• Health Policy and Management
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• v.33 no.1
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• Journal of The Korea Institute of Healthcare Architecture
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• v.19 no.3
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• pp.21-28
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• 2013

Purpose: General hospital in korea is getting large-scaled, specialized and upgraded. So, nursing unit of race track type has been advanced along with a spatial organization, building equipment and environmental approach. This study is to search the guidelines for renovation of nursing unit with race track type in the case of K university hospital in Daejeon. Methods: 9 cases of recently opened general hospital has been analyzed for spatial and environmental design solution. Questionnaires and interviews about user needs of nursing staff, patient and visitors, have been conducted for a nursing care system and facility of nursing units in K university hospital. Results: The user needs are represented as followings. Center core public zone in each floor plan and center core nursing station and supporting areas in nursing unit are good for an adjacency and separation of spatial organization. Toilet of group patient room is necessary to equip for easy, safe and infective aspects, and so toilet install will decrease the patient number and increase the nursing care service. Hall type of station front is good for visibility and observation. It is appropriate to renovate into south facing group patient room for privacy, enough space for nursing care facility and supporting area, enough width of door to move portable medical equipment, room for medical doctor and practical student, noise absorbing of day room. Implications: Upgrading the nursing care service and facility equipment is necessary to reflect the user needs and cooperate with hospital management.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.65-78
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• 2020

Purpose: The purpose of the study was to investigate the core competency and educational needs of paramedic students in disaster management. Methods: A self-reported questionnaire was completed by 207 paramedic students between June 1 and October 29, 2017. The study instrument included disaster preparedness (15 items), disaster management core competency (26 items), disaster education needs (26 items). Data were analyzed using t-test, ANOVA, and Duncan's multiple range test using IBM SPSS 24.0. Results: The students reported that only 13% had experienced or witnessed disasters; however, 95.2% would be willing to help in the event of a disaster. Their disaster preparedness was 1.84 points on a 3-point scale. We did see differences in disaster preparedness by background: hospital practice (F=5.352, p=.001); fire-fighting practice (F=8.994, p=.000). The students had a core competency of disaster management at 3.25 points on a 5-point scale with differences depending on major satisfaction (F=3.760, p=.006). The level of student demands for disaster education was 4.29 points. Conclusion: If variety of educational environments are provided for disaster-related learning and training, the core competency of disaster management for paramedic students will improve. The students will be available as disaster management experts in various fields, even after graduation.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.11-38
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• 2012

The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

• Journal of Haehwa Medicine
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• v.24 no.1
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• pp.1-14
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• 2015

Objectives : The purpose of this study is to examine senior citizens' perception of medical welfare service in Daejeon, and to investigate the level of Korean Medicine University students' satisfaction about medical services that they have done. Methods : We visited Daejeon city hall and Dae jeon Seo-gu community health center, and interviewed them. After that we select two population and did two different surveys. First, to investigate the current state of medical services and medical welfare in Daejeon, we select neglected class senior citizens who were serviced at social welfare center. Second, we select Daejeon Korean Medicine University student to investigate the level of satisfaction about medical services and pre-education. In first population, we random select 25 of 34 senior citizen who visits mere social welfare center. In second population, we random select 78 of 115 Korean Medicine University student who belongs to medical welfare club. Results : We found some advantages and problems in medical services. A lot of senior citizen who were serviced at social welfare center showed high level of satisfaction about medical service. But there were few citizens who knows about health & medical welfare. And most Korean Medicine University student who services medical service to neglected class senior citizens showed high level of satisfaction. Conclusion : We concluded that medical welfare for senior citizen needs more publicizing. Because result of our survey, many senior citizens showed not only low level of recognition in medical welfare service, also showed low utilization rate in public health center. And most Korean Medicine University students were satisfied with themselves about medical service that they have done, it seemed medical service gives beneficial influence to not only senior citizen but also Korean Medicine University student.

• The Korean Journal of Health Service Management
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• v.1 no.1
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• pp.59-74
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• 2007

Considering the characteristics of the Korean family which maintain a close connection with their patients from the moment of their falling sick to hospitalization to discharge, the family is the most important environmental factor of the social supporting system, and is the important object of the client as well as activity system. The medical social work intends to meet the practical needs of aged chronic patients, providing them and their family with a professional human service. The end of this study is to find out the hardships of both the aged chronic patients and their family as well as their needs for the social welfare service, and to search out the way of comprehensive social work service. The summary of the analysis of the survey is as follows: 1. The needs of aged chronic patients are divided into those of the solution of the problems of falling ill, social welfare program and discharge. Those needs arc affected by the various factors of the types of hospitals, the patients' age, the kinds of insurance, and the supporting systems, etc. Accordingly, the assessment of the needs of the patients are asked to be done comprehensively in accordance with the kinds of diseases and social environments. 2. The importance of the family to the aged chronic patients is evident. The family plays a decisive role in the patients' hospitalization and discharge, the family being an important supporting system and making it necessary to take an approach to client system. The family has difficulty in getting connection of community resources, in adapting to social life after the patient's discharge, and in paying the treatment. The family suffers the secondary hardships more than the burden of the treatment expenses. 3. For this reason various interventions are needed to reduce the stress caused by supporting and nursing patients. Thus the social welfare service for the aged chronic patients and their family needs the following prepositions: 1. It is the characteristics of the aged chronic patients that they need continuous care and that the strengths of the patients and their family cannot be too much emphasized, and that comprehensive assessment based on the connection 'with the community and the mutual interchange 'with the environment, is much emphasized. 2. The family of the aged chronic patient is a resources system as well as a client one. 3. Another characteristic of the aged chronic patients is that with the resources connection in mind, it needs an active intervention of social workers in the community. With these prepositions considered, the development of practical social work service for the aged chronic patients is thought urgently needed.

