• Journal of Korean Academy of Nursing
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• v.43 no.1
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• pp.39-49
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• 2013

Purpose: To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing. Methods: Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions. Results: For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable. Conclusion: The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

• Research in Community and Public Health Nursing
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• v.30 no.3
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• pp.307-323
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• 2019

Purpose: The purpose of this study is to analyze the contents of disaster nursing education at universities in Korea and Japan, with focus on textbooks. Methods: Disaster nursing contents from 11 Korean community health nursing textbooks and 3 Japanese disaster nursing textbooks were analysed. Results: Three themes and 8 categories of disaster nursing content in the selected textbooks were analyzed. The themes classified include 'understanding of disaster', 'disaster management' and 'disaster management system'. The theme of 'understanding of disaster' consists of such categories as 'disaster concept/outline', 'classification of disaster', 'disaster management step' and 'disaster impact'. The theme of 'disaster management activities' consists of categories such as 'disaster management activities' and 'disaster nursing'. The theme of 'national disaster management system' consists of categories like 'national disaster management system' and 'international disaster relief'. From the comparison of disaster nursing education in the two countries, we found that themes were similar but there were differences between the two countries in content configuration. Korea and Japan have adopted the framework of International Council of Nurses for disaster nursing education. Korea stressed legal and ethical capabilities, while Japan included psychological support for disaster management service providers. Conclusion: Disaster education is an important factor in a nurse's ability for a disaster management. Development of a comprehensive disaster education program is necessary to enhance disaster care capacities.

• Korea Journal of Hospital Management
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• v.8 no.3
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• pp.32-48
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• 2003

Korea is to open its medical markets to foreign hospitals starting in the year 2006 regardless of our will(DDA, Doha Development Agenda). To accurately understand the characteristics of Korean medical users, their detailed and various needs, their attitudes toward the opening of Korean medical markets, and factors affecting these users in choosing foreign medical service providers would be first step needs to be taken by the Korean medical facilities that need to survive and develope through the fiercely competitive era coming with the opening of Korean medical markets to foreign medical service providers and would be very important in hospital management. The subjects of this study were 500 patients randomly selected from the outpatients who visited one of university hospitals in Seoul on the 14th-16th days of April 2003, and conducted a self-completion questionnaire. The answers of 463 respondents among the selected patients(93% of a responding rate)were analyzed through the Excel and statistics programs. The attitudes on the opening of the medical markets were shown in agreement 56.5%(247 persons), disagreement 6.9%(30 persons), and no idea 36.6%(160 persons). In consideration of only the answers as agreement and disagreement exclusive of the answer as no idea, 89.2% of the respondents agreed to the opening of the medical markets while 10.8% objected to the opening. The approval rate was higher with the higher education and income levels. Moreover, The approval rate for the opening of the medical markets was relatively high regardless of the satisfaction in the medical service, and the most important reason of the agreement was the guarantee of the patients(national)option. The main reason of the disagreement was high medical fee(50.5%), and the other reasons showing low rates were outflow of the domestic fund to the foreign countries(13.6%), damage of medical influences on the public(11.4%), lack of competition of the domestic medical industry(9.1%)and so on. As for the factors of selecting the foreign hospitals in the opening of the medical markets, the patients considered the authority(competency)of doctors firstly, and the other principal factors were worldwide fame and reliance, specific explanation of doctors, modernized medical instruments, convenient consultation procedure, etc. The patients agreed to the opening of the medical markets at a high rate regardless of the satisfaction in the medical service, and the most principal reason of the agreement was the guarantee of the patients(national)option for the medical care. Connected with the factors to select the hospitals, the approval reasons for the opening of the medical markets were the authority(competency)of the doctors as the first one, and then fame and tradition, reliance, overall diagnosis and modernized medical instruments, doctors specific explanation, and so on. However, these factors are actually associated with the Quality of the medical care, and consequently the approval reasons for the opening of the medical markets are connected with the security of the medical care. Accordingly, the guarantee of the patients(national)option answered as the main reason of the agreement can be also understood as the awareness of the right to have a variety of options for the security of the medical quality.

