• 보건행정학회지
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• 제19권4호
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• pp.66-77
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• 2009

This study aims to examine the effect of socioeconomic status (hereafter, SES) on healthcare utilization of the patients with rare and incurable diseases. Information of 2,973 patients who were self-employed insured and utilized healthcare service in 2007 was drawn from the National Health Insurance (hereafter, NHI) claim data. SES was set as four groups based on the monthly contribution. Outcome variable was the expense for outpatient and in-hospital services, which was log-transformed and square-rooted in oder to obtain normal distribution. Covariates included age, gender, residence and diagnosis. To examine the effects after controlling for covariates, we employed generalized estimating equation model, since patients with the same diagnosis are likely to have similar characteristics of demographics and healthcare utilization. Univariate statistics showed that lower SES was associated with less utilization of healthcare services. After controlling for covariates, a significantly smaller amount of money was expended for the lowest SES group compared to the highest one. Rural residence was associated with less utilization, except that residents in Seoul significantly more utilized outpatient services in tertiary hospitals. Considering that there is a subