• Health Policy and Management
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• v.28 no.2
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• pp.151-161
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• 2018

Background: Family values of a married woman may be related to her own depressive mood. Since depressive mood of a married woman is likely to exert a negative influence, in terms of mental health, on her, her family members, and the whole society's, it may be very important to explore the relationship between family values in married women and their depressive mood. Methods: In this study, we analyzed nationally representative 5,818 married women aged 20 years or older from the 4th panel data of 2012 Korean Longitudinal Survey of Women and Families. As for variables of interest, we constructed three family values variables: family-oriented view of marriage, individualistic view of marriage, and traditional view of marital roles. Then we employed multivariate logistic regression analyses to explore the relationship between family values and depressive mood, adjusting for family and socio-demographic factors. Results: In total, 804 married women (18.4%) had experienced depressive mood. All of the three family values variables were significant in their relationships with depressive mood. The women categorized as 'very weak' in family-oriented view of marriage were more likely to experience depressive mood than the women categorized as 'very strong' (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.53-2.55). By contrast, the women categorized as 'very weak' in individualistic view of marriage (OR, 0.43; 95% CI, 0.33-0.55) and in traditional view of marital roles (OR, 0.68; 95% CI, 0.51-0.92) were less likely to experience depressive mood than their respective counterpart women categorized as 'very strong.' Conclusion: In Korea, married women's values towards marriage itself and roles between wives and husbands had significant associations with their depressive mood. This suggests that in order to improve mental health in married women, we need to take social and cultural dimensions into consideration along with public health interventions.

• Health Policy and Management
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• v.30 no.3
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• The Journal of Korean Academic Society of Nursing Education
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• v.4 no.1
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• pp.66-80
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• 1998

With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

• Journal of Oriental Neuropsychiatry
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• v.25 no.4
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• pp.389-400
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• 2014

Objectives: Though there are many studies about sleep disorder, no research has been performed on the utilization of oriental medicine as a treatment. Therefore, the oriental medical treatment pattern of Korean patients with sleep disorders was examined herein using the Health Insurance Review and Assessment Service (HIRAS). Methods: The medical records of patients with sleep disorders (G47) or nonorganic sleep disorders (F51) as a main diagnosis were adopted from the HIRAS database from 2011 to 2013. Analysis was performed on the number of patients and cost per patient, with comparison between oriental and western medicine in terms of gender, age, patient care service type, and hospital type. Results: 1) Regarding sleep disorders, the medical visits and insurance charges have been increasing. Western medicine was utilized 8 times more often than oriental medicine during 3 years. 2) There were 2.5 times more women than men. 3) Among all ages, the 50~59 year group had the highest representation. 4) In comparison of average portions of patient care type over 3 years, outpatients were the majority, while the number of visits of outpatients and hospitalization has been increasing. 5) Comparison of average portion of oriental hospital type over 3 years revealed oriental clinics to be used most. The use of general hospitals was higher in western medicine treatment, while public health centers used oriental medicine more. 6) Regarding average oriental medical cost per patient over 3 years, the total was 88,000 won, with 353,000 won for hospitalization and 85,000 won for outpatients. The outpatient cost has been increasing. 7) In line with 6, oriental medical hospitals cost 126,000 won, local clinics were 85,000 won, and etc. was 95,000 won. Average costs of all types have increased during 3 years, except oriental medical hospitals in 2013. Conclusions: This study provided objective information about the epidemiologic characteristic of oriental medicine used for treatment of sleep disorder. For expansion of oriental medical demand for sleep disorder, this study would be helpful in understanding the recent status.

• Journal of Nutrition and Health
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• v.54 no.5
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• pp.515-533
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• 2021

Purpose: A systematic review and meta-analysis of nutrition educational intervention studies was performed to assess the association between nutrition education intervention and fruit & vegetable (F&V) preferences and nutrition knowledge in preschool children. Methods: The relevant studies of nutrition education intervention and F&V preferences and nutrition knowledge published from January 2000 to June 2020 were located using PubMed, Web of Science, Cochrane Library, Research Information Sharing Service, Korean Studies Information Service System databases, and lists of references. A random-effects meta-analysis was conducted to estimate the standardized mean difference with a 95% confidence interval (CI). Subgroup analyses were performed to identify the association between nutrition education and F&V preferences and nutrition knowledge. Results: The results show that the effect sizes (ES) of F&V preferences and nutrition knowledge of preschool children were 0.31(95% CI, 0.23, 0.39), and 1.69(95% CI, 1.27, 2.12), respectively. The result of subgroup analysis, nutrition education focused on F&V (F&V preferences, ES: 0.32; nutrition knowledge, ES: 2.09) presented a slightly larger effect than general nutrition education (F&V preferences, ES: 0.26; nutrition knowledge, ES: 1.62). As for the type of exposure to F&V, direct exposure education (F&V preferences, ES: 0.40) had a greater effect than indirect exposure (F&V preferences, ES: 0.26). This meta-analysis showed that nutrition education intervention had positive effects on the F&V preferences and nutrition knowledge in preschool children. Conclusion: In conclusion, from the meta-analysis and subsequent subgroup analysis, we found that varied types of nutrition education intervention had varying effects on F&V preferences and nutrition knowledge in preschool children.

