• Research in Community and Public Health Nursing
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• v.14 no.2
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• pp.287-298
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• 2003

The purpose of the study was to develop an integrated prevention program to strengthen elders self-care capability and to examine its effectiveness on their psychological condition. This study used one group pre- and post-test design. Subjects were 85 elderly residents (over 65 years of age) who lived alone, and received free basic medical care and social welfare services in a rural community in Korea. Subject eligibility criteria for this study were to an elders who 1) is not currently taking any anti-depressant medication 2) is able to communicate, and 3) agrees to participate in this study. The integrated program was composed of horticulture, reminiscence, and friendship activities. Twelve sessions were provided for 12 weeks in community-based partnerships to achieve better outcomes. The intervention was case-managed by a public health nurse and aided by six volunteers. The main outcome variable was depression, which was assessed by using 15 items selected from the Geriatric Depression Scale-short form Korean version. Socio-demographic characteristics, functional status, and satisfaction with social support were used as covariates. Results showed that there was a significant intervention effect at post-intervention time point compared to pre-intervention time point(E.S. 0.94). Multiple linear regression analysis showed significant interaction effects between intervention and satisfaction with social support. These findings must be interpreted within the context that an effects of an integrated program could be more synergistically increased when social support factor is considered in the program. A community-based integrated prevention program of depression is effective for vulnerable rural elderly. It is suggested that randomized controlled trials within community setting for better methodological strength as well as multi-level outcomes on community need to be conducted in future.

• Korea Journal of Hospital Management
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• v.4 no.1
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• pp.21-40
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• 1999

This study attempts to analyze the relationship between various job-related factors and the intent to turnover of employees working at different types of hospitals/clinics in urban and rural areas. The data was compiled from 1,506 employees in 21 hospitals and 10 clinics located in Kyung-gi Do. Korea, using a self-administered questionnaire. Major findings are as follows: 1) The intent to turnover was higher for the employees of small hospitals located in rural areas. It was also higher when the employees were less than 30 in age, female, single, had not received college education, and had worked for 2-5 years in their hospitals. 2) An important factor affecting the intent to turnover was job satisfaction, which in turn had a strong correlation with the job itself(opportunity of utilizing abilities and skills, subjective value attached to the current job, sense of accomplishment) and had a rather weak correlation with salary, supervision, promotion and co-worker relationship. 3) In the analysis by job category, it was found that, besides job satisfaction, the intent to turnover was significantly affected by the job itself in case of administrative personnel and by the level of salary in case of nurses. 4) For a successful management of turnover, hospitals need to develop (a) programs for improving adaptive abilities of 'new' employees(who have worked for less than 2 years), and (b) for the other employees(who have worked for more than 2 years), strategies for enhancing job satisfaction by providing the environment where they can show their maximum abilities.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.173-184
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• 2022

Purpose : The purpose of this study was two-fold: to identify the effect of dental hygienist's self-determination motivation on their job engagement and to analyze the moderating effect of compensation satisfaction that affect the relevance. Methods : Data were collected using a structured self-report questionnaire administered to 260 dental hygienists working in dental hospitals and clinics in Busan, South Korea. These were analyzed using IBM SPSS Statistics version 26.0 and SPSS Process Macro 3.5. A frequency analysis, including the respondents' general characteristics, frequency, percentages, and standard deviations, was performed. A regression analysis was also performed using SPSS Process Macro to verify the moderating effect of compensation satisfaction in the effect of self-determination motivation on job engagement. Results : The self-determination motivation of the dental hygienists had a statistically significant positive effect on their job engagement, which was the dependent variable. Higher intangible compensation satisfaction levels led to a stronger effect of intrinsic motivation but a weaker effect of extrinsic motivation on job engagement. Moreover, higher tangible compensation satisfaction levels strengthened the effect of intrinsic motivation on job engagement. Conclusion : Recently, the demand for oral health care has been increasing, Competition in the dental medical service market warrants, high-quality dental services based on accurate diagnosis and treatment. In this context, dental hygienists' job engagement must be improved. For this purpose, increasing the satisfaction of dental hygienists with self-determination motivation and appropriate compensation is effective. In addition, attention must be paid to the moderating effect of compensation satisfaction on the relationship between intrinsic motivation and job engagement. On the basis of the implications of this study, the results can be used as basic data for improving dental hygienists' welfare system and manpower management.

