• 한국콘텐츠학회논문지
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• 제12권12호
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• pp.282-290
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• 2012

현재 우리나라의 재가간호서비스는 보건소의 맞춤형 방문건강관리사업과 의료기관 가정간호사업, 그리고 노인장기요양보험의 방문간호서비스의 독립성과 전문성을 인정하면서, 각 영역간의 연계를 통해 사업의 중복성을 최소화하는 연계방안이 필요한 상황이다. 이에 본 연구는 재가간호서비스의 연계방안을 도출하기 위해 전문가들의 의견을 바탕으로 합의를 이끌어내는 델파이 기법을 활용하였다. 그 결과 제도적 차원의 연계와 의료적 차원의 연계라는 두 영역 안의 총 24개 항목이 연계방안으로 도출되었다. 재가간호서비스의 연계방안으로 도출된 24개의 항목은 재가간호사업 체계의 개선과 제공되는 서비스 질의 향상, 대상자의 만족도 증대 효과를 가져 올 수 있을 것으로 기대되며, 서비스의 중복을 최소화할 수 있는 방안을 모색함으로서 국가적 차원에서 복지 및 국민 건강관리의 효율성을 증대할 것으로 보인다. 이를 통해 궁극적으로 국민의료비의 절감과 더불어 재가간호서비스 증진에 기여할 것으로 여겨진다.

• 대한조현병학회지
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• 제24권2호
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• pp.52-59
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• 2021

Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment-resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response. Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review. Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine. Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037). Conclusion: Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.

• 대한치과보철학회지
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• 제58권3호
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• pp.193-200
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• 2020

목적: 대규모 인구집단데이터를 사용하여 양측 또는 편측 완전 무치악 여부와 치매와의 관련성에 대하여 알아본다. 재료 및 방법: 만 60세 이상을 대상으로 구축된 건강보험공단 노인 코호트 데이터베이스를 사용하여 후향적 코호트 연구를 설계하였다. 실험군은 완전 무치악 코호트로 2012년 7월 1일부터 2013년 12월 31일 까지 1개 이상의 상악 또는 하악 레진상 완전의치 보험 처방 이력이 있는 사람을 대상으로 하였고, 대조군은 유치악 코호트로 같은 기간 동안 잔존치아에 대한 보존적 치아 처치 이력이 있는 사람을 대상으로 하였다. 모든 대상자들은 이 기간 동안 치매로 진단 또는 치료 받은 기록이 없었다. 성향점수매칭법에 따라 연령과 성별, 그리고 거주지역을 고려하여 실험군과 대조군을 1:1 동수로 매칭하였고, 두 코호트 집단간 2년 동안 치매로 이환된 비율을 비교하였다. 결과: 실험군과 대조군을 비교했을 때, 실험군인 양측 또는 편측 완전 무치악 환자에서 치매 발병률(12.13%)은 대조군인 유치악 환자의 치매 발병률(9.74%) 보다 유의미하게 높다는 것을 확인할 수 있었다 (P < .05). 다른 요인들과 치매와의 명확한 관련성은 확인되지 않았다. 결론: 대규모 인구집단데이터 분석을 통해 양측 또는 편측 완전 무치악 환자에서 치매 발병률이 높다는 것을 확인할 수 있었다.

• 한국학교ㆍ지역보건교육학회지
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• 제6권
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• pp.89-107
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• 2005