• Journal of Christian Education in Korea
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• v.72
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• pp.183-203
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• 2022

The purpose of this study is to construct factors of AI education utilization competency. AI education utilization competency is used as basic data for education to enhance the AI education competency of pre-service early childhood teachers. To this end, 7 studies related to competency factors and models were selected by searching for previous studies. Seven preceding studies were analyzed. As a result, 18 competency factors were extracted, including understanding of artificial intelligence. The extracted competency elements were divided into six areas, which are divided into understanding subject knowledge through coding, class preparation, class management, class result feedback, class guidance, and self-development. And 15 factors were constructed. The draft formed through coding was improved through review by three early childhood education experts. Factors improved through expert review were structured by classifying them into knowledge, skills, and attitudes to organize the curriculum. The validity of the structured competency factor was verified through expert Delphi. As a result of the Delphi verification, all factors were converged in the first survey. Through this, 6 competency areas, 11 competency factors, and 19 competency factors were composed of knowledge, 10 skills, and 5 attitudes. The implication is that the competency factors presented as a result of this study can be used as basic data for organizing a curriculum to improve the ability of pre-service early childhood teachers to use artificial intelligence education.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Journal of Service Research and Studies
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• v.13 no.2
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• pp.62-81
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• 2023

The purpose of this study is to propose policies to improve and revitalize rural bus services in Jeollabuk-do in the future by identifying the factors that affect service satisfaction and policy satisfaction and the relationship between them, targeting rural bus users in 4 cities and counties in Jeollabuk-do. In the four cities and counties in the study area, the number of rural bus users is continuously decreasing, and various transportation policies, such as unification of bus fares and demand-response transportation, are being piloted to promote bus use. In this study, three major service quality factors that affect rural bus service satisfaction and policy satisfaction were derived after a literature review. Modifying the research model presented in previous studies, we have presented a research model to verify the relationship between the three factors affecting service satisfaction and policy satisfaction, and the relationship between service satisfaction and policy satisfaction. For the verification of the research model, a total of 520 survey data collected from passengers near bus stops and bus terminals in four cities and counties, Gochang, Gimje, Buan, and Jeongeup, were used. As a result of the verification, it was found that the three factors of economic feasibility, convenience, and safety had a statistically positive (+) effect on service satisfaction, but only convenience and safety had a positive (+) effect on policy satisfaction. Contrary to the research hypothesis, it was found that there was no statistically significant relationship between service satisfaction and policy satisfaction. Although the result is different from the research hypothesis, it was a meaningful result that can make policy suggestions on the improvement of the unified fare system policy, service satisfaction, and policy satisfaction to Jeollabuk-do rural bus transportation policy makers and working-level officers. In conclusion, based on the results of research analysis, the unified fare system, and transportation policy, measures to improve service satisfaction and policy satisfaction were presented.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.3
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• pp.31-46
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• 2013

Objective : To find a collaboration strategy between western medicine and traditional Korean medicine (KM), this study aims to figure out the changes in the perception and attitude of medical doctors toward KM through systematic review. Method : Systematic literature searches were performed on six Korean databases. Studies were categorized according to the respondents and question items and analyzed by the context of questions, similarity of respondents and measurement scale. And we analyzed the changes of response regarding to medical doctors' and medical students' perspective and attitude to KM. Results : Eighteen survey studies including attitude of medical doctors and medical students toward KM were selected, which were conducted from 1993 to 2011. Although the attitude toward KM did not show any positive change, medical doctors have had more interest in acupuncture than herbal medicine and appreciated KM's treatment effect for musculoskeletal disease. In spite of little KM education experience, they had intentions for acupuncture education at least. Many medical doctors have listed the unscientific aspect as a major reason why they cannot trust KM. Medical doctors working for cooperative practice showed more positive attitude than other medical doctors and medical students had more positive attitude in general than medical doctors Conclusion : Though the growth of KM service and cooperative practice since 1990s, medical doctors' attitude toward KM seems to become more negative. To improve their attitude, making scientific evidences for KM is required as well as giving more education and treatment experience.