• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.137-147
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• 2012

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.

• The Journal of Asian Finance, Economics and Business
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• 제7권7호
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• pp.531-541
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• 2020

The purpose of the study is a theoretical and practical justification for building a mechanism for financing health facilities based on public-private partnerships from a pension fund in regions with environmental problems. The theoretical background is built on works of local and foreign authors on state and non-state pension provisions issues, pension funds' assets management. This study provides an analysis of the health status of the population of the Kyzylorda region; it analyzes also the worldwide and Kazakhstan practice of investing pension funds and implementing projects. There has been legislative and methodological framework for financing health projects based on public-private partnerships in Kazakhstan. The scientific methods considered in this study made it possible to develop a mechanism for financial support for the modernization of a healthcare facility using the budget of pension funds. The authors point out possible risks in the implementation of projects in the field of healthcare and make recommendations on the construction a mechanism for financing healthcare facilities in the regions of Kazakhstan with environmental problems. In addition, they underline the key insights of the analysis, which are requisites for identifying the profitability of project for business and social effects for the public. Factors influencing efficacy, effect and implementation risks identified.

• 지역사회간호학회지
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• 제29권2호
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• pp.244-256
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• 2018

Purpose: This study tried to understand discourses of life-sustaining treatments in general daily and healthcare newspapers. Methods: A text-network analysis was conducted using the NetMiner program. Firstly, 572 articles from 11 daily newspapers and 258 articles from 8 healthcare newspapers were collected, which were published from August 2013 to October 2016. Secondly, keywords (semantic morphemes) were extracted from the articles and rearranged by removing stop-words, refining similar words, excluding non-relevant words, and defining meaningful phrases. Finally, co-occurrence matrices of the keywords with a frequency of 30 times or higher were developed and statistical measures-indices of degree and betweenness centrality, ego-networks, and clustering-were obtained. Results: In the general daily and healthcare newspapers, the top eight core keywords were common: "patients," "death," "LST (life-sustaining treatments)," "hospice palliative care," "hospitals," "family," "opinion," and "withdrawal." There were also common subtopics shared by the general daily and healthcare newspapers: withdrawal of LST, hospice palliative care, National Bioethics Review Committee, and self-determination and proxy decision of patients and family. Additionally, the general daily newspapers included diverse social interest or events like well-dying, euthanasia, and the death of farmer Baek Nam-ki, whereas the healthcare newspapers discussed problems of the relevant laws, and insufficient infrastructure and low reimbursement for hospice-palliative care. Conclusion: The discourse that withdrawal of futile LST should be allowed according to the patient's will was consistent in the newspapers. Given that newspaper articles influence knowledge and attitudes of the public, RNs are recommended to participate actively in public communication on LST.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권1호
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• pp.25-36
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• 2017

Purpose: The analysis of space configuration of dentistry through examining Korean dental history and comparison are necessary for the development of planning of the dental healthcare system. This study has been started in order to provide basic information for the planning of hospital architecture in dentistry. Methods: Literature review of space configuration and historical background in dentistry have been conducted. The changes of site plan and space configuration of Seoul National University, Yonsei University and Kyunghee University, School of Dentistry and Dental Hospital have been analyzed in dental history of Korea and corresponding spaces. Results: The result of this study can be summarized in three points. The first one is that space configuration of dentistry in Korea is different from that of West. The clinical treatment space had been started first and the education and research space was followed after a short interval. The second one is that the space configuration in School of Dentistry and Dental Hospital shows that dental space had differentiated and specialized to dental education and clinical space in a building. It had spatially divided and separated to the education and research complex and the dental hospital and it had a branch building. The third one is that the dental public health in Korea has not been actively applied until recently and it should be developed in a near future. Implications: It is necessary to analyze space configuration of other dental schools and their hospitals to develop the relationship between space and program in healthcare system.

• 한국융합학회논문지
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• 제12권9호
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• pp.315-322
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• 2021

본 연구의 목적은 종합병원 간호사의 신종감염병 관리에 대한 건강신념과 건강관리 자기효능감의 관련성을 확인하고, 건강관리 자기효능감에 영향을 미치는 요인을 규명하기 위함이다. 본 연구대상자는 S와 Y시의 종합병원에 근무하는 간호사 150명을 대상으로 2021년 1월 11일부터 1월 22일까지 설문조사를 하였다. 연구결과 종합병원 간호사의 건강관리 자기효능감에 영향을 미치는 요인은 지각된 유익성(β=.17, p=.040) 지각된 민감성(β=.19, p=.020), 연령(β=.21, p=.005)으로 건강관리 자기효능감을 14.0% 설명하였다(F=4.28, p<.001). 본 연구를 통해 종합병원 간호사의 신종감염병 관리에 대한 지각된 유익성과 지각된 민감성을 높일 수 있는 건강관리 자기효능감 교육 프로그램 개발이 필요하다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권3호
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• pp.57-65
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• 2019

Purpose: The purpose of this study is to find the relationship between Michell Foucault's the primary, secondary, and tertiary spatialization of disease and spatial composition for the development of architectural planning of the healthcare architecture. Methods: Literature review of spatialization of disease and comparison between medical and dental disease have been conducted. The synchronic structure and diachronic change of spatialization process have been analyzed through spatial composition and history of Seoul National University, School of Dentistry and Dental Hospital. Results: The result of this study can be summed up in three points. First of all, spatialization of dental disease is similar to that of medicine but it should be more focused on the tertiary spatialization. The second one is that the process of spatialization of dental disease started the secondary spatialization first and the primary spatialization followed after a short interval and spatial composition has been followed the process of spatialization of dental disease in Korea. The third one is that the tertiary spatialization has not been actively gone along until recently and it has to be developed in near future. Implications: It is necessary to analyze spatialization of dental disease in other dental facilities to develop the relationship between spatial composition and program in healthcare system.

