• 대한불안의학회지
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• 제14권1호
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• pp.28-35
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• 2018

Objective : The purpose of this study was to assess the use of mental health services by North Korean defectors. The study sought to understand the determinants of use with socio-demographical characteristics and the barriers of using mental health service. Methods : Data were collected from a sample of the 300 North Korean defectors who have settled in South Korea within the last three years, aged 18 years and older. Face-to-face interviews and a survey using the North Korean version of the Composite International Diagnostic Interview were conducted. Results : 21.0% of respondents reported the use of mental health services. Among them, 16.0% reported the use of mental health specialty, 2.0% reported the use of general medical services, and 3.0% reported the use of others. Of the respondents who had one or more psychiatric disorders, 28.8% used mental health services. The highest rate of use of mental health services was by respondents who are aged over 50 years old, had less than 10 years of education, and were unemployed. Of those who suffered from a psychiatric disorder but did not seek for consultation, 74.4% said that they could handle the problem by themselves, and 74.6% asserted that they had no psychiatric disorder. Conclusion : North Korean defectors in South Korea used mental health services more than the general South Korean population. It would be crucial to provide appropriate mental health services based on the needs of North Korean.

• 지역사회간호학회지
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• 제27권3호
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• 지역사회간호학회지
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• 제14권2호
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• pp.179-189
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• 2003

Objectives: This study described the features of home-bound industrial accident victims and their needs for rehabilitation services. This study was also aimed to find a future direction of development of community rehabilitation programs that are suitable for their needs demands. Methods: This study is a descriptive study, were collected through two phases using structured questionnaire. In the first stage, su were performed via telephone interviews. In the se stage, surveys were performed via home visit Subjects in the first stage included 2203 indu injured victims staying at home, of whom. individuals complaining of post-traumatic complic became the subjects of the second stage. Results: This study showed that the home-bound industrial accident patients were complaining of complications from the injury even after receiving treatment by IACI. However, they were neglecting their health problems without any intervention. Even if they use health care services. the treatment is mainly focused on acute medical care, which may not effective for them. Furthermore, they had unstable employment status and suffered from financial burden for health care costs. The Labor Welfare Organization has established a plan to remove barriers of industrial accident victims in reinstatement, and has been preparing various programs in order to establish an all-embracing service system for industrial accident victims from accident occurrence to reinstatement. However, these rehabilitation services can be truly helpful only when the injured are able to obtain enough information about them. The current restrictive system is also not appropriate for solving health problems of the industrial accident victims. Therefore, it is necessary to develop a plan that can provide industrial accident victims high-quality rehabilitation services so that they can use those services in the community without being dependent on hospitals. This study proposes visit nursing services as a way to provide various health services within community for the industrial accident victims.

• 보건행정학회지
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• 제20권2호
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• pp.40-52
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• 2010

Health insurance fees are set by relative value scales and conversion factors. Since 2008 the conversion factor has been classified into 7 according to the provider type, and a separate contract has been made respectively. As such classification of the conversion factor reflects only the different characteristics of providers, however, further classification to reflect the different cost structures of providers is proposed. Cost varies according to the type of not only providers but also services each provider supply. In fact different cost structures of providers are the result of their different services. This study analyzed the cost structure of medical services to propose a new approach to the classification of the conversion factor. This study analyzed the cost structure of medical services using cost data constructed in the revision study of relative value scales. The cost data consist of doctor's fee, support staff's fee, cost of medical equipments, cost of medical supplies and indirect cost. The proportion of each cost component to the total cost was analyzed in terms of service department and service type. 72 service groups are defined in terms of the combination of service department and service type. Through cluster analysis, 72 service groups were reduced into 7 clusters each of which has a similar cost structure. Conversion factor is contracted annually to reflect the change in the cost of providing medical services. So the classification of conversion factor has to be based on the cost structures of medical services, not the characteristics of providers. Service clusters derived in this study can be used as a new classification for health insurance fee contract.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.815-829
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• 1996

A physician survey was done by mailing for the purpose of performing hospital services evaluation and ranking. A slightly over one thousand samples were drawn from the list of professional societies, and 324 physicians(about 32 percent) replied. This study has focused on developing easy and simple method to evaluate hospital services, and providing patients with useful information. Hospital service structure and process were evaluated without outcome evaluation, because it is difficult to obtain reliable data regarding health services outcome indicators. Clinical specialty was targeted to evaluate, and three specialties were chosen, that is obstetrics & gynecology, cardiology, and proctology. Among 16 structural indicators, four indicators were finally chosen in each specialty by respondent specialists. And then using these indicators, structural score was calculated for study hospitals. For process evaluation, physicians were requested to nominate five most famous hospitals. The nomination score and structural score were summed up to produce final score and hospital ranking. This method is very easy to conduct rather than other hospital services evaluation methods prevailing in Korea. And it is more useful for patients to choose hospitals, according to his/her own purpose, because it gives high ranking hospitals with specific clinical specialty.