The purposes of this study were to investigate the recognition and the needs and problems of in-service education for school nurse, and to suggest the desirable guidelines, for supples the basic data of in-service education for school nurse to upgraded the quality as school nurse's professional specialist. The subjects of this study were 376 school nurses who were working in Jollanamdo. The research instruments used in this study was 'Needs of In-service Education questionnaire'. 305 collected Data were analyzed with the frequency analysis, $x^2$-test. The conclusions were as follows; First of all, the most important motives for the school nurses to participate in-service education are the enhancement of their specialties on teaching profession, self-realizations as educators, and improvement of health teaching skill. However, the motives to obtain the skill for school management or to obtain a high rank qualification and promotion are quite low. School nurses are generally satisfied with duration, time, place of in-service education, But they are not satisfied with contents of in-service education, professional specialist and understanding of real educational situation of the instructors. On the urgent problem of school nurses, promotion of health teaching skill was highest in the rank, and establishment of firm educational philosophy and a sense of teaching profession, proceed to university and graduate school ranked next, respectively. Second, the need of a school nurses on in-service education direction ranked the application of teachers' character and need, practicable and concrete educational programs, planning of school health development, reinforcement of health education, expansion of practical knowledge and on reflection thought, respectively. The need of a school nurses on in-service education contents(major part) ranked health education, health promoting program of student, knowledge and practice of practical medicine and oriental medicine, consultation process, health education of advanced country, respectively. The need of in-service education supervisory organization, the need for a cities provinces educational office was highest in the rank. The need of in-service education type, duty training ranked high, and abroad training, qualification training, general training ranked next. the need for specialist for lecturer of in-serve education ranked among the highest, along with school nurses and university professor. The need of school nurses on education method(duplication answer), need for conference and discussion teaching was highest in the rank. The need on evaluation method, evaluation through a examination ranked the highest. On the needs of in-service education times, need for vacation during the winter and summer was the highest. As for the duration, 31 to 60 hours in duration of in-service education was need most, and most school nurses need cities and provinces in-service training institute as the location of in-service education. On the organization size, need for 21 to 30 people was the highest, where as need for 41 people was relatively low. Lastly, on the problem of in-service education for school nurses, lack of opportunity of in-service education for school nurses was highest in the rank, and improperness of in-service education contents and method, lack of incentive ranked next, respectively.

• 보건행정학회지
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• 제28권1호
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• pp.70-76
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• 2018

Background: The purpose of this study was to investigate the determinants of North Korean refugees' trust in South Korea health service. Methods: This study surveyed 168 North Korean refugees aged 19 and over living in Seoul, Gyeonggi, Incheon, and Gangwon. The collected data were analyzed by frequency analysis, t-test, analysis of variance, and hierarchical regression analysis to analyze the effect on the trust of refugees. Results: The difference analysis showed statistically significant difference according to duration of residence and employment status. The determinants of North Korean refugees' trust in South Korea health services were duration of residence, basic communication skills, health communication skills, and experience of health service. Conclusion: In order to increase the trust of North Korean defectors in South Korea medical services, it is necessary to resolve communication problems and improve the satisfaction of health services. For this, the interpreter service should be activated. And specific education should be given to the North Korean refugees about the health care system and the utilization methods of health service in Korea.

• 보건의료산업학회지
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• 제6권2호
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• pp.133-140
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• 2012

This research analyzes on the difference of the management performance in public health care institution, especially between provincial medical center and national university hospital. The meaningful results of this study as follow. First of all, management performance was showed the loss in both of provincial medical center and national university hospital. but national university hospital is superior to provincial medical center in management performance. Secondly, It is noteworthy that social working expenses have influence on national university hospital. Finally, It shows that personnel expenses are the most important factor in the management performance in public health care institution. We hope that these results will be useful in the performance management of public health care institution.

• Tuberculosis and Respiratory Diseases
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• 제80권3호
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• pp.221-225
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• 2017

Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.

• 한국환경보건학회지
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• 제41권6호
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• pp.397-404
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• 2015

Objectives: The aim of this study is to investigate microbial contamination in the school food service environment for the assessment of microbial food safety. Methods: We collected both swab samples from tables and desks and airborne bacterial samples from an elementary school (School A) and a high school (School B). Heterotrophic plate count, total coliform, Staphylococcus aureus, and Bacillus cereus were measured with selective media to quantify microbial concentration. PCR assay targeting 16S rRNA genes was performed to identify the strains of S. aureus and B. cereus isolated. In addition, we made a food service checklist for the locations to evaluate the food service environment. A Wilcoxon test was employed to examine the differences in microbial concentration between before lunchtime and afterwards. Results: Heterotrophic plate counts showed higher levels after-lunch compared to before-lunch at School B. However, levels of S. aureus were higher in the after-lunch period (p<0.05) in both classrooms and in the cafeteria in School A. B. cereus was only sparsely detected in School B. Several samples from food dining carts were found to be contaminated with bacteria, and facilities associated with food delivery were found to be vulnerable to bacterial contamination. Although microbial concentrations in the air showed little difference between before- and after-lunchtime in the cafeteria in School A, those in classrooms were greater after-lunchtime at both schools. Conclusion: Our results suggested that the microbial safety in schools after lunchtime of concern. Necessary preventive measures such as hygiene education for students and food handlers should be required to minimize microbial contamination during food service processes in schools.

