• 보건행정학회지
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• 제23권1호
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• pp.59-65
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• 2013

Background: The purpose of this study was to analyze the related factors which decide the percentage of health care expenditure of the total fiscal expenditure of local governments and to provide the basic data to contribute for the efficient allotment of healthcare budget. Methods: This study was conducted by the percentage of health care expenditure for 3 years by classifying a total of 230 local governments into the metropolitan cities (gu, 69), the counties (si, 75), and the boroughs (gun, 86) all over the country. With the collected data, the general characteristics of independent variables and the dependent variable were analysed using SPSS ver. 18.0, The correlation analysis and multivariate regression analysis were conducted for the characteristics of variables according to regions by year. Results: In correlation between health care expenditure by year and other variables, there was a significant positive correlation with unemployment rate, metropolitan cities (gu) and other regions, the percentage of health center personnel, health care expenditure in last year as a independent factors. On the other hand there was no correlation with social assistance recipients and the percentage of aging population, financial self-reliance, industrialization rate, suicide rate, cardiac disease mortality, cerebrovascular mortality on health care expenditure. Conclusion: The study clearly shows that health care expenditure of local governance was not correlated with health care need factors comparing social welfare expenditure.

• 대한예방한의학회지
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• 제14권1호
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• pp.37-48
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• 2010

Objective : The purpose of this research was to provide basic data for developing the collaborating care of Korean traditional medicine and western medicines by analyzing the perceptions of residents visiting local health centers on the collaborating care. Method : To this end, a self-administrated questionnaire was surveyed to 417 participants from March 10 to March 19, 2005. The questionnaires were regarding medical preferences, effectiveness, co-operative treatment types, and the demographic characteristics of the study population. The main statistical methods employed for analysis were frequency chi-square test analysis, using SPSS system 12.0 software for Windows. Result : First, the perceptions of collaborating care, such as preference and effectiveness, were better for residents who had experienced Korean traditional medicine(p < 0.05). Second, the most favorable collaborating care type was the neuromuscular disease and rehabilitation, and in particular, the preference of the patient who had experienced Korean traditional medicine was much higher than those who had not experienced it(p < 0.05). Third, as for recognizing the future of collaborating care, respondents insisted that collaboration care has to be conducted under evidence-based research. The reasons why collaborating care has not been active were reported as "difference in solving disease problems between oriental medicine and western medicine." The most important role of the Korean traditional medicines in the public sector was to provide specialized service for the elderly and low income households. Conclusion : Most respondents expected the positive effects of the collaborating care and wanted it to develop, particularly for neuromuscular diseases. As for the health promotion program in health centers, it was more popular than the home visiting program for the elderly and preventive rehabilitation for stroke. Now we must plan to balance between the need of the community and the medical provider on collaborating care.

• Journal of Preventive Medicine and Public Health
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• 제22권2호
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• pp.236-241
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• 1989

The purpose of this study was to introduce the methodology of intervention analysis with time series data and to investigate the influence of the patient referral system on medical care utilization in Kangwha county. The data were obtained at the Kangwha Medical Inurance Society and we analysed the material based on the outpatient care fee. The results were as fellows: 1. The average outpatient care utilization in the hospital decreased by 41.7% due to the patient referral system. 2. The utilization of the health instituation increased by 278.8 persons per month due to the patient referral system. 3. The patient referral system did not influence the total outpatient are utilization. The methodology of intervention analysis, which detected the effect of intervention, will be helpful to the study of public health area.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.355-360
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• 1999

1995년 1월과 7월에 전라남도 일부 농촌지역에 거주하는 20세 이상의 주민 3,085명을 대상으로 자가건강인지도를 측정하였다. 이후 3년간의 지역의료보험 지불자료에서 나타난 의료이용도 및 해당 지역 행정관청의 사망신고 자료를 이용하여 사망여부를 파악하여, 이들 변수들과 자가건강인지도와의 관련성을 조사해본 결과, 다음과 같은 결과를 얻었다. 1) 지역의료보험 대상자 1,090명에서 자가건강인지도에 대한 설문을 실시하기 이전인 1994년의 의료이용량에 비해 이후 3년간의 의료이용량이 자가건강인지도 불량군에서 더 많았으며, 수진일과 투약일은 더 크게 증가하였다. 2) 조사대상자 3,085명중 3년간의 사망자는 123명으로 연령과 성별을 보정한 생존분석 결과, 자가건강인지도 불량군이 양호군에 비해 더 높은 사망위험도를 나타냈다. 94년 지역의료보험에 가입되었던 1,376명중 사망자는 72명, 연령과 성별, 그리고 94년도 의료이용량을 보정 한 생존분석 결과 유의한 차이는 보이지 않았다. 이상의 결과를 요약해 볼 때, 비교적 단기간의 비교를 통해서도 의료이용도와 사망은 자가건강인지도에 따라 차이가 발생함을 알 수 있다. 특히 기존에 같은 정도의 의료이용을 하는 사람 중에서도 자신을 건강하지 않게 생각하는 사람이 향후 의료이용량이 더 크게 증가할 것으로 예측되었다. 따라서 자가건강인지도의 측정은 향후 개인 및 지역사회집단의 의료이용도와 사망 등 건강상의 문제를 예측하는데 유용한 도구로 사용할 수 있을 것으로 생각된다.

