• Journal of Preventive Medicine and Public Health
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• v.25 no.1 s.37
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• pp.88-100
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• 1992

This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

• Journal of the Korean Regional Science Association
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• v.39 no.3
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• pp.65-83
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• 2023

The purpose of this study is to conceptually define "spatial inclusivity" and empirically examine the impact of disability severity and spatial inclusivity on social participation among individuals experiencing physical discomfort. The social and spatial environment of the residential area is crucial for individuals with disabilities who face limited activity range and complex barriers due to physical constraints. In this study, spatial inclusivity from the perspective of people with disabilities is defined as establishment of equal relationships with non-disabled individuals within the local community, as well as the availability of basic facilities and services in a safe urban space that allows for access and utilization. This concept consists of three dimensions: individual networks, social environment, and physical environment. The physical environment encompasses safety levels, natural environment, living environment, public transportation conditions, medical services in residential areas. We used the 2019 Community Health Survey to examine the relationship between disability severity, spatial inclusivity, and social participation using a two level regression model. The findings are as follows: Firstly, personal relationships at the individual level and the physical environment at the local level have a positive impact on social participation. Secondly, when identifying dividing the physical environment into five sub-factors, no significant influence of individual factors is found. Thirdly, trustworthy and friendly social environment at the local level has a negative impact on social participation. These results provide empirical evidence that spatial inclusivity has an effect on the social participation of individuals with disabilities and suggest implications for urban planning to create and enhance conditions for the social participation of individuals with disabilities.

• Journal of dental hygiene science
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• v.5 no.4
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• pp.233-238
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• 2005

The study was intended to investigate elementary schoolers' oral health status according to whether the school have and manage an school oral health clinic or not in order to provide useful information for continuously developing the school oral health clinic 1,163 children in Hwasan elementary school in Hwasung city and 485 children in S elementary school in the same locality were selected as the experimental group and the control group, respectively, and orally examined from May 1st to 30th, 2004. The findings from the oral examination were as follows. 1. DMF rate was higher in the higher grades in both the groups. The rate was lower in the experimental group with 45.1% of the children than in the control group with 65.3% of the children. 2. DMFT rate also were higher as the grades were higher in both the groups. The ratio was lower in the experimental group with 30.4% of the children than in the control group with 44.6% of the children. 3. DMFT index was 1.0 in number in the experimental group and 1.6 in the control group. Index increase from the 1st grade to the sixth grade was also more positive in the experimental group. 4. DT rate was a little higher in the experimental group in the first graders, but comparatively decreased to the grades while increased in the control group. In the sixth graders, the rate was 42.4% in the experimental group and 87.7% in the control group, the former was less than the latter by about 50% point. 5. FT rate was a little higher in the control group for the first graders but increased in the experimental group to the grades. The rate in the sixth graders was higher by more than double in the experimental group. Based on the above findings, the region of the study had better oral health statistics than in other regions. The operation of school oral health clinics that provide dental health care to children at the right time seems to contribute to enhancing their dental health status by preventing against dental diseases and changing their relevant knowledge, attitude and behaviors. In the future, more school oral health clinics should gradually be prepared to push ahead with a sustained, extensive dental health project geared toward school-aged children. To make it happen, dental hygienists who are professional medical personnels should be taken advantage of, and in order to beef up the efficiency of preventive measures and oral health education, the best dental health care services should be offered by harnessing dental hygienists and dentists who work at public dental clinics run by local governments.

