• Title/Summary/Keyword: Needs of Health Services

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Health Care Policy: Decision-Making System Needs Innovation (보건의료정책, 의사결정체계 혁신이 필요하다)

  • Sun-Hee Lee
    • Health Policy and Management
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    • v.34 no.3
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    • pp.223-225
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    • 2024
  • It has been 7 months since medical students boycotted classes and resident doctors left hospitals in protest against the government's policy to increase the number of doctors. As education was suspended and services at university hospitals reduced, medical gaps in medical care have emerged. As a result, concerns are growing about a potential crisis in the healthcare system. The reason for the doctors' strong opposition to the policy lies in several issues that need improvement in the government's decision-making process. By reviewing these issues, we look forward to drawing lessons for making better policy decisions in the future. First, because the evidence supporting policy decisions has various characteristics and scopes, it is important to thoroughly discuss these grounds with stakeholders. Second, the discussion structure for reviewing evidence and making decisions should consist of members capable of fully negotiating diverse perspectives and should be operated through a fair and transparent process. If these steps are not properly implemented, conflicts surrounding the evidence could escalate, thereby lowering trust in the government. When stakeholders lose trust in the government, the social costs of implementing policies may rise, and policy efficiency may decline. Therefore, it is time to restructure the decision-making system in the direction of reducing potential conflicts that may arise during the future policy implementation process and increasing trust in the government.

A Study of Nursing Manpower Requirements based on the Nursing Times spent in Operating Room of an University Hospital (수술실 간호인력의 수요측정 및 간호제공량분석 - 수술대기시간과 수술시간을 중심으로 -)

  • YooN Ke Sook
    • Journal of Korean Public Health Nursing
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    • v.1 no.1
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    • pp.45-61
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    • 1987
  • This Study was an attempt to estimate the optimum numbers of Operating Room Nursing Manpower by measuring the amount of service hours required by the patients in Operating Room in relation to the service amount actually provided by the nurses. The major concern of this study was placed on the measurement of Nursing Service Requirements by using the Operating Room (O. R) Patient Acuity System recently developed by M. M. Hart to classify the O. R. patients into four groups according to the degree of the complexity of operative procedure and some other elements which increase nursing activities in respect of patient care; Acuity IV group is the one requires nursing services most, on the other hand Acuity I requires least. nu sing The objectives of this study were as follows; 1. To analyze functions of the nursing personnel in O. R. by time unit and to estimate the average time a nurse can activate for productive functions. 2. To measure the actual amount of nursing times provided by nurses to the surgical patients. 3. To develop a patient classification system in order to measure the amount of Nursing services required by the patients. 4. To calculate an appropriate number of nursing manpower to meet the needs of the patients. In order to conduct the research both selected nurses and patients in 'S' University Hospital were Studied by utilizing the O. R. Patient Acuity System as well as the Classification Chart developed by Association of Operating Room Nurses (A. O. R. N) as a means of classifying functions of O. R. nurses. That is; Functions of the 10 selected O. R. nurses observed during the period of June 30 to July 4, 1986, whereas the amount of nursing services required by or provided to the 974 patients who had received surgeries during the period of June 9 to July 4, 1986. The results of this study were as follows; 1) The actual working hours per a nurse averaged 6.7 hours a day. 2) Each nurse's daily routine schedule consists of $71.4\%$ for Technical Functions, $16.1\%$ for Nonprodective Functions, $6.6\%$ for Assessment and Evaluation, $3.9\%$ for Overseeing and Supervision and the rest $2.0\%$ for Patient Preparation respectively. 3) Preoperative waiting time per a patient was 24.1 minutes on the average; for the first case was 10.7 minutes, whereas for the following cases was 32.0 minutes. 4) Total Operation time for the 974 patients during the period of observation for this study amounted to 2759.6 hours, weekly hour was equivalent to 689.9 hours, Whereas daily operation time averaged 130 hours. Meanwhile the average operation time per patient was 2.8 hours ; for the case of Acuity IV was 5.6 hours, 5. 1 hours for the case of Acuity III, 2.3 hours for Acuity II and 1.1 hours for Acuity I. 5) According to the O. R. Patient Acuity System, $64.5\%$ of the whole patients belonged to Acuity II, $23.7\%$ to Acuity III, 11. $3\%$ to Acuity IV and $0.7\%$ to Acuity I respectively. 6) Required amount of nursing times based on the preoperative waiting time and operation time was 7167.8 person hours, which showed that $5.5\%$ of them needed for preoperative nursing care, whereas the rest $94.5\%$ for intraoperative nursing care. In terms of the O. R. Patient Acuity System, $49.7\%$ of total nursing service requirements was needed for Acuity II patients, $27.4\%$ for Acuity III patients, $17.2\%$ for Acuity IV patients and $0.2\%$ for Acuity I patients. 7) The rate of the nursing services provided against the required nursing times was about $81.4\%$ on the average; some departments, like those of Plastic Surgery, Otolaryngology and Ophthalmology whose patients mostly belonged to Acuity II recorded hegher provision rate than average, whereas other departments of Thoracic Surgery. Neurosurgery and Orthopedic Surgery whose patients belonged to Acuity III and Acuity IV as well as Acuity II recorded lower provision rate than average. 8) Subsequently, required numbers of nursing manpower was 10.7 nurses additionally. Based on the above findings the following recommendations will be made; 1) this study recommends, develops. and adopts an accurate and realistic O. R. Patient Acuity System which can help measure the nursing service requirements objectively to elicit the rationales of allocation of nursing personnels. 2) this study proposes storongly place nurses who take the role of preoperative nursing care exclusively for the waiting patients in O. R. and shortening their waiting time by close communication between the designated O. R. and the ward.

