• Title/Summary/Keyword: The Public medical facility

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Effect of Coverage Expansion Policy for an Ultrasonography in the Upper Abdomen on Its Utilization: A Difference-in-Difference Mixed-Effects Model Analysis (상복부초음파검사 급여확대에 따른 의료이용의 변화: 이중차이 혼합효과모형 추정방법을 이용하여)

  • Son, Yena;Lee, Yongjae;Nam, Chung-Mo;Kim, Gyu Ri;Chung, Woojin
    • 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.

A Study on the Fee-Based Model Development of Day Care Centers for the Elderly (유료 노인 낮보호 시설 모형개발에 관한 연구)

  • Chung, Shin-Sook;Chung, Yeon-Kang
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.5-18
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    • 1999
  • The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

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A Survey on Status of Pregnancy and Delivery at a Rural Village, Nepal(Dolakha Bazar Area) (네팔 돌카지역의 임신분만 환경)

  • Ahn, Young-Woo;Kang, Yune-Sik;Kam, Sin;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.721-732
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    • 1996
  • This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year$(1994.4.13\sim1995.4.12)$ at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows ; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8 % of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.

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Status and prospects of Knowledge Information Security Industry (지식정보보안 산업의 현황과 전망)

  • Choi, Jeong-Il;Chang, Ye-Jin;Lee, Ok-Dong
    • Korean Security Journal
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    • no.39
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    • pp.269-294
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    • 2014
  • Korea is concerned with information security industry due to recent leak-out private information of 3 card companies. Executives are aware of damage from breach of security such as personal data spill, is more dangerous than any other financial risks. The information security industry, which was limited in physical security and network security formerly, is evolving into convergence security of public and facility security industry. The field of interest has also been changed into security of smart phone and intelligence image recently, from firewall or Anti-virus. The convergence security is originally about access control of facility, but recently its demand has been increased mostly by public institutions and major companies. The scope of the industry also varies from finance, education, distribution, national defense, medical care to automobile industry. The market of convergence security has been expanded and new various products and services of security of intelligent vehicle, 'U' healthcare, finance, smart grid and key industries are also developed. It is required to create and enhance of new curriculum and cultivate human resources for the development of knowledge information security industry. Raising standard of education and security consciousness of the nation is also necessary to strengthen the global competitiveness.

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A Study of Follow-up Test' and Related Factors in Students Who have Positive Result in Urine Tests (학생뇨검사 유소견자의 추후검사율 및 관련 요인)

  • Kim, Dong Sik;Park, Jae Yong;Kam, Sin;Cha, Byung Jun
    • Journal of the Korean Society of School Health
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    • v.10 no.2
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    • pp.157-167
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    • 1997
  • This study was conducted to investigate follow up tests and related factors in students who tested positive for in urine tests. For the purpose of this study, the authors analysed a self-administered questionnaire collected from 316 middle school students and 451 high school students who had positive urinalysis results in Kyungpook province during the month of February, 1996. The major findings of this study were as follows : The proportion of follow up tests among students was 39.2% in middle school students and 34.1% in high school students. There was a significant relation among a number of factors : parents' environment, health concern, and knowledge of urinalysis results, existence of nursing teachers, education concerning urinalysis, medical facility visits, and notification methods. In a multiple logistic regression analysis a higher economic level, parents' concern, knowledge of urinalysis results, medical facility visits, anti direct notification of parents were all significantly related with the follow up tests. On consideration of the above findings, in order to perform practical and effective follow-up management of students who have a positive result in urine test, direct notification of urine test result to parents as well as active health guidance in school are required.

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Reconstruction of Radiation Dose Received by Diagnostic Radiologic Technologists in Korea

  • Choi, Yeongchull;Kim, Jaeyoung;Lee, Jung Jeung;Jun, Jae Kwan;Lee, Won Jin
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.5
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    • pp.288-300
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    • 2016
  • Objectives: Diagnostic medical radiation workers in Korea have been officially monitored for their occupational radiation doses since 1996. The purpose of this study was to design models for reconstructing unknown individual radiation doses to which diagnostic radiation technologists were exposed before 1996. Methods: Radiation dose reconstruction models were developed by using cross-sectional survey data and the personal badge doses of 8167 radiologic technologists. The models included calendar year and age as predictors, and the participants were grouped into six categories according to their sex and facility type. The annual doses between 1971 and 1995 for those who were employed before 1996 were estimated using these models. Results: The calendar year and age were inversely related to the estimated radiation doses in the models of all six groups. The annual median estimated doses decreased from 9.45 mSv in 1971 to 1.26 mSv in 1995, and the associated dose variation also decreased with time. The estimated median badge doses from 1996 (1.22 mSv) to 2011 (0.30 mSv) were similar to the measured doses (1.68 mSv to 0.21 mSv) for the same years. Similar results were observed for all six groups. Conclusions: The reconstruction models developed in this study may be useful for estimating historical occupational radiation doses received by medical radiologic technologists in Korea.