• Journal of Arbitration Studies
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• v.20 no.3
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• pp.47-69
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• 2010

From the review of Korean arbitration systems with the comparison of those of other countries, we can summarize some issues to be tackled as follows: First, Korean arbitration system started with the purpose of export promotion. This may be the main reason that various domestic disputes have not been resolved by arbitration. Second, the Korean Arbitration Law applies to private disputes. The Law's arbitration scope is wider than that of China and France, but narrower than that of the U.S.A. that encompasses a variety of disputes in the filed of consumer, labor, medical services, patents, etc. Third, active judges or public officials in Korea can not be arbitrator and there is no arbitration court. However, if chief judge allows the necessity, court's judges in the UK can be arbitrator with the mutual agreement of the parties and also arbitration system is operated in the court. Fourth, the Korean Commercial Arbitration Board(KCAB), the only representative institution for arbitration in Korea, is under the Ministry of Knowledge Economy(MKE). This makes it difficult for the KCAB to handle other disputes related to the Ministry of Health and Welfare, the Ministry of Strategy and Finance, the Ministry for Food, Agriculture, Forestry and Fisheries, the Ministry of Employment and Labor, etc. Fifth, as mentioned, the KCAB is the unique institution for arbitration by the Law in Korea, while other countries allow have a diversity of arbitration agencies such as maritime arbitration organization, consumer arbitration institution, arbitration court, etc. Therefore, we suggest some ideas to expand the arbitration's area of coverage in Korea as follows: First, there should be more active policies that promote various domestic disputes to be settled by the arbitration system. Second, it is quite needed to expand the scope of arbitration to cover many disputes in the fields of consumer, labor, medical service, advertising, fair trade, etc. Third, there should be discussions to allow court judges as arbitrator and to introduce the arbitration court. Fourth, the KCAB should strengthen its status and roles as general arbitration organization to overcome the limited scope of commercial disputes. For this, there should be the strong support and coordination among the MKE and other government agencies. Fifth, to reduce the burden of the court's complicated and expensive procedures, more efficient disputes resolution systems should be established on the basis of the parties' free will. Each central government agency should streamline the legal barriers to allow industrial organizations under its control to establish their own or joint arbitration system with the KCAB.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.69-89
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• 2001

This study is focused that the electronic commerce(EC) on the purchasing section may improve the efficiency and transparency of the hospitals management. After reviewing the purchasing activity of hospitals, I study the introduction, expected effects, and problems of EC. So, I am going to provide basic information for activating EC. The samples are managers of 170 hospitals, which are located on Seoul. As a result of collection this survey, I analyze 79 hospitals. For data analysis, I use $X^2$-test and ANOVA for purchasing management and the relevance of EC according to the level of care. The results of this study are 1. The problems on the management of purchasing section are: firstly, they don't have sufficient time to study market. Secondly, it is difficult to find competitive suppliers. And, lastly, they cannot gather a lot of information about the price of products. 2. There are many answers of the needs on the introduction of B2B. However, some hospitals think they don't need it. But, the most answers are that the EC will be settled within 4 years. So, we can realize that these hospitals are getting interested on the EC. On the other hand, I find that they prefer outside EC companies for the introduction of EC. 3. On the expected effects on EC, first is the effectiveness of the market survey. The next is to collect information of adequate price of products owing to clear transaction, find easier new suppliers and gather useful data. 4. On the external problems of the introduction of EC, there is low credibility related to the security and the weakness of suppliers' information system. Especially, on the Real Transaction Price Payment system, the bigger bed size, the higher understanding on these problems. On the internal problems of the introduction of EC, first is the burden of the introduction of EC and operating cost. Especially, on the burden of the disclosure of revenue source, the smaller bed size, the higher understanding on this problem So, this is a point which deserves my attention statistically. However, this shows relatively little understanding about incomplete the standard of product category and the weak information system of hospital. Through this study, I am going to suggest 3 points for the activation of the introduction of EC on hospitals. 1. The reform of the Real Transaction Price Payment System on medical supplies and materials for medical treatment 2. The establishment of the standard of product category 3. The promotion of information system based on network.

• Korea Journal of Hospital Management
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• v.14 no.4
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• pp.149-162
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• 2009

The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.