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Effects of the Field Management Training Program for Home Care Services : Understanding and Professional Competence (현장관리중심 교육훈련프로그램의 방문건강관리 이해도 및 업무수행능력 인식에 대한 효과)

  • Kim, Jae-Hee
    • Journal of agricultural medicine and community health
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    • v.35 no.2
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    • pp.111-123
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    • 2010
  • Objectives: The purpose of the present study is to examine the effects of the Field Management Training Program for home care services personnel on their understanding and professional competences. Methods: The subjects were 373 team managers of public home care services who participated in the training program. Data was collected with a self-administered questionnaire in April and September, 2007. The subjects' level of understanding of home care was measured by 35 questions divided into 8 categories while their professional competence was measured by 15 questions divided into 5 categories. Result: After attending the training, the subjects' understanding improved from 20.90 points (possible range: 4~32) to 26.11 points. The most improvement was evident in the Planning and Public Health Education categories. Their professional competences improved from 10.81 points (possible range: 4~16) to 12.51 points. The improvement of their understanding and professional competences differed across to training places. It was also evident that an increase in understanding brought about an increase in professional competence. Conclusion: The Field Management Training Program needs to be continued with efforts to reduce the differences of training effects between training places. And additional recommendations should be made through further evaluation of subsequent training programs.

Research on the Current Situation of ICT Using and Learning among the Elderly in Urban China (중국 도시 노인의 ICT 이용 및 학습실태에 관한 연구)

  • Li, Yue-Yi;Pan, Young-Hwan
    • Journal of the Korea Convergence Society
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    • v.12 no.6
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    • pp.17-25
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    • 2021
  • Population aging is an inevitable problem in our society nowadays, and the current aging trend in Asia is prominent and the number of elderly people is huge, among which the World Health Organization predicts that by 2050, 35% of China's population will be over 60 years old, making it the most serious aging country in the world. According to actual reports and surveys, there is a clear digital divide between a large proportion of the elderly and ICT technology, which has had a negative impact on the quality of life and mentality of the elderly living in cities due to the rapid development of technology and the dramatic changes that have occurred in urban life in recent years. The author chose Chinese urban elderly as the main research topic, the research method through the collation of existing literature and information combined with the actual data research, narrative collation of the current situation of ICT use among the Chinese urban elderly and the causes of the difficulties, summarize the ability of the Chinese urban elderly as the representative of the elderly users to master and learn ICT. The study concluded that the needs of the elderly for ICT are multi-layered and there is a gradation in the ability of the elderly users to master various ICT services, so that the elderly can better use and enjoy ICT services and provide teaching and services in a hierarchical and targeted manner can be the next research direction.

