• Journal of Preventive Medicine and Public Health
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• 제28권3호
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• pp.588-608
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• 1995

This study was intended to enhance the level of hospital personnel management through analysing job satisfaction of hospital employees in terms of structural, personal and environmental variables. The sample of this study consist of a total of 790 persons including doctors, residents, interns, pharmacists, nurses, medical engineers, office workers and manual workers who have worked for general hospitals with 200 beds, 300 beds and 800 beds respectively. The Likert's 5 scales were used for the measurement of satisfaction. The results can be summarized as follows: 1. Structural Variables The level of satisfaction on the job itself was generally low, 2.8 in Likert's 5 scales, with the order of role ambiguity(3.87), routinization(2.6), work overload (2.45) and autonomy(2.37). Hospital employees are aware of their responsibility and they regarded their work as heavy one. The compensatory satisfaction degree was 2.5 which was also low: There were in the order stability(3.1), distributive justice(2.57), pay(2.3) and promotion(1.9). Usually hospital employees showed high degree of stability, while, their satisfaction on promotion possibility is quite low due to specially differentiated structures of hospitals. The degree of satisfaction on the internal conditions of organizational culture was relatively higher as 2.92: They were co-worker's support(3.69), supervisory support(3.15), role conflict(2.64) and welfare(2.17) in order. The satisfaction on welfare as an economic condition was the lowest. 2. Personal Variables The level of satisfaction on personal variables was 3.27 which seemed to be quite high: Contribution to the hospital(3.38), attitude on job performance(3.28) and pride as a member of the hospital(3.07). They seem to believe that their work has been helpful to the performance of hospitals. 3. Environmental Variables The degree of satisfaction on these variables was 3.07 on the average which was derived from environmental factors such as family-role conflict and community support related to hospital employees' environment. The order of satisfaction for each variable is community support(3.2) and family-role conflict(2.94). They turned out to be fairly satisfied with their job in community and yet, they wanted more spare time to spend with their family.

• Health Policy and Management
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• 제16권2호
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• Health Policy and Management
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• Journal of Preventive Medicine and Public Health
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• 제7권2호
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• pp.333-342
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• 1974

In September 1974, a survey was conducted towards 900 women respondents, each representing a household, residing in 18 selected Myuns(townships) of 18 Guns(counties) in Kyunggi-Do. Fifty households were selected randomly in each Myun and the sample Myuns were also randomly selected from the 18 Guns home-visiting interviews were carried out by Myun level maternal and child health workers with questionnair forms designed to measure the maternal and child health status at each household. Major findings obtained from this survey can be summarized as follows: 1. Of the women responents who were investigated in this survey, 13.1% of them were comprised in the illiterates, indicating no difference in literacy rate from that in most urban areas. 2. Most(93.8%) of the respondents were found to have married at ages of 20-24 years old. 3. Most(85.8%) of the respondents were found to have delivered their first babies at ages of 20-24, while only 13.4% had their first babies at 25-29. 4. About 22% of the respondents had 2 children, while 19% and another 19% had 2 and 4 children, respectively. 5. A great majority of the respondents (78%) experienced not a single death of a child within the family, while about 17% experienced death of one child. 0.7% of the women experienced deaths of 4 or more children. 6. 18% and 17% of the women experienced 4 and 3 pregnancies, respectively, and 12% of them experienced 7 or more pregnancies. 7. About 29% of the women experienced an induced abortion at least once. Nearly 2% of them were found to have experience of 4 or more induced abortions. 8. One half (51%) of the women were found to have received prenatal guidances in the latest pregnancies by (Ub(town) and Myun (township) level maternal and child health workers at least once or more times. 9. 52% women received professional prenatal care in the latest pregnancies: 24% at hospitals or clinics and 20% at health centers. 10. Most (89%) of the last-born children were delivered at home, while only 8.7% were delivered at hospital or clinics. 11. Materials used at delivery comprise vinyl (40%), cement bags (32%) ana gauzed or absorbent cottons (19%). 12. The largest preportion of the attendants at delivery comprises mothers in-law (48). Only 24% were found to be attended by either doctors, midwives or maternal and child health workers. 13. In most (90%) of the deliveries scissors were used to cut the umbilicus. But most (7%) of them used unsterilized scissors, 6 while only 20% of them used sterilized ones. 14. About 68% of the last-born babies were breast-fed for 12 months or more. Those who weaned during 6-12 months were 21%. 15. During 12 months after birth, 65% of the last-born babies were breast-fed, while 24% were given a combination of breast milk and cooked rice. 16. About nine out of the 10 births were found to be registered. 17. 71% of babies received BCG vaccination, while 79% and 56% received samllpox and DPT vaccinations, respectively within a year after birth. Those who were vaccinated against poliomyelitis were about 50%. 18. About 87% of the respondents recogninized the existence of government-sponsored maternal and child health guidance program.