• Journal of Society of Preventive Korean Medicine
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• v.6 no.2
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• pp.19-35
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• 2002

To know the differences between health concern, health behavior, and subjective health cognition in urban and rural area, author used the correlation analysis between variables and wanted to provide basic data for public health service to support appropriate health care, health maintenance, and health promotion in community. Data collection were done in JeonBuk area from September 10 to October 10, 2001, and subjects were above 20 years old adult. 350 and 250 subjects were from urban and rural area by random sampling, respectively. Questionnaire were completed by interview with direct or self-recording type. Research tool was questionnaire with health concern, health behavior, and subjective health cognition, and data collected were analyzed into descriptives, crosstabs, T-test, ANOVA, Pearson correlation coefficient by SPSS 10.0 program. The results were as follows: 1. Health concern was 9.0% for upper group, 39.1% for middle group, 51.9% for lower group in urban area, and 10.1% for upper group, 41.0% for middle group, 48.8% for lower group in rural area. Health concern for middle and lower group was totally high percentage, and rural area had higher health concern than urban area. 2. Health behavior in both urban and rural area was statistically significant(p<0.01). Women who had higher age and with spouse had high degree of health behavior, and urban area had totally high score for health behavior compared to rural area. 3. Subjective health cognition was 71.0% for health, 29.0% for non-health in urban area, and 61.3% for health, 38.7% for non-health in rural area. Percentage of health group was higher in urban area than in rural area. 4. Degree of health behavior by health concern was statistically significant only in rural area. That is to say, the higher health concern had the higher degree of health behavior in rural area. Subjective health cognition by health behavior was totally significant correlation with health behavior in urban and rural area(p〈0.05). That is to say, the higher health behavior in urban and rural area had the higher subjective health cognition. 5. For correlations between 3 variables, there was significant correlation between health behavior and subjective health cognition in urban area (p<0.01). There were correlations between health concern and health behavior, health behavior and subjective health cognition(p<0.05). Considering above results, the higher health behavior had the higher subjective health cognition in urban area. The higher health concern had the higher behavior, and the higher health behavior had the higher subjective health cognition in rural area.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.199-210
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• 2004

Since the 119 fire department was legally permitted to serve in Emergency Medical Service(EMS)Operation of emergency patients in 1983, 119 EMS operation in general has made a big progress in serving the needs for emergency patients. Currently EMS operation is carried out by 119 EMS unit, private ambulance Co.,etc. But due to the public recognition and volunteers, 119 EMS operation carries the major share of the service. This observation is not surprising in that such a trends occured in Japan 20 years ago. This paper compared the 119 EMS operation conducted by the fire department in Korea with that of Japan in order to draw some inferences from the comparison. The results of the study compared to Japan were as follows: 1. Japan was higher 1.5 times in the number of EMS units per population(100,000), 1.1 times in the number of patient transports per unit. 2. Japan was higher 4.54 times in the number of the 119 EMS personnel per population(100,000), 30.6 times in that per square killometers, 30.6 times per 119 EMS unit, in per ambulance 2.48times. 3. Japan was higher 1.83 times in the number of ambulance per population(100,000), 1.26 times in that per square killo meters. 4. Japan was higher 1.7 times in the number of transport patients per population (100,000), but Korea was higher 2.68 times in the transport patients per EMS personal. 5. Compared to Japan, there was no emergency care related to ALS, for example, such as administering dugs orally and intravenously, interpreting elctrocardiograms, performing endotracheal tube or LMA insertion, using monitors and other complex equipments in Korea.

• Korean Journal of Health Education and Promotion
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• v.2 no.1
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• pp.56-80
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• 1984