A Suggestions of Future Direction of the Integrated Community Care Business for Improvement of the Elderly's Life Care (노인의 라이프케어 향상을 위한 지역사회 통합돌봄사업 미래 방향에 대한 제시)

  • Yang, Seung-Hoon
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.423-432
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    • 2021
  • In this study, we investigated and the following conclusions are presented by identifying the current status and problems in order to expand the future's value of the community care project introduced and implemented to improve the quality and care for the elderly's life. First, the needs analysis of the elderly receiving services is composed of patient-centered rather than investigator-centered, and in particular, medical management through medical staff visits should be strengthened, and specialized service items according to gender, age, disability type, and personal preference should be strengthened. This will have to be gradually strengthened. Second, by analyzing the satisfaction, redundancy, and effectiveness of service items, we save money, and consider the consumer-oriented service item composition and application of items necessary for new services. Third, through the introduction of an integrated schedule management system, it is necessary to specialize in pre-booking and visit schedule management between the elderly and the direct service organizations that provide services. Fourth, as an effort to solve the financial problem, it is necessary to prepare a rational resource sharing system with health and medical finance, long-term care insurance system, and social welfare financial project. and it may consider that putting the medical personnel who are from local public medical college input. Through these proposals, the community care business will be able to complete and have future value as a universal aged care system.

A Study on the Strategic Vitalization Plan of Korean Integrated Medical Tourism

  • Kweon, Kee-Tae;Kim, Hwa-Kyung
    • The Journal of Korean Medicine
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    • v.34 no.2
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    • pp.41-50
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    • 2013
  • Objectives: As a newcomer to the medical tourism industry, Korea needs to differentiate itself from the leading competing countries to vitalize its early-stage medical tourism industry. This study aims to introduce a strategic plan to vitalize the Korean integrated medical tourism so that Korea can differentiate itself from competing countries and create high added value. Methods: The concept and actual conditions of medical tourism and Oriental medical tourism were examined. A plan to differentiate Korea from the competing countries in the medical tourism industry was studied to create high added-value through strategic vitalization of its medical tourism industry. Results: Korean integrated medical tourism must be developed differently from those of other South-East Asian countries in order to strategically promote the cash-cow medical tourism industry. In order to develop such medical tourism, Korean medical practice, which integrates Western and Oriental medicine, is to be developed through mutual understanding and fusion of other disciplines among medical doctors and Oriental medical doctors who are working in local healthcare for health promotion of local residents and disease prevention and control. This will play a key role in developing a unique medical tourism product of Korea by means of strategic alliances as an integrated medicine. Manpower specialized for integrated medicine is to be specially supplied for Oriental medicine-related business lines at city, county and borough levels, among local governments, that are enthusiastically carrying forward Oriental medical tourism with an interest to promoting more active and strategic business development and raise the effectiveness and efficiency of public health centers handling related medical tourism. Manpower specialized for Korean integrated medical tourism is to be specially supplied for the Ministry of Culture, Health and Tourism, a policy control tower to develop and vitalize high value-added fusion (theme) tourism products such as the Korean integrated medical tourism, in order to discover, promote and support Korean integrated medical tourism's differences from existing medical tourism. Conclusions: The differentiated integrated medical tourism that only Korea can offer in a variety of forms, in order to create a key area of high value-added medical tourism, should be strategically vitalized through a liaison between integrated medicine and tourism and the realization of patient-centered health care services with medical technology developed based on mutual understanding of Western and Oriental medicine.

