• 보건의료산업학회지
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• 제10권4호
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• pp.141-151
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• 2016

Objectives : The purpose of this study was to examine the effects of an oral health promotion program. And suggest that education on oral health should be given by a professional. Methods : Sixty-four people over the age of 65 years were selected from three elderly care facility located in Gyeongsangbuk-do, A city. From June 7 to August 19, 2016, an oral health promotion program was given to two experimental groups (N=21 and 20) for a total of eight times. One program was conducted by a professional and the other by a non-professional although both were considered experts. Additionally, a control group(N=23) was a observed. Results : While both experimental groups showed a positive change from the oral health promotion program, the experimental group that was given the oral health promotion program by a professional showed more positive changes in oral cavity function. Conclusions : By using professionals, it is possible to provide a health promotion program that actively monitors the oral cavity of the elderly as well as provide elderly care services for oral hygiene. Appropriate elderly health policies and oral health business model for elderly are needed.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.153-174
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• 1995

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

• 농촌의학ㆍ지역보건
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• 제47권3호
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• pp.166-180
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• 2022

본 연구는 팬데믹 시기 비대면 비만관리 프로그램의 개발하여 적용한 후 그 효과를 평가하고자 하였다. 근거기반 비대면 비만관리 프로그램 개발은 Intervention Mapping Protocol (IMP)를 이용하였다. 프로그램의 운영은 대구광역시 시민건강 놀이터 온라인 채널을 통해 참여를 신청한 과체중 및 비만 성인 48명을 대상으로 2020년 9월 14일부터 11월 13일까지 8주 동안 실시하였다. 효과평가는 프로그램 전·후 자가 신체 계측 측정, 건강행태 설문 및 만족도 설문 분석을 통해 평가하였다. IMP를 통한 중재 프로그램의 개발은 IMP 6단계의 과정을 적용하였고 1단계 요구사정은 간호·영양·운동 교육자 면담을 통해 대상자 선정 기준, 프로그램 운영 방법 등을 결정하였다. 2단계 목표 설정은 비만관리를 위한 행동 변화목표 3가지를 설정하였고 3단계에서는 건강·영양·운동 영역별 근거기반으로 건강행태 변화를 위한 중재 방법 및 수행 전략을 선택하였다. 4단계 프로그램 설계는 8주 동안 대상자의 수행 과제 및 인증방법 등 구체적으로 프로그램을 설계하였고 5단계에서는 개발된 프로그램의 실행 계획을 작성하고 실제 적용하였으며 6단계에서는 적용한 프로그램의 효과를 평가하였다. 비대면 비만관리 프로그램 참여 전·후 신체 계측 값을 통한 효과 평가 결과 평균 체중은 1.2kg이 감량되었고, 허리둘레는 3cm가 감소하였으며, 체질량지수(BMI)는 0.8kg/m² 감소하였다(p<0.05). 대상자의 건강행태 설문을 통한 효과 평가 결과는 프로그램 참여 전·후 1일 평균 섭취 열량, 과일 섭취, 걷기 운동 실천 등의 생활습관이 긍정적으로 개선되었고 통계적으로 유의한 차이가 있었다(p<0.05). 프로그램 과정 평가를 위한 만족도는 4.57±0.63점으로 높게 나타났다. 본 연구 결과에 근거하여 비대면 비만관리 프로그램은 팬데믹 시기에 시간과 장소의 제약 없이 전문가의 개별상담과 자가 신체 계측 측정 및 기록을 통한 대상자의 적극적인 참여가 가능한 프로그램으로 지역사회 성인 대상 비대면 비만 관리에 유용하게 활용될 수 있을 것이다. 그러나 비대면 비만관리 프로그램은 앱 사용 등 대상자의 나이에 따라 비대면 프로그램 참여에 일부 제약이 있다. 따라서 본 연구로 개발된 비대면 프로그램과 함께 필요시 대면 프로그램의 병행을 제언하며, 추후 장기적인 프로그램의 운영에 따른 효과 평가를 검증하기 위한 지속적인 연구들이 필요할 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.393-401
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• 2000

Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

• 지역사회간호학회지
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• 제21권3호
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• pp.351-361
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• 2010

Purpose: This study was done to analyze the effects of tele-care case management services using secondary data. Methods: A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Casemanagement services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test. Results: After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group. Conclusion: The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.

• 농촌의학ㆍ지역보건
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• 제49권3호
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• pp.179-193
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• 2024

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions: In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

• 보건행정학회지
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• 제28권3호
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• pp.251-256
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• 2018

The origin of hospital accreditation in Korea is the Hospital Standardization Program of the Korea Hospital Association. Current accreditation program implemented by the Korea Institute for Healthcare Accreditation has succeeded in stimulating quality improvement activities of participating hospitals since its launching in 2010. However it has been criticized due to some unintended consequences of accreditation. In order to fully enjoy the benefit of the accreditation program in Korea, national efforts to expand accreditation scheme and coverage, upgrade accreditation standards, insure substantiality of accreditation process, provide consumers with more useful information, and strengthen the professional capacity of accreditation organization will be needed.

• 대한한의학회지
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• 제31권4호
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• pp.141-150
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• 2010

Objectives: The study evaluated efficacy of the Gigong program in health promotion service programs using oriental medicine. Methods: The data were collected from 31 female participants who completed the Gigongprogram from February to May of 2009 in Eumsung-Gun. The questionnaires to measure efficacy of the Gigong program were composed of demographic items, past history, family history, why they joined the program, satisfaction with the Gigong program, lipid profile, etc. The lipid profiles were collected before and after the Gigong program. Results: Satisfaction with the Gigong lectures and program was 88.4%. Improvement of daily life after the Gigong program was 92.2%. Mood and exercise habits of daily life significantly improved. Conclusions: From these results, the Gigong program is worthwhile for promoting health, so further study is needed to determine its efficacy.

• 보건행정학회지
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• 제6권1호
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• pp.144-162
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• 1996

This study was conducted to identify the problems related to operation of the committee system in university hospitals and to propose the direction for reforming it. Data were collected by surveying 138 working-level administration managers of committees from 12 university hospitals in Seoul in October, 1995. The results were as follows: 1. The purposes of the committee were to promote the reasonable dicision making in the hospitals, to satisfy the requirement of Hospital Accreditation Program and, to execute the administrational instructions in due order. The sort of job which was charged of chairmen and the majority of committee member was doctor. 2. The committees which were to be held the meeting frequently in a year were general management committees(8.25 times/year). But in case of operation rate, medical care-related committees showed the most frequent meeting(90.15%). Most of committees made the regulations and reported the results of their meeting to the CEO of their hospitals by written documents. 3. Most doctors thought the medical care-related committees useful. Medical technicians regarded education and research-related committees as useful, while administrators favored the general management committees. 4. The factors related to the perceived performance of the committee were the kind of job, the class of job and the kind of committee. Also, the perceived performance of the committee was positively related to the usefulness in efficient management of work, and negatively to uncertainties in responsibility and a nominal role of the committee. 5. Most of the respondnts thought that the concern of the top manager about the committee was the most important factor for the improvement of committee system at hospitals. They also regarded that formalization of the objectives and regulation rule and composition of committees with members which work in various fields as essential. Further studies on the organizational and operational cjharacteristics which include general hospitals in various areas are required.

• Journal of Preventive Medicine and Public Health
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• 제44권2호
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• pp.74-83
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• 2011

Objectives: This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. Methods: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP ${\geq}$ 140 mmHg, a diastolic BP ${\geq}$ 90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. Results: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. Conclusions: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.