The main objectives of the present study is to evaluate Physician's Health Education Activities by means of physician's direct response to the prepared questionnaire and patient's perception to the physician in the course of medical care. For the data collection, the present study was conducted from Aug. 16 to Oct. 7, 1983 for 739 patients and 91 physicians who were attended outpatient clinics of 5 general hospitals in Seoul. The major findings are summarized as follows: 1. Self-evaluation on Physician's Health Education Activities (1) In consideration of health education services for the patient, the data revealed that 9.9% of the sampled physician wanted to strength public health and preventive medicine lecture in the curricula at medical education. On the other hand, only 1.1% expressed that they wanted to make it short. (2) In consideration of the necessity of health education service, it was shown that 95.6% of physicians agreed to take it into consideration. Self expression for the practice of health education was placed on the 3.15 score when 5 point scale used. (3) To evaluate the degree of an explanation about medical care for the patient, Index score with 4 point scale was employed. The Index score for the first time was shown that scale was placed on 3.23 for 'diagnosis', 3.12 for 'progress of the disease', 3.11 for 'discription of procedure' and 3.02 for 'cause of the disease' respectively. In comparison of the physician's explanation about the status of disease for the first and the second visitors to clinic, they evaluated themselves as giving more detailed explanation for the second visitors rather than the first visitors. 2. Physician's Health Education Services evaluated by patients (1) To evaluate physician-patient communication at beginning time for taking history about disease, the Index score with 5 point scale was employed. The data on taking history have shown that the score placed on 3.07 for those patients who visited the first time and 2.53 for second visitors. And the score about listening from the patients was placed on 3.52 and 3.42 respectively. (2) The Index score with 5 point scale, as used before, was also employed to evaluate medical care services for the patient. The data evaluated by the patients was shown that the score placed on 4.21 for patient treatment in general, 4.58 for physician's credibility, and 3.6 for physician's kindness. However, approximately 80% of those who failed to understand physician's explanation was caused by highly sophisticated medical terminology. (3) According to the Index score with 4 point scale, to evaluate physician's explanation, the data was shown that the patient who visited the first time gave 2.51 for 'diagnosis', 2.35 for 'progress', 2.11 for 'cause of the disease' and so on. It is acknowledged on the whole that the patients who visited the second time have more satisfaction in physician's explanation about their disease, than those who visited the first time. 3. Comparison of self-evaluation of Physician's Health Education Activities and patient's perception. (1) There was communication barriers between physicians and patients in expressing some medical terminology. For example physician understood that they explained more than 50% of medical terminology into common words for the patient, but 30% of patient complained medical terminology used by physician. (2) Comparing the index score of health education practice recognized by patients and physicians for both first visit and revisit groups, it was shown that the Index score of health education activities evaluated by physicians themselves were slightly higher than the score evaluated by patients.

• Korean Journal of Social Welfare
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• v.69 no.2
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• pp.143-169
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• 2017

The purpose of this study was to explore the implications of the integrated support through the 'health - medical - welfare' network and the specific context of the operation through the experiences of the users who participated in the 301 network project of Seoul northern municipal hospital. To do this, In-depth interviews were carried out with 10 research participants. The data was analyzed by general qualitative research methods. As a result of analysis, users lost their willingness because of living in a vicious cycle of poverty and illness before participating in 301 network services, but through the participation of the service, they were able to receive the integrated support of 'cure-care-life stability'. These experiences ultimately led to the regeneration of the will of their lives. At the basis of this experience were operating strategies and conditions such as the formation of a diverse professional team, the establishment of a linkage system within and outside the hospital, the establishment of a treatment linkage system through the acquisition of treatment subsidies, and the linkage of resources at mediation level. As the attempt to integrate 'health, medical and welfare' with well-coordinated strategies and conditions showed the possibility of complementing the limitation of the health welfare support system in Korea, the extension of the related business was suggested. For this, it suggested the more stable stabilization of the linkage system and the improvement of the institutional aspect.

• The Journal of the Korean dental association
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• v.53 no.4
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• pp.266-274
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• 2015

The price for health service are decided by very complicated process because many of factors are related with them. The RBRVS(resource-based relative value scale) were used to calculate the Korean health service fees including dental fees. This study aimed to compare dental fees of Korea with other countries, such as Japan, Germany, and the US for evaluating the adequacy. Dental fees were categorized as oral evaluation and imaging, dental treatment including restorative, periodontal, and surgical work, and preventive treatment and compared by each country. The official documents about dental fees were collected from Korea, Japan, Germany, and the US. Each fee was presented as their own currency at first. Then they were converted into Korean won (KRW) by applying the market exchange rates at a specific point of time. Finally the fees were adjusted by purchasing power parities (PPPs) which equalize the different currencies. In general, the level of Korean fees were markedly low compared to those of Japan, Germany, and the US. German fees were similar or higher than that of Japan, and the US. The Korean fees were lower than three other countries 1.2~4.1 times for oral evaluation and 2.2~7.3 times lower for panoramic radiography. The endodontic fees of Japan, Germany, and the US were higher 1.8~15.3 times and 4.0~35.9 times for the deciduous teeth extraction compared to the Korean. In Japan the prophylaxis was 3.2 times more priced than the Korean fee. Exceptionally, the fees for re-evaluation, amalgam filling, and scaling were lower priced in Japan than other countries. This study has limitations on the items in definition and contents of dental practices units which were not exactly comparable and differently determined by countries. However, this study is meaningful because it surveyed the price levels to compare four different countries and then applied PPPs adjustment. This finding can be used to develop the dental RBRVs of Korean national health insurance and will contribute to improving the payment systems of health care.

• Journal of Korean Clinical Health Science
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• v.1 no.1
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• pp.35-45
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• 2013

Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.

• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.1-13
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• 1995

Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.