• The Journal of the Korea Contents Association
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• v.20 no.2
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• pp.360-370
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• 2020

In order to understand the factors related to the unmet dental needs, analysis was performed using the data of community health survey data. Targeting population of 214,861 aged 25 and over demographic factors, socioeconomic factors, social support, social environmental factors, social and physical environmental factors, and factors related to necessary unmet dental needs visit it was confirmed. The lower the age, the higher the income level, the lower the education level, the less contact with relatives and friends, the less likely they are to participate in relatives and leisure activities, dissatisfied with sociophysical environment(safety level, natural environment, living environment, public transportation, medical services) the higher unmet dental needs. It was confirmed that not only demographic and socioeconomic factors but also social support, social environmental factors, social and physical environmental factors had a statistically significant impact on the need of unmet dental needs. Future research that includes policy factors as social determinants of health will be needed as a way to increase the unmet dental needs.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.175-209
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• 2019

The bundled discounting which the dominant undertakings engage in is problematic in terms of competition restraint. Bundled discounts generally benefit not only buyers but also sellers. Specifically, bundled discounts usually costs a firm less to sell multiple products. In addition, Bundled discounts always provide some immediate consumer benefit in the form of lower prices. Therefore, competition authorities and courts should not be too quick to condemn bundled discounts and apply the neutral and objective standard in bundled discounting cases. Cascade Health v. Peacehealth decision starts ruling from this prerequisite. This decision pointed out that the dominant undertaking can exclude rivals through bundled discounting without pricing its products below its cost when rivals do not sell as great a number of product lines. So bundled discounting may have the anticompetitive impact by excluding less diversified but more efficient producers. This decision did not adopt Lepage case's standard which does not require the court to consider whether the competitor was at least as efficient of a producer as the bundled discounter. Instead of that, based on cost based approach, this decision said that the exclusionary element can not be satisfied unless the discounts result in prices that are below an appropriate measures of the defendant's costs. By adopting a discount attribution standard, this decision said that the full amount of the discounts should be allocated to the competitive products. As the seller can easily ascertain its own prices and costs of production and calculate whether its discounting practices exclude competitors, not the competitor's costs but the dominant undertaking's costs should be considered in applying discount attribution standard. This case deals with bundled discounting practice of multiple healthcare services by the dominant undertaking in healthcare market. Under the Korean healthcare system and public health insurance system, the price competition primarily exists in non-medical care benefits because public healthcare insurance in Korea is in combination with the compulsory medical care institution system. The cases that Monopoly Regulation and Fair Trade Law deals with, such as cartel and the abuse of monopoly power, also mainly exist in non-medical care benefits. The dominant undertaking's exclusionary bundled discounting in Korean healthcare markets may be practiced in the contracts between the dominant undertaking and private insurance companies with regards to non-medical care benefits.

• The Journal of the Korea Contents Association
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• v.17 no.5
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• pp.366-375
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• 2017

The purpose of this study is to analyze the use of hospital, hospitalization, medical service, discharge and power of medical care patients who are concerned about moral hazard. We conducted focus group interview with 3 medical care patients and their families and 5 workers who had worked for more than 4 years in a nursing hospital. The main results and implications are as follows. First, admission to nursing hospitals was mostly based on the linkage between the medical institutions and the competition to attract the patients rather than the choice of the patients. Second, the main cause of the long-term hospitalization of medical assistance patients was the lack of social protection measures such as absences of residence and care giver, although there are factors that cause moral hazard such as low self-pay. Third, most of the patients were in need of treatment, but they were admitted to the hospital even though their needs were not higher than those of the health insurance patients. Fourth, the rehabilitation service is the mainstay of the medical service of the nursing hospital, and the roles of nursing staff and care givers are important. Fifth, medical care patients are paying medical expenses for nursing hospitals due to cost of living and family support, but they are exempted from the hospital expenses or the burden of their own expenses in the hospital. Sixth, public institutions and social welfare institutions have not managed continuously since commissioning patients to nursing hospitals and have neglected the connection with community services after discharge.

• Journal of agricultural medicine and community health
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• v.12 no.1
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• pp.36-53
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• 1987

It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.7
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• pp.2459-2467
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• 2010

The purpose of this study was to survey visiting health care personnel who worked for their public medical health institutions and thereby investigate their oral health knowledge and behavior. Findings of this study are summarized as follow; First, our visiting health care personnel had a significant tendency toward higher score at correct answers to questions about oral health knowledge (mean knowledge about periodontal disease: 67%, mean knowledge about dental caries: 68%, mean knowledge about common dentistry: 68.4% or higher). Secondly, in terms of oral health care behavior, 50% or higher of all our visiting health care personnel visited dental clinic for preventive purposes, and 60.1% visited dental clinic for oral treatment. 46.6% of health care personnel relied on dental clinic for regular scaling services, and 89.6% relied on general hospital or dental clinic for oral treatment. 89.5% of health care personnel brushed their teeth 3 times or more per day; more than half (58%) of them preferred dental floss to other oral hygiene supplies; and 46% practiced roll technique to brush their teeth. Thirdly, health care personnel's oral health knowledge was significantly correlated with their age (F=5.25, p<0.01) and career of health care (F=3.94, p<0.01), while their oral health behavior was significantly associated with their career of visiting health care (F=3.20, p< 0.05).

• Korean Journal of Hospice Care
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• v.1 no.1
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.