• 대한한의학회지
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• 제31권1호
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• pp.112-121
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• 2010

Objectives: The aim of this study was to reflect upon the process of the legislation of the National Medical Services Law for traditional Korean medicine practitioners (TKM practitioners), especially at the Assembly plenary session of 1951. Methods: Various primary sources related to the legislation were examined, especially those in National Assembly Records and newspapers. Results: In 1950, the National Assembly wanted to establish the National Medical Services Law (國民醫療法) replacing the colonial medical services law (朝鮮醫療令), but it ended in failure. So in 1951, the National Assembly tried again. First, legislator Han Gukwon (韓國源), with 83 other legislators, introduced a bill for the new national health care system. The Society and Health (社會保健委員會) and the Legislation and Judiciary subcommittees (法制司法委員會) deliberated on this bill, and each proposed an amendment to the National Assembly. In the process of careful deliberation of these three proposals, the Ministry of Health and legislator Kim Ikgi (金翼基) each came up with a further amendment. Ultimately, Kim Ikgi's amendment was accepted by the National Assembly. According to his proposal, TKM practitioners were titled 'Hanuisa (漢醫師)', and the medical office name of TKM practitioners became 'Hanuiwon (漢醫院)'. Conclusions: The National Medical Services Law passed in 1951 was the beginning of the unique dual national medical license system of Korea. It recognized Western medicine and TKM practitioners equally under the national license system.

• 가정∙방문간호학회지
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• 제2권
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• pp.52-59
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• 1995

This Study was done to examine the home health care service provided by home care nurses and the level of client satisfaction. Data were collected from 60 clients who received services from a home care center. The tool for measurement of satisfaction was composed 13 items and was 3 score scale. The results of this study are summarized as follows ; 1. By the disease pattern, subjects were distributed into cardiovascuvr disease(73.5%), digestire disease(10.2%), endocrine disease (6.1%), Senile dementia(6.1%) and the others(4.0%). 2. By the disease pattern, provided home health care services were follows; In cardiovascular disease and digestire disease, direct nursing service, education and physical assessment were provided every time. In senile dementia, direct nursing services were mainly provided and transfer and medication were rarely provided. 3. The level of satisfaction on provided home health services was high; mean score was 2.4 out of 3.

• 지역사회간호학회지
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• 제18권3호
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• pp.480-491
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• 2007

Purpose: This study was to investigate the needs of health & community services among the disabled at home in rural areas. Methods: The subjects were 146 persons with disabilities living in J-gun. The questionnaire was based on the needs of 8 categorical services. Data were analyzed using frequency, percentage, mean, standard deviation, minimum, maximum, t-test, one-way ANOVA and Scheffe test. Results: Among the respondents, 27.4% visited the public health center in community for rehabilitation therapy. The average score of need was $2.62{\pm}.79$: education services $(2.92{\pm}1.05)$; medical services $(2.81{\pm}.82)$ nursing care services $(2.75{\pm}1.08)$; connection services $(2.62{\pm}1.20)$;, housing services $(2.60{\pm}1.09)$; emotional services $(2.41{\pm}1.03)$; other services $(2.24{\pm}1.06)$; and support of self-sustenance service $(1.92{\pm}1.15)$. The items in highest need were medical checkup (70.7%), medication (62.1%), traditional oriental therapy (60.4%) and physical therapy (58.9%), and those of lowest need were device repair (8.7%) and guidance of facility admission (7.1%). Needs were significantly different according to age (F=4.751. p=.001), employment status (t=2.108, p=.037) and medical fee payer (F=5.061, p=.002). Conclusion: The needs of education & medical services were relatively high. Demographic factors were statistically significant in determining needs. For the disabled at home in rural areas, more various services or programs should be executed based upon the needs and characteristics of based upon the needs and characteristics of the subjects.

• Journal of Preventive Medicine and Public Health
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• 제49권2호
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• pp.118-128
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• 2016

Objectives: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. Methods: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. Results: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only ('I'-only) and of fixed amount+indemnity-type ('F+I') increased, whereas the proportion of holders with fixed amount-type only ('F'-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding outpatient care, subjects with 'F'-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with 'I'-only PMI or 'F+I' PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for 'I'-only: 1.39, 1.63, and 1.38, respectively; ORs for 'F+I': 1.67, 2.09, and 1.37, respectively). Conclusions: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

• 대한장애인치과학회지
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• 제14권2호
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• pp.78-87
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• 2018

Patients with mental disability who are classified as dental severely disabled, have poor oral health status and many difficulties in taking health services. The purpose of this study was to investigate factors of influencing in visiting oral health care services. After receiving approval from institutional review board in Seoul National University, 39 participants were recruited and the oral health examination and questionnaire were taken. Data were analyzed using one-way ANOVA, independent t-test, hierarchical linear regression for predicting influence of each participants' characteristics on oral examination time and care time. In regression model, the higher the disability grade and the lower the degree of cooperation, the more oral examination time increased. However possibility of communication was not significantly influenced. Also, the higher the disability grade and the lower the degree of cooperation, the more oral care time increased. However possibility of communication was not significantly influenced. These results are expected to provide objective data for introduction and establishment of visiting dental care.