• Journal of Information Technology Services
• /
• v.16 no.3
• /
• pp.17-45
• /
• 2017

Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

• Journal of Korean Academy of Nursing Administration
• /
• v.12 no.2
• /
• pp.225-232
• /
• 2006

Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

• Quality Improvement in Health Care
• /
• v.10 no.2
• /
• pp.216-231
• /
• 2003

Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.

• Journal of the Korean Society of Marine Environment & Safety
• /
• v.24 no.2
• /
• pp.215-222
• /
• 2018

This study aims to compare and analyze the quality of life of residents between those living in coastal and non-coastal areas. The indicators for the quality of life were divided into three different sectors. First, the economic sector observed the rate of population growth, the number of businesses per 1000 people, the employment and unemployment rate. The second was the environmental sector, which included the number of car registrations per capita, water supply and sewer service ratio, the urban park composition area per 1000 people and the road pavement rate. Thirdly, the social sector comprising data about the number of students per teacher, the number of sickbeds in medical institutions per 1000 people, the rate of traffic accidents per 1000 cars and the portion of social welfare budget in general accounting. The analysis method of standardized indicators and T-Test were carried out in 24 coastal cities and 51 non-coastal cities across the country. Results of the indicator comparison suggested there were significant differences in the number of businesses per 1000 people, the road pavement rate and the rate of traffic accidents per 1000 cars. From the results of each sector comparison, the coastal cities showed a higher value than non-coastal cities only in the economic sector. The quality of life comparison showed that coastal cities were better than non-coastal cities but were not statistically significant.

• Fire Science and Engineering
• /
• v.33 no.4
• /
• pp.140-151
• /
• 2019

It is to assess the indoor air quality of the chemical hazardous materials exposed to the fire after firefighters returned to the fire scene. The research subject randomly selected four fire stations located in Seoul, Korea. Two fire stations were set up as control groups after the return of the firefighting activities at the actual fire scene, and two other fire stations were set up as control groups to measure the air quality of the room at normal levels regardless of the action. We conducted 24-hour monitoring for all fire accidents that occurred in Seoul Metropolitan using fire safety map computer system. Also, indoor air quality was measured immediately after homecoming if the experiment group was to be dispatched due to an accident of intermediate or larger scale. 11 hazardous substance items such as fine dust, formaldehyde, volatile organic compounds, PAH, VCM, acidity, asbestos, CO₂, NO₂, O₃ were measured according to the process test method. Three of 11 types of harmful substances exceeded domestic and foreign standards, and one of them was found to be close to foreign standards. In particular, total volatile organic compounds, carbon dioxide and sulfuric acids were 2.5 times, 2.2 times and 1.1 times higher than the standard. Also, for formaldehyde and sulfuric acid, it was measured higher in the control group than in the case group. This findings could be used in policies to improve indoor air quality in the fire station of the Seoul Metropolitan Government.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.5
• /
• pp.275-284
• /
• 2019

This study was conducted to evaluate the health promotion behavior level, health beliefs, and self-efficacy of individuals preparing for civil service examinations, as well as the main factors that influence their health promotion behavior. The study subjects were 290 individuals who were preparing for civil service examinations in Noryangjin, where there are a lot of private institutions that provide training for the examinations. Data were collected by questionnaire surveys conducted from December 1 to 19, 2017. With the use of SPSS ver. 23, descriptive statistics, t-tests, one-way ANOVA, correlation analysis, and stepwise multiple regression were conducted. On average, the score for health promotion behavior practice was $2.37{\pm}0.45points$, health beliefs $3.13{\pm}0.45points$, and self-efficacy $3.55{\pm}0.74points$. Health promotion behavior was significantly positively correlated with perceived severity and perceived benefits, which are sub factors of health beliefs (r=.60, p<.001; r=.55, p<.001), while it was significantly negatively correlated with perceived barriers, which are a sub factor of health beliefs (r=.32, p<.001). The factors that influenced health promotion behavior were perceived health condition and perceived barriers, and the explanatory power of health promotion behavior was 25.1% (F=13.58, p<.001). In general, respondents studied for the examinations for a long time and were under severe job pressure; accordingly, they need to have quality meals, regular exercise, and regular medical check-ups to enhance health promotion behavior to control their stress.

• Journal of the Korean BIBLIA Society for library and Information Science
• /
• v.30 no.2
• /
• pp.117-144
• /
• 2019

Today, interest in health information has risen overall due to the aging society, increased public interest in the quality of life, and the increased state's interest in reducing medical costs. Accordingly, efforts have been made across the library and information science in terms of academic research, libraries in terms of providing health specialized services, and the state, yet policies and strategies for providing the health related information in an integrated and systematic manner through the libraries have not been proposed with clarity to date. Thus, this study aimed to propose a method to provide the health information in an integrated manner by the libraries through the previous studies, policy studies, and case studies. Consequently, it proposes to build a system to integrate the health information, build an overall database of the health related information, develop and operate a health specialized library program, operate a general support center for the health information service, and build a cooperative network among the related departments and institutions for the health information service. The details proposed by this study is likely to contribute to developing services for improving the health of the citizens of this country.

• Journal of Korean Academy of Nursing Administration
• /
• v.3 no.1
• /
• pp.119-133
• /
• 1997

Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

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

• Journal of Korean Medicine Rehabilitation
• /
• v.27 no.3
• /
• pp.61-70
• /
• 2017

Objectives The purpose of this review is to analyse the trend in papers related with Korean Medicine Treatment after musculoskeletal disorder surgery. Methods We reviewed Korean Medicine papers by searching Korean web databases 'Korea Traditional Knowledge Portal', 'Scientific and Technological Information Integration Service (NDSL)', 'Academic Research Information Service (RISS)', 'Korea Medical Informati on Portal (OASIS)'. We classified the papers by the year of publishment, the title of journals, the type of study, surgery region, chief complain after surgery, main treatment, periods after surgery, assessment for outcomes. Results 1. Korean Medicine treatment after musculoskeletal disorder surgery has received more attention than in the past and there are attempts to do various studies besides the case reports. 2. 41 research papers were divided in to 3 original articles, 3 review articles, 35 case reports. But almost presented a low level of evidence. 3. Pain was the most common symptom after the musculoskeletal disorder surgery. Pain should be the primary goal of Korean rehabilitation treatment after musculoskeletal disorder surgery. 4. Assessment tools for outcome were concentrated in questionnaries, VAS and NRS. In order to evaluate better, it is necessary to evaluate the overall condition of the patient such as the quality of life evaluation and patient satisfaction. Conclusions In this study, we expect that the development and clinical application of Korean rehabilitation treatment program after musculoskeletal disorder surgery will be actively pursued.