The Awareness and Educational Needs of Some Health Major Students on The Forth Industrial Revolution (4차 산업혁명에 대한 일부 보건계열전공 학생들의 인식과 교육요구도 조사)

  • Lee, Mi-Lim;Lee, Hyo-Cheol
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.3
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    • pp.193-202
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    • 2021
  • The purpose of this study was to examine relation of awareness and education requirement of the 4th industrial revolution in health care students in attempt to provide basic data of determining the principle and education plan. The subject of study were 280 students of health department of H university in Gwangju and analyzed by gender and grade. The female students were positive awareness of the 4th industrial revolution and the level of influence on the major field was highest in lower grade students. The level of negative factors such as generation gap(p<0.05), gap between rich and poor (p<0.01), personal information infringement(p<0.05), decrease in existing jobs(p<0.05), and abuse of artificial intelligence(p<0.05) was highest in male students. In prepration for the 4th industrial revolution, education on bio and medical device(22.2%) was the most desired. The higher positive awareness, the higher educational demand(p<0.001). It is necessary to develop programs and various education to increase positive factors such as the creation of new jobs and improve the quality of life in the era of the 4th industrial revolution.

The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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A Study on Weaning Practice of Infants in Kangnung Area (강릉지역 영유아의 이유 실태에 관한 조사연구)

  • Kim, Eun-Kyung;Lee, Sun-Hee;Park, Kye-Wol;Chi, Kyung-A
    • Journal of the Korean Society of Food Culture
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    • v.14 no.5
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    • pp.555-563
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    • 1999
  • This study was executed for 300 mothers bringing up a child below 3 years in the area of Kangnung to assess the current weaning practice of infants. 24.6% of mother surveyed were breast-fed, 57.8% were formula-fed and 17.5% were mixed-fed. The rate of breast feeding was lower and the rate of bottle feeding was higher in infants whose mothers had more income or higher educational period or full-time job. Most of the respondents knew the significance of supplementary food. 41.4% of the subjects started weaning of their infants at 3-4 months, and 84.1% of them set on weaning in less than 7 months after babies were born. And 39.4% of the subjects finished weaning of their infants in less than one year. The infants of this study preferred the fruits and fishes to meats, vegetables and beans that served to them as supplementary food. Mothers showed deep interest in recipe of weaning food(48.5%), adequate quantity of weaning food(36.3%), information on commercial food for infants(32.2%), and sequence in which semi-solid food are introduced(31.9%). From these results, it is suggested that education program in primary health center for improvement of weaning practice of infants should be implemented reflecting needs of mothers.

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A Study on Community Perceptions of Common Cancers, Determinants of Community Behaviour and Program Implementation in New Delhi, India

  • Seth, Tulika;Kotwal, Atul;Thakur, Rakesh Kumar;Ganguly, K.K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2781-2789
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    • 2012
  • Assessment of perceptions of the community, the determinants and development of their behavior regarding common malignancies, helps in establishing evidence-based activities for prevention and early diagnosis of cancer. However information on this important aspect is lacking in our country. Qualitative methods were here used to obtain information through in depth interviews and Focus Group Discussions (FGDs) with all categories of identified stakeholders. Most were unaware of the activities of the cancer control program. Even the providers were not fully conversant. All respondents mentioned lack of diagnostic and treatment facilities in government, primary and secondary level facilities. Perceptions of different categories of stakeholders regarding why many community members did not attend screening camps and other services reflect the determinants of community behavior, acting independently as well as in combination. The cancer control program was thought to be restricted only to some private facilities and overcrowded government tertiary care facilities where the visits were time consuming. Almost all the facilities were considered curative oriented. Issues of supervision, monitoring and feedback were inadequately addressed by providers who were inadequately trained in many program activities. The program lacked effective planning, coordination and appropriate implementation at the grass roots level in Delhi. Social mobilization was grossly inadequate, as most of the community members were unaware of the existence of the program. Misconceptions about the risk factors, signs and symptoms, diagnosis, and treatment were common amongst community members as well as many of the providers. Thus the national cancer control program in our country needs further community participation and social mobilization. Accessibility, availability, acceptability and affordability of various preventive, curative and rehabilitative activities, as well as intersectoral coordination, training, supervision and monitoring of program activities, all need to be addressed to ensure the success of this important public health program.