh;Park, Sang-Hwa
    • The Korean Journal of Health Service Management
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    • v.8 no.3
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    • pp.147-155
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    • 2014
  • The objective of the study was to analyze the regional variance of late preterm birth (LPT: 34-36 weeks) by analyzing 2008-2012 birth certificated data of seven metropolitan cities (536,984 births: primiparous singleton birth) from Korea Statistics. The odds ratio and 95% confidence intervals were calculated from multinominal logistic regression analyses to describe the regional variance of LPT adjusted for maternal and infantile variables. The highest incidence of LPT rate by region were observed in Ulsan metropolitan city (3.7 percent), and the lowest in Deajon metropolitan city (3.1 percent). After adjustment by logistic regression for infantile sex, maternal variables, there was a significant increase in the risk of late preterm birth in Ulsan metropolitan city (odds ratio: 1.21) as compared with the incidence of LPT in Deajon metropolitan city. The odds ratio of LPT by region were 1.17 in Daegu metropolitan city, 1.13 Busan metropolitan city, and 1.12 in Incheon metropolitan city. More research is required to understand the risk factors for late preterm birth in this area including socio-demographic factors, medical factors, and regional and environmental factors.

Process Evaluation and Influencing Factors of Building up a Network System between a National University Hospital and a Public Community Hospital in a Korean Provincial Area (한 광역자치도에서 국립대병원과 지방의료원간 협력체계 구축 사례의 성립 요인 및 과정평가)

  • Lee, Weon-Young
    • The Korean Journal of Health Service Management
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    • v.6 no.4
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    • pp.219-229
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    • 2012
  • This study aimed to explore influencing factors on the establishment of the network system between public hospitals and to make a process evaluation of it. we analyzed the case of a strategic alliance contracted by a National University Hospital(NUH) and a Community Hospital(CH). Main points of the project were regular dispatch of clinical specialists in the NUH such as gastroenterologist and running teleradiology program. The NUH considered the improvement of it's image as a public hospital as a successful element of the network program. The provincial office which have to manage the CH satisfied with these program in terms of helping CH in need of clinical specialists. Staffs in the CH pointed out the problem of discontinuity for patients who visited the CH. Three institutes argued that continuous support of central government in the relevant institution and budget could play the most important role in the advance of the network system between public hospitals.

Investigation of benzimidazole residues in the meat in Sejong area (세종지역 유통 식육 중 벤지미다졸계 구충제 잔류실태 조사)

  • Kim, Tae Pyoung;Kim, Tae Won;Lee, Jong Hoon;Kim, Mun-Bae
    • Korean Journal of Veterinary Service
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    • v.44 no.3
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    • pp.125-131
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    • 2021
  • Benzimidazole is an widely used anthelmintics in livestock clinics. The aim of present study was to investigate benzimidazole residues in the meat in Sejong City. A total of 338 samples of meat(beef 287, pork 37, chicken 14) were selected from the laboratory meat(Korean beef genetic test, hygiene test) supplied to school in Sejong City. Representative benzimidazole class drug such as thiabendazole, 2-amino albendazole sulfone, fenbendazole, oxfendazole, and oxfendazole sulfone were monitored in samples by using lc-ms/ms and the analysis was preformed based on the Korea Food Code guideline. Limit of quantitation (LOQ) was ranged from 0.56 to 3.02 ppb for target drugs and the accuracy was within the acceptance criteria. Among the sample analyzed only one case, the pork meat was found to have drug levels that exceed LOQ. However, the overall residue concentration was 2.17 ppb, which was lower than the maximum residue levels (100 ppb).