• Journal of Biomedical Engineering Research
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• 제20권1호
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• pp.81-90
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• 1999

This paper describes an EEG(electroencephalogram) software for two-channel cerebral function monitoring system to detect the cerebral ischemia. In the software, two-channel bipolar analog EEG signals are digitized and from the signals various EEG parameters are extracted and displayed on a monitor in real-time. Digitized EEG signal is transformed by FFT(Fast Fourier transform) and represented as CSA(compressed spectral array) and DSA(density spectral array). Additional 5 parameters, such as alpha ratio, percent delta, spectral edge frequency, total power, and difference in total power, are estimated using the FFT spectra. All of these are effectively merged in a monitor and displayed in real-time. Through animal experiments and clinical trials on men, the software is modified and enhanced. Since the software provides raw EEG, CSA, DSA, simultaneously with additional 5 parameters in a monitor, it is possible to observe patients multilaterally. For easy comparison of patient's status, reference patterns of CSA, DSA can be captured and displayed on top of the monitor. And user can mark events of surgical operation and patient's conditions on the software, this allow him jump to the points of events directly, when reviewing the recorded EEG file afterwards. Other functions, such as forward/backward jump, gain control, file management are equipped and these are operated by simple mouse click. Clinical tests in a university hospital show that the software responds accurately according to the conditions of patients and medical doctors can use the software easily.

• Journal of Hospice and Palliative Care
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• 제9권2호
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• pp.106-111
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• 2006

Purpose: In terminal cancer patients, pain control with narcotic analgesics and supportive care by hospice are very useful treatment modality. However, many patients and their caregivers are poorly compliant in using narcotic analgesics for fear of addiction and tolerance. And also many patients and family caregivers are reluctant to accept hospice, presuming that hospice means patient's condition is no longer reversible and progressively deteriorating. The purpose of this study was to evaluate and analyze the perception of using narcotic analgesics and hospice by family caregivers of terminal cancer patients who play a critical role in health care in Korean culture. Methods: A total of 54 terminal ranter patient's family caregivers participated in this study. Questionnaire consisted of 15 questions about narcotic analgesics and hospice. Results: The study revealed following results. 1) family caregivers who are not aware of hospice are more than half (56.7%). 2) 81.8% of family caregivers agreed that hospice care is beneficial to terminal cancer patients. 3) 85.1% of family caregivers were under financial burden. 4) 83.2% of patient complained pain in 24 hours. 3) while 88.5% of family caregivers believed that narcotic analgesics can control pair, 79.1% and 79.6% of them also believed that use of narcotic analgesics would result in addiction and tolerance, respectively. Conclusion: There still exist barriers to family caregivers in using narcotic analgesics for pain control. And also, terminal cancer patient's family caregivers have poor information about hospice. Therefore, educational intervention about narcotic analgesics by pharmacist and doctors are needed for proper pain control for terminal ranter patients. In addition, more precise information about hospice care should be provided for terminal cancer patients and their family caregivers.

• Journal of agricultural medicine and community health
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• 제4권1호
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• pp.41-61
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• 1979

Two interview surveys (1976 for 800 patients, 1978 for 200 patients) and an inventory survey through medical records(1978) for epileptic patients who have registered with the Korean Epilepsy Association (Rose Club) since 1971 were carried out by trained health workers in advance of survey. The data obtained from the analysis showed as follows: 1) 35.2% of patients were born in Seoul and 70. 6% of patients born elsewhere have lived in Seoul. 2) 50-60% of patients were 15-30 years cid. 3) 33.4%, 24,6 and 24.6 of all pupils and students went to elementary, junior and senior high schools respectively. 4) 21.2% of all pupils and students had dropped out of school and 51.4% of them were away from school because of epilepsy. 5) 3.1% of all patients had no job at all and students comprised 20.9% of patients followed by clerical work, commercial business and farming with about 6% in each group.6) Reasons given for unemployment such as dismissal (4.3%), quit (27.7%), hesitation to employ (42.5%)and discontinuance of job (25.5%) were basically due to epilepsy. 7) About half(46.2%) of all patients have become Christian since the Rose Club was a voluntary agency which has been sponsored by Christians. 8) 82. 6% of patients were diagnosed as having grand mal as the most. 9) 29.4% of patients explained aura with psychomotor disturbances and 13.8% with sensory disorders. 10) 46.3% of patients were attacked with seizures when they were tired and others(11.6% and 4.9%) after excessive eating and hunger. 11) Patients suffered more seizures in spring and summer rather than in autumn and winter and most patients had attacks 1-5 times a month. 12) For etiologic reasons of epilepsy, 35.5% of patients considered it was caused by psychological stress and 11.5% by trauma. Only 1.1% of patients considered it as having hereditary components. 13) 51% of patients were slow in caring for their own illnesses. They started to reat epilepsy after spending 5 years of time from the initial seizure. Only 5.4% of patients had received the modern anti-epileptic therapy right after the nitial seizure. 14) 62.1% of patients had no therapy or irregular or incomplete treatment before registration at the Rose Club Clinic. 15) Before registration at the Rose Club, 42.4% of patients received medical care. On the other hand, 25.6% went to herb doctors and 12.5% used to go to the drugstore in order to get anti-epileptic drugs. 16) 41. 6% of patients who took anti-epileptic drugs had more or less side-effects. Indigestion was the most common. 17) For continuation of treatment, 30.3% have received treatment for more than 5 years and the evident showed that epilepsy took a longer time to be cured. 18) Regarding the medical care received 44.2% of patients were very satisfied with effective care and 26.5% felt as good. 19) For attitudes toward epilepsy. 27.0% of patients and 68.2% of patients family were pessimistic. 20) 65.9% of patients had optimistic attitudes toward effectiveness of medical care of epilepsy. 21) 64.8% of wives and husbands had better understanding and cooperative for their spouses who had epilepsy. 22) 33.3% of patients were under-treated at the place of work. 23) 70.2% of patients wished to marry when they reach childbearing age and 63% wished to have children. Through the above results it is recommended for nation-wide epilepsy control that the sound and correct health education not only from health aspect but also from welfare aspect should be planned and implemented as soon as possible.