• Health Policy and Management
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• v.25 no.1
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• pp.11-21
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• 2015

Background: The objective of this research is to investigate and provide analysis of the economic participatory change affecting the unmet needs of health care in Korean adults. Methods: We used Korea health panel 4th and 5th data of 10,261 adults. The method of investigation is threefold. First, We identified the regional factors affecting unmet needs of health care. Second, we analyzed the effect of economic participatory change as it affects the unmet needs of health care. Third, we also investigated whether there were discernable differences between the age subgroups. Results: It was determined that influencing factors included sex, education, economic level, and health status. And after the subgroup analysis of age, we found that the economic participatory change was associated with the economical unmet needs of health care especially for those over 40 years of age. Also the population are facing unemployment enduring particular economic hardship in meeting their medical needs. Conclusion: This study finds that there are some policy recommendations for the sake of medical service equality. Medical welfare policy for those 40 years of age and older has been identified as an area that needs improvement. And considering that those 40 years of age and older are facing unemployment enduring particular economic hardship in meeting their medical needs, this study finds a need for government sponsored medical stipends or subsidizing of medical premiums, co-payment, and other fees.

• Journal of the Korean Dietetic Association
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• v.18 no.3
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• pp.266-275
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• 2012

The purpose of this study was to evaluate the perception and needs of doctors on clinical nutrition services. A cross-sectional survey design was used. The doctors' perception and needs were assessed by questionnaires that had been specifically designed for the study. The research was conducted from February 14 to March 15, 2011 for 544 doctors at 42 large hospitals (with over 400 beds). Ninety-eight percent of doctors responded that clinical nutrition service was important. The mean scores of importance on clinical nutrition service were 4.45 for 'nutrition screening at admission', 4.50 for 'treatment of malnutrition', and 4.43 for 'nutrition education and counseling'. The mean scores of needs for clinical nutrition service were 4.42 for 'individual nutrition counseling & education' 4.39 for 'nutrition management for malnourished patients' and 'nutrition management for tube fed patients'. The medical specialists showed significantly (P<0.01) higher scores than the residents on the importance and needs for clinical nutrition services. Eighty-five percent of the doctors recognized the necessity of the specialized dietitians classified by diseases. The medical specialists (93.8%) showed significantly (P<0.01) higher recognition of this necessity than the residents (77.7%). The low residents' perceptions of the importance and needs for clinical nutrition services will necessitate clinical nutrition education plans. The departments of clinical nutrition in universities should improve the ability and skills of the clinical dietitians.

• The Korean Journal of Emergency Medical Services
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• v.23 no.3
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• pp.17-27
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• 2019

Purpose: To provide legislative data for the amendment of Article 36 of the Emergency Medical Service Act on the qualifications of emergency medical technicians. Methods: The study was drafted based on the Emergency Medical Service Act; data on the emergency medical technicians (EMT) system and curriculum in Korea, United States. Japan, and Taiwan; and previous studies on the EMT system in Korea. Results: The length of education. work scope. amd role of level 1 EMTs vary significantly depending on the type of qualifications they have as emergency medical professionals, while the supply of level 1 EMTs has already reached a point of saturation. Accordingly, the current regulation on allowing level 2 EMTs with at least three years of experience to take the level 1 EMT test presents serious inequity for students just graduating from their emergency medical services program. It is also a factor that degrades the professionalism of level 1 EMTs. Conclusion: Article 36, paragraph 2. subparagraph 3 of the Emergency Medical Services Act pertaining to regulations on "EMTs who have worked as level 2 EMTs for at least 3 years" needs to be removed.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.201-214
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• 2019

Objectives: The purpose of this study was to identify the needs of the senior welfare center users of the health service program, and to establish a plan to adjust the health service functions of the senior center. Methods: A survey of 2,130 users of the Gyeonggi-do Senior Welfare Center was conducted from May 28 to June 30, 2018. Results: The major results of the study are as follows. First, 66.8 percent of senior welfare center users were willing to participate in health care. The requirement for health service programs was 3.87 points out of 5 points followed by cognitive ability improvement programs, senior movement programs, and chronic disease programs in lower areas. Second, the factors affecting the needs of health care service programs of senior welfare center users had a significant impact on women; the younger the age, the better the subjective health condition; the higher the number of medical conditions, the lower the out-of-patient experience; the longer the welfare center isused, the more people are willing to participate in healthcare. Conclusions: We believe that there is a need for social service policies and management to better understand the situation of senior citizens who are demanding various services due to illness and to integrate health and welfare services.