• 한국치위생학회지
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• 제19권3호
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• pp.343-350
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• 2019

This study focused on the status of dental care development for children and adolescents. In contrast to the chronic disease management project, this research intended to provide basic data for the expansion of the system. We summarized the status of the system's expansion since 2012. It analyzed research reports, papers, related literature and books on the system of children and adolescent dental care service. The literature analysis classifies year, publication, title and published location. The current state of the system is listed as location, target, support funds, etc. Implementation of the project was first discussed in 2007. Initial planning focused on the Oral Health Policy Research Society of the Gunchi. Effective measures were formulated in 2008 under the center of the Gunchi. It is time to discuss the dental care system's direction and development, as well as future aims based on a beneficial program of preventive care. A system of dentistry should be introduced to benefit the entire population.

• 대한치과의사협회지
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• 제54권11호
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• pp.840-849
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• 2016

The purpose of this study was to examine dental care utilization and expenditures among children aged 0 to 19 years using Korea Health Panel Survey (KHPS) data in 2008 - 2013. Weighted estimates were nationally representative and statistical significances were analysed by $x^2$ test or adjusted Wald test using STATA 13 software. While dental care utilization increased steadily among children from 2008 through 2013, less than one-third the children received dental care in 2013. Compared with 2008, the proportion of restorative care, oral surgery, preventive care decreased and the proportion of orthodontic care, prosthetic care increased. While the proportion of amalgam markedly decreased, the proportion of resin increased. This study highlight socioeconomic disparities in dental utilization and expenditures among children. Especially the findings provide a baseline assessment for examining trends on dental care for children in the future.

• Perspectives in Nursing Science
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• 제7권1호
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• Journal of Preventive Medicine and Public Health
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• 제21권2호
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• pp.419-430
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• 1988

This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.

• 한국의료질향상학회지
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• 제23권1호
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• pp.25-38
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• 2017

Root cause analysis (RCA) is systematic process for identifying contributing factors and root causes. It detects system-level vulnerabilities and prevents them from occurring in the future. In many countries, RCA guidelines have been developed and used for these purposes, and various practical tools are suggested according to stages of RCA implementation. In Korea, adverse events occur in 7.2-8.3 percent of inpatients according to studies conducted in hospitals. However, frontline staffs are suffering from lack of knowledge about RCA implementation. This study introduces RCA guidelines that may be used in hospitals to improve the quality of medical care and patient safety.

• Journal of Preventive Medicine and Public Health
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• 제42권1호
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• pp.35-41
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• 2009

Objectives : The changing population age structure and rapidly increasing medical costs make providing high-quality, effective medical care for the elderly a challenge. This study assessed the satisfaction with medical care in terms of comprehensiveness, general satisfaction, and accessibility among community-dwelling Korean elders. Methods : Data were obtained from a nationwide representative sample of the older adults(aged 65 years old or older) living in the community, who participated in a 2006 telephone survey conducted using random digit dialing(n=881). General satisfaction, comprehensiveness and accessibility were measured using a 10-item satisfaction survey questionnaire. Descriptive analysis was used to assess the distribution of each of three components of subjective satisfaction. Analysis of covariance(ANCOVA) was used to examine the association of each of the three components with socioeconomic variables. Results : Comprehensiveness and general satisfaction were low among older people with a high socioeconomic status. Accessibility was evaluated as low among older people of low socioeconomic status, those living in rural areas and those who were medical aid beneficiaries. Conclusions : Urgent interventions should be considered in order to improve accessibility to medical care for elders of low socioeconomic status and those living in rural communities. Given the rapid aging of the population, we need to develop a monitoring system to improve the quality of geriatric care.