• Journal of Preventive Medicine and Public Health
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• v.39 no.6
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• pp.493-498
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• 2006

Objectives : Diabetes has been reported as a risk factor for several cancers. However, the association between diabetes and gastric cancer has been inconsistent. The aim of this study was to evaluate the association between the fasting serum glucose level and gastric cancer risk in Korea. Methods : Among the members of the Korean Multi-Center Cancer Cohort (KMCC) from 1993 to 2004, a total of 100 incident gastric cancer cases were ascertained until December 31, 2002 and 400 controls were matched according to age, sex, and year and area of enrollment. Of the eligible subjects, those without fasting serum glucose level information were excluded, with a total of 64 cases and 236 controls finally selected. On enrollment, all subjects completed a baseline demographic and lifestyle characteristics questionnaire, and had their fasting serum glucose level measured. The Helicobacter pylori infection status was determined by an immunoblot assay using long-term stored serum. The odds ratios (ORs) were estimated using conditional and unconditional logistic regression models adjusted for the H. pylori infection status, smoking, drinking, education, follow-up period and matching variables. Results : The ORs for risk of gastric cancer according to the serum glucose level were 1.33 [95% CI=0.50-3.53] and 1.66 [95% CI=0.55-5.02] for the categories of 100-125 and 126 mg/dL or greater, respectively, compared to the category of less than 100 mg/dL. No increased risk of gastric cancer according to the serum glucose level was found (p-trend=0.337). Conclusions : This study provides no evidence for an association of the serum glucose level with gastric cancer.

• Journal of dental hygiene science
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• v.12 no.4
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• pp.404-412
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• 2012

The main object of this study is to render a better dental education to mental disabilities, teachers, and their parents. By providing a better dental education to them, mental disabilities would understand the importance of their oral hygiene. The study was held in Seoul at two different locations, named H and E mental welfare facilities. Ninety Three mental disabilities were studied by observing their oral behavior, simple oral hygiene index and plaque index prior and post to dental education. At the end of education, following result were gathered from two mental facilities. First, the level of oral behavior in Class 1,2, and 3 mental disabilities were observed prior and post to the dental education. Overall, there was no significant difference among Class 1 mental disabilities with the dental education. Second, in simple oral hygiene index, the severity of mental illness has affected on their oral behavior (F=6.322, p<.001). Third, in simple oral hygiene index, the frequency of dental education, regardless of severity of mental illness has affected on their oral hygiene (F=5.961, p<.01). Fourth, the plaque index also illustrated that the frequency of dental education, regardless of severity of dental illness has affected on their oral hygiene (F=5.126, p<.05). Finally, the general characteristics of mental disabilities according to changes in oral health awareness to gender, age, disability type, educational level do not statistically significant in all variables. Their simple oral hygiene index and plaque index advanced, although after a while they started to lose focus, which brought back their old habits. Nevertheless, in conclusion I believe that helping mental disabilities more frequently to constant reminder, will not only keep them entertained, but help them realize how important oral hygiene practice is, hopefully increasing and benefiting those with mental disabilities for future reference.

• Journal of the Korea Convergence Society
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• v.7 no.4
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• pp.107-121
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• 2016

This study aimed to seek the way of effectively managing job stress of shift work nurses, to improve nursing performance, the influence of job stress of shift work nurses on nursing performance through convergence research. A total of 244 questionnaires obtained by a survey targeting nurses, who were doing shift work in a university hospital located in B city, in the period from March 2 to 15, 2015 were analyzed using the SPSS 21.0 program. As a result, the mean score of job stress was 3.57 points, and the mean score of nursing performance was 3.69 points. Job stress made a significant positive(+) influence on the sub-dimensions of interpersonal duty. Therefore, efforts should be made to more accurately identify shift work nurses' job stress and efficiently manage the nursing personnel. Moreover, if shift work nurses' job stress is effectively managed by preparing practical job stress management intervention programs for continuous improvement of nursing performance, high quality medical services will be provided through high quality nursing practice.