• Obstetrics & gynecology science
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• 제61권6호
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• pp.649-654
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• 2018

Objective Isotretinoin is a notorious teratogen otherwise used for the treatment of acne vulgaris. Some countries, including those in North America and the European Union, implemented the pregnancy prevention program (PPP); however, no PPP has yet been established in South Korea. So the aim of this study was to evaluate the rate of pregnant women exposed to isotretinoin among the callers of the Korean Mother Safe Counseling Center. Methods This is a prospective cohort study. We evaluated the demographic characteristics, obstetric history, and isotretinoin exposure of pregnant women based on the mother safe registry from April 2010 to July 2016. Results Among 22,374 callers, 650 (2.9%) pregnant women were exposed to isotretinoin. The mean age was $29.0{\pm}4.4$ years in the isotretinoin-exposed group and $32.0{\pm}4.2$ years in the unexposed group (P<0.001). Moreover, the incidence of pregnancies within 30 days after isotretinoin discontinuation or during isotretinoin intake was 78.9% (513/650). The median duration of isotretinoin exposure was 18 (1-4,231) days. Furthermore, from 2011 to 2015, the incidence of isotretinoin exposure was $2.9{\pm}1.2$ pregnancies per 10,000 births in South Korea. Conclusion Approximately 80% of pregnant women are exposed to isotretinoin within the recommended 30 days of contraception or during pregnancy. Therefore, the PPP has to be established in South Korea.

• Journal of Preventive Medicine and Public Health
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• 제55권3호
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• pp.226-233
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• 2022

Objectives: The aim of this study was to evaluate the subjective level of health-related quality of life of Korean healthcare workers using various quality-of-life instruments. Methods: This study included 992 participants, who were doctors and nurses. A survey was conducted between November 28 and December 4, 2019. Data from 954 participants divided into 3 groups (physicians, residents, and nurses) were analyzed. Four measurement tools (29 questions) were used in the survey to evaluate subjective health status and well-being. Results: In the Mayo Well-being Index, burnout during work (88.5%) and emotional difficulties caused by work (84.0%) were frequently cited by the respondents. Regarding questions on burnout and emotional difficulties, residents and nurses had the highest scores (91.0 and 89.6%, respectively). Emotional problems, such as anxiety, depression, and irritability, accounted for a high percentage (73.1%) of the total, while 82.2% of respondents reported that their work schedules interfered with their leisure and family time. There was no significant difference among the groups in subjective health status. However, 10.1% of the residents experienced very low quality of life, which was a higher proportion than that of physicians (2.7%) and nurses (5.2%). Conclusions: The level of well-being that Korean medical workers experienced in relation to work was lower than the results of the United States healthcare workers surveyed using the same tool. This study was unique in that it conducted a subjective quality-of-life survey on Korean healthcare workers.

• 보건의료산업학회지
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• 제6권1호
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• pp.195-203
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• 2012

The purpose of this study was to identify clinical practice (clinical training education) and satisfaction depend on university hospital availability according to a survey with 850 healthcare-affiliated students. The collected data were analyzed with the SPSS17.0 program. The result was shown statistically significant difference depends on gender, major departments and satisfaction of college life. In addition, there were significant differences in satisfaction of clinical training education in the environmental aspects of practice depending on whether affiliated hospital or not. There were no significant correlation found between degree of satisfaction of clinical training education and the need for affiliated hospital (r = .204, p <.01). As a result, Attached to the university hospital can be helpful to healthcare-affiliated students on environmental and educational aspects of clinical training education. Therefore, the effective and practical training programs using university-affiliated hospitals are surely needed to develop and to apply the active support.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제18권4호
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• pp.53-65
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• 2012

Purpose: With the increasing national interest in health, the number of health examination centers is growing rapidly, and it is growing as independent medical institutes separated from hospitals. With the growing functions and size of health examination institutes, considerations for testees, who are the most important users of the health examination centers, have taken the back seat. In particular, for health examination programs that take on a sequential traffic line, it is important to be aware of the space of each examination room, but the lack of a scientific evaluation method for this has resulted in great discomforts for testees using the health examination center. Method: Thus, this study proposes risk evaluation indices (RCF TCF, RC3, RR, ARR), and set a standard health examination program based on the national health examination program. This was applied to 11 different sized health examination centers to find their features, and together with identifying the trends of the indices, the following results were deduced. Result: 1) ARR showed a wide-range feature as the number of unit spaces increased, while RR were discovered regardless of the size, thus displaying local features. 2) The increase of ARR is affected more by internal factors in the health examination center than from outside factors. 3) By gender, when separating the basic health examination fields, the connective relation of the comprehensive health examination fields had a big effect on ARR. 4) By becoming larger, the fields of function become independent and the waiting space that results from it increases the number of total movement, so there is space for improvement in this.