• Journal of the Korean Orthopaedic Association
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• 제54권1호
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• pp.59-66
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• 2019

Purpose: Several radiologic reference lines have been used to evaluate individuals with a clubfoot but there is no consensus as to which is most reliable. The aim of this study was to identify which radiologic parameters have relevance to the predictability of additional surgery after Ponseti casting on clubfoot and the effect of clubfoot treatments that contain Ponseti casting and additional surgery. Materials and Methods: A total of 102 clubfeet (65 patients, 37 bilateral) were reviewed from 2005 to 2013. The patients were divided into two groups (Group A, those for whom the result of the Ponseti method was successful and did not require additional surgery; and Group B, those for whom the result of the Ponseti method was unsuccessful and required additional surgery), and the following parameters were measured on the plain radiographs: i) talo-calcaneal angle on the anteroposterior and lateral view, ii) talo-1st metatarsal angle on the anteroposterior view, and iii) Tibio-calcaneal angle on the lateral view with the ankle full-dorsiflexion state. Each radiograph was reviewed on two separate occasions by one orthopedic doctor to characterize the intra-observer reliability, and the averages were analyzed. Next, 20 cases were chosen using a random number table, and two orthopedic doctors measured the angle separately to characterize the interobserver reliability. Results: Groups A and B included 73 clubfeet (71.6%) and 29 clubfeet (28.4%), respectively. The initial talo-calcaneal angle and tibiocalcaneal angle in the lateral view were significantly different among the groups. In addition, inter- and intra-observer biases were not detected. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view were significantly different after treatment in both groups. Conclusion: Congenital clubfeet treated with the Ponseti method showed successful results in more than 70% of patients. The initial talocalcaneal angle and tibio-calcaneal angle on the lateral view were the radiologic parameters that could predict the need for additional surgical treatments. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view could effectively evaluate the changes in clubfoot after treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제14권2호
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• pp.161-170
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• 2011

Purpose: The aim of this study was to investigate the feeding patterns, use of dietary supplements, and nutrient intake of Korean toddlers. Methods: We used data for 930 toddlers who participated in the 4th Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2009. Feeding patterns and use of dietary supplements were assessed using standardized questionnaires, and nutrition intake was assessed using the 24 hr recall method. Results: In 2007~2009, 48.7% of toddlers used dietary supplements. Most parents (95.4%) initiated a regime of dietary supplements for their children following the advice of friends or relatives. Only 0.4% of parents followed the advice given by their doctors for dietary supplements use. In the survey of nutrient intake for toddlers, the prevalence of inadequate calcium intake was 53.9% for subjects aged 1 year, 55.2% for 2 years and 65.6% for subjects aged 3 years. The prevalence of inadequate iron intake was 52.0% for subjects aged 1 year, 48.7% for 2 years and 48.4% for subjects aged 3 years. In the survey performed on feeding patterns of toddlers during the infant period, mixed feeding accounted for 57.4%, breast feeding for 32.2%,and formula feeding for 10.4%. Sixty-five percent of toddlers began weaning between 4 and 6 months. Conclusions: This study indicated that a number of toddlers were at risk of inadequate calcium and iron intake. The role of professionals in counseling for qualified dietary intake and dietary supplement use is therefore necessary for Korean toddlers.

• Journal of Hospice and Palliative Care
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• 제5권2호
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• pp.94-100
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• 2002

Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.