• Health Policy and Management
• /
• v.21 no.1
• /
• pp.115-131
• /
• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Journal of Digital Convergence
• /
• v.14 no.9
• /
• pp.407-415
• /
• 2016

This study was to evaluate the effect on the oral health awareness and oral health education for children, depending on oral health education experience of day care teachers. The survey considering integrated factors was conducted from January 5 to 23, 2015, and was analyzed by SPSS 19. The result of this study, 58.9% of teachers had an experience with oral health education and training for children had 62.3% of them. The education for children was accomplishing once with 42.9%. 49.8% of the teachers said that they teach and supervise tooth brushing(p<0.05). They are aware of the importance of deciduous teeth's health and necessity of maintenance(p<0.01), sealant(p<0.01), the necessity of tooth brushing and education(p<0.01). As a result, it is essential to build up a systematic and continuable program on oral health education for the day care teachers.

• Journal of Korean Public Health Nursing
• /
• v.20 no.1
• /
• pp.5-15
• /
• 2006

Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.

• IMMUNE NETWORK
• /
• v.22 no.2
• /
• pp.18.1-18.15
• /
• 2022

Dysfunction of mitochondrial metabolism is implicated in cellular injury and cell death. While mitochondrial dysfunction is associated with lung injury by lung inflammation, the mechanism by which the impairment of mitochondrial ATP synthesis regulates necroptosis during acute lung injury (ALI) by lung inflammation is unclear. Here, we showed that the impairment of mitochondrial ATP synthesis induces receptor interacting serine/threonine kinase 3 (RIPK3)-dependent necroptosis during lung injury by lung inflammation. We found that the impairment of mitochondrial ATP synthesis by oligomycin, an inhibitor of ATP synthase, resulted in increased lung injury and RIPK3 levels in lung tissues during lung inflammation by LPS in mice. The elevated RIPK3 and RIPK3 phosphorylation levels by oligomycin resulted in high mixed lineage kinase domain-like (MLKL) phosphorylation, the terminal molecule in necroptotic cell death pathway, in lung epithelial cells during lung inflammation. Moreover, the levels of protein in bronchoalveolar lavage fluid (BALF) were increased by the activation of necroptosis via oligomycin during lung inflammation. Furthermore, the levels of ATP5A, a catalytic subunit of the mitochondrial ATP synthase complex for ATP synthesis, were reduced in lung epithelial cells of lung tissues from patients with acute respiratory distress syndrome (ARDS), the most severe form of ALI. The levels of RIPK3, RIPK3 phosphorylation and MLKL phosphorylation were elevated in lung epithelial cells in patients with ARDS. Our results suggest that the impairment of mitochondrial ATP synthesis induces RIPK3-dependent necroptosis in lung epithelial cells during lung injury by lung inflammation.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.31 no.3
• /
• pp.79-96
• /
• 2018

Objectives: The objective of this study was to survey the performance of postpartum care and compare the western medicine and Korean medicine according to women's postpartum disease. The purpose of this study was to provide basic data for the prevention and management of postpartum disease. Methods: The subjects were 228 women who experienced postpartum disease. This research was conducted in G city, at outpatient department of western medicine hospital and Korean medicine hospital. The degree of performance of postpartum care was measured on a 4-point scale divided by each area, and was compared in three groups. Results: Postpartum care includes traditional postpartum care and postpartum care in hospitals. The degree of performance of postpartum care means that the higher the score, the better. The traditional postpartum care performance score was 2.35 and the postpartum care performance score at the hospital was 1.63. The results of this study showed that the performance of traditional postpartum care was higher than that of postpartum care administered in hospitals. The perception of traditional postpartum care methods was 'An indispensable postpartum care method for health' (75.9%). The most effective method of postpartum care was 'consolidate in harmony traditional postpartum care and guidance of the medical team' (88.2%). Conclusions: The improvement and satisfaction degree of postpartum care were higher in Korean medicine than in western treatments. Therefore, the most efficient method of postpartum care must be integrated in harmony with the direction of the medical staff and traditional methods of postpartum care.