• 대한예방한의학회지
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• 제4권1호
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• pp.1-16
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• 2000

From 1998, Oriental Medical Physicians(OMP) is distributed in Public Health Sector. but long term plan for Oriental Medicine in Public Health is not existed. So, this study is designed for the activation of OMP Subjects in this study were comprised 3 groups of oriental medicine related persons, the group of which are Students of 11 Oriental Medical Schools, Oriental Medical Physicians in Public Health Sector, Specialist Croup of Oriental medicine Policy(total 1,458 persons). Data were collected from July 1st to November 30, 1999. Direct interview with key persons, systematic interview by using of interview protocol, e-mail and facsimile have been conducted. The results of survey were coded by Excel 5.0, and analysed with SAS 6.12 statistical package. Inter-group difference determined by T-test, and descriptive statistics have been examined. Major findings can be epitomized as follows. 1) OMP disposition to multifarious organizations and institutes such as Public Health Centers, Public Health Sub-centers, Public Hospitals, Private Hospitals in Remote-Vulnerable Area, Community Social Welfare Centers, Institutes for Heath Policy Research, etc, will promise an effective use of Oriental Medical Physician. 2) Average number of patients treated by OMP was 22.8, average budget for oriental medical department, in which OMP were affiliated, was 39.6 million Won per year. Direct cost per every patient visit was 7,210.9 Won, which is considered expensive for public health service. Therefore, development and transformation for Oriental Medical Service in Public Health Sector is desirable in economic and political aspects. 3) It is recommended that ${\ulcorner}Advisory\;Committee{\lrcorner},{\ulcorner}Planning\;Commission\;for\; Public\;Health\;in\;Oriental\;Medicine{\lrcorner}$ should be established for the activation and for the support of Oriental Medical Physician in Public Health Sector, 4) Most effective programmes for oriental public health doctor are health service programmes for the elderly, Home health visit, chronic degenerative disease control services(p<0.001). 5) Standard guideline for facilities and equipments of Oriental Medicine Department in Public Health Center is needed for optimal supply of resources and activation of public health activity.

• 보건행정학회지
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• 제23권4호
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• pp.387-396
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• 2013

Background: The purpose of this study was to analyze the association between areas of Korea Train Express (KTX) region and external medical service use in Korean society using spatial statistical model. Methods: The data which was used in this study was extracted from 2011 regional health care utilization statistics and health insurance key statistics from National Health Insurance Corporation. A total spatial units of 229 districts (si-gun-gu) were included in this study and spatial area was all parts of the country excepted Jeju, Ulleungdo island. We conducted Kruskal-Wallis test, correlation, Moran's I and hot-spot analysis. And after, ordinary linear regression, spatial lag, spatial error analysis was performed in order to find factors which were associated with external medical service use. The data was processed by SAS ver. 9.1 and Geoda095i (windows). Results: Moran's I of health insurance patients' external medical service use was 0.644. Also, population density, Seoul region, doctor factors positively associated with health insurance patients' external medical service. In contrast, average age, health care organization per 100 thousand were negatively associated with health insurance patients' external medical service use. Conclusion: The finding of this study suggested that health insurance patient's external medical service use correlated for seoul region in korea. The study results imply the need for more attention medical needs in the region (si-gun-gu unit) for health insurance patients of seoul region. It is important to adapt strategy to activation of primary health care as well as enhancing public health institution for prevent leakage of patients to other areas.