A Case Study on the Local-based Welfare Facilities of Urban Renaissance Agency in Japan by Business Entry System for Stable Living (일본 UR도시기구의 안심주공간사업자참여제도를 통한 지역복지거점시설 정비사례 연구)

  • Yoo, Soon-Seon
    • Journal of the Korean housing association
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    • v.24 no.5
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    • pp.9-16
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    • 2013
  • The purpose of this study is to analyze local-based social welfare facilities to respond to secular change of the UR rental housing estates in Japan. The selected case studies for the analysis are Hibarigaoka, Hamakousien, Turumai UR rental housing estates constructed around 1960's. The analysis was done through UR website, MLIT (Ministry of Land, Infrastructure, Transport and Tourism) and MHLW (Ministry of Health, Labour and Welfare) policy report, and related literature. These case studies are connected with housing policy as well as welfare policy and performed to Stable Living Creation Project by Business Entry System for Stable Living. The types of local-based social welfare facilities are classified by welfare corporation and medical corporation. The results are as follows: 1) The implementation of cooperative and participative system not only the private sector (welfare and medical Corporation, etc.) but also the public (MLIT, MHLW, UR Renaissance Agency, Local government, etc.). 2) Repurposed of land through rent and transfer of land for local-based social welfare facilities in the process of housing stock renewal utilization. 3) The pursue of regional revitalization through attached to multi-generation facility or local community space for elderly in local-based social welfare facilities.

Types of Breastfeeding and its Predictors of Mothers in Twenty-four Months after Birth (산후 24개월 이내 어머니의 수유형태와 예측요인)

  • Kim, Mi-Young;Kim, Sun-Hee;Lee, Ja-Hyung
    • Women's Health Nursing
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    • v.17 no.1
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    • pp.21-30
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    • 2011
  • Purpose: This study was done to investigate the types of breastfeeding visits by mothers twenty-four months after birth and to identify the factors that increased breast feeding rates. Methods: The subjects of this study totaled seven hundred and seventy-four mothers with infants aged 2 years or less who had visited national medical institutions including Sanhujori service facilities, breastfeeding care service facilities, and community health centers. Data was collected from June 22 to July 31, 2009. Data was analyzed using descriptive statistics, $x^2$ test, ANOVA with a post hoc Scheffe test, and multiple logistic regression. Results: Major findings of this study were significant differences of planned length of breastfeeding and breastfeeding self-efficacy in relation to the differing types of breast feeding community visits by mothers. In multivariate logistic regression, baby's age, exclusive breastfeeding at hospital, utilization of breastfeeding care service facility, planned length of breastfeeding, and breastfeeding self-efficacy were independent predictors of the feeding type. Conclusion: In order to increase breastfeeding rates, programs provided by public health care services and medical facilities should start education on breast feeding in the hospital before mothers are discharged and then continue through the use of Sanhujori service facilities and workplace at 3 month and 6 month postpartum.

The Medicare Service Facility Location Problem (의료서비스시설 입지문제)

  • 이금숙
    • Journal of the Economic Geographical Society of Korea
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    • v.1 no.2
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    • pp.71-84
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    • 1998
  • Health has been seen as a resource necessary for both maintaining oneself and for living in a society pursuing high quality of life. Therefore, the medicare provision takes place of one of the most significant indexes for evaluating the regional welfare level. The purpose of this study is to investigate the locational characteristics of medicare service facilities. For the purpose, the distribution patterns of the medicare resources are analyzed both at the regional and local scales. The medicare resources are concentrated at the Metropolitan Seoul area in the regional scale, and they are also concentrated at the economic core areas in the local scale. Especially, higher level medicare resources, such as the general hospitals and medical specialists, show more concentration at the economic core areas than lower level services. This means that access to opportunities to receive higher level medicare is poorer in a more socially disadvantaged area. Since medicare service facilities are invested and operated by both private and public sectors, whose locational mechanisms are deferent, we analyzed the distribution patterns. Most medicare facilities are invested and managed by private sector in Korea, which is operated by market mechanism. This is related with the fact that the medicare facilities are concentrated at the economic core areas. The proportion of private sector is higher in the Metropolitan Seoul area, and thus this region shows stronger spatial disparity of medicare provision. In general, the medicare service facilities are located in the hierarchical structure, and thus the services levels and facility scales are differentiated by the hierarchy. We examined the hierarchical structure in the medicare service facilities in Korea. The referral medicare system has been applied with the assumption of the three level hierarchical structures in Korea. However, we could not find any distinct hierarchical structure in the scales of the medical service facilities.

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Development of Models for Regional Cardiac Surgery Centers

  • Park, Choon Seon;Park, Nam Hee;Sim, Sung Bo;Yun, Sang Cheol;Ahn, Hye Mi;Kim, Myunghwa;Choi, Ji Suk;Kim, Myo Jeong;Kim, Hyunsu;Chee, Hyun Keun;Oh, Sanggi;Kang, Shinkwang;Lee, Sok-Goo;Shin, Jun Ho;Kim, Keonyeop;Lee, Kun Sei
    • Journal of Chest Surgery
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    • v.49 no.sup1
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    • pp.28-36
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    • 2016
  • Background: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. Methods: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts. Results: After partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the 'independent regional cardiac surgery center' model, the 'satellite cardiac surgery center within hospitals' model, and the 'extended cardiac surgery department within hospitals' model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually. Conclusion: The operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.