• The Korean Journal of Rehabilitation Nursing
• /
• v.9 no.2
• /
• pp.145-152
• /
• 2006

Purpose: The purpose of this study was to investigate the depression, anxiety, stress response and self-care, to analyze the correlation among depression, anxiety, stress response and self-care by gender, and to determine factors associated with self-care in diabetic patients. Method: The subjects of this study were 103 participants with diabetes mellitus. Data were analyzed by chi-square test, t-test, Pearson correlation coefficient and multiple regression analysis by using SAS program. Result: Items for self-care evaluation by gender were significant differences in hospital visit, hypoglycemia preparation, proper hygiene, taking a rest, foot injury check, drinking, and smoking. The female patients are more likely to have higher self-care score than the male patients. However, there were no differences in depression, anxiety and stress response by gender. In male patients, there were positive correlations between the degree of depression and stress response, the degree of anxiety and stress response. In female patients, there were positive correlations between the degree of depression and stress response, the degree of anxiety and stress response. In multiple regression analysis, gender and experienced admission is associated with self-care. Conclusion: We should consider integrated approaches for psychological problems in the management of diabetic patients.

• International journal of advanced smart convergence
• /
• v.10 no.2
• /
• pp.37-44
• /
• 2021

At the time of entering the super-aged society, the health problem of the elderly is becoming more prominent due to the rapid digital era caused by COVID-19, but the gap between welfare budgets and welfare benefits according to regional characteristics is still not narrowed and there is a significant difference in emergency medical access. In response, this study proposes an ICT-based New Normal Smart Care System (NNSCS) to bridge the gap I n health and medical problems. This is an integrated system model that links the elderly themselves to health care, self-diagnosis, disease prediction and prevention, and emergency medical services. The purpose is to apply location-based technology and motion recognition technology under smartphones and smartwatches (wearable) environments to detect health care and risks, predict and diagnose diseases using health and medical big data, and minimize treatment latency. Through the New Normal Smart Care System (NNSCS), which links health care, prevention, and rapid emergency treatment with easy and simple access to health care for the elderly, it aims to minimize health gaps and solve health problems for the elderly.

• Journal of Chest Surgery
• /
• v.55 no.4
• /
• pp.325-331
• /
• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.28 no.1
• /
• pp.9-15
• /
• 2014

Recently, interest in traditional medicine has increased steadily. Nations having traditional medicine system have been attempting to change it institutionally for the purpose of public application boost in use of traditional medicine. But there are not too many countries which have established the modern system of education and licensing system for traditional medicine with it maintained as a part of a national health care system. The best known examples of nations utilizing traditional medicine are the People's Republic of China, Republic of Korea, Japan, and Taiwan. These countries follow different patterns in the relationship with western medicine according to different social and historical backgrounds. Taiwan has dual medical system as Korean. In this study, we looked through history and the current state of affairs of national health care system in Taiwan, and also found out the licensing system, the educational system, and the curriculum in several universities. thoroughly. Furthermore, we looked into the direction of the policy of Taiwanese health care system which has been becoming an integrated medical system between traditional Chinese medicine and western medicine. With findings based on this study, we deduced implications of a future policy line about the integrated medical system in Korea to minimize conflicts between the concerned parties.

• Safety and Health at Work
• /
• v.6 no.1
• /
• pp.35-38
• /
• 2015

Background: Organizational changes that involve healthcare hospital departments and care services of health districts, and ongoing technological innovations and developments in society increasingly expose healthcare workers (HCWs) to work-related stress (WRS). Minimizing occupational exposure to stress requires effective risk stress assessment and management programs. Methods: The authors conducted an integrated analysis of stress sentinel indicators, an integrated analysis of objective stress factors of occupational context and content areas, and an integrated analysis between nurses and physicians of hospital departments and care services of health districts in accordance with a multidimensional validated tool developed in Italy by the National Network for the Prevention of Work-Related Psychosocial Disorders. The purpose of this retrospective observational study was to detect and analyze in different work settings the level of WRS resulting from organizational changes implemented by hospital healthcare departments and care services of health districts in a sample of their employees. Results: The findings of the study showed that hospital HCWs seemed to incur a medium level risk of WRS that was principally the result of work context factors. The implementation of improvement interventions focused on team development, safety training programs, and adopting an ethics code for HCWs, and it effectively and significantly reduced the level of WRS risk in the workplace. Conclusion: In this study HCW resulted to be exposed to occupational stress factors susceptible to reduction. Stress management programs aimed to improve work context factors associated with occupational stress are required to minimize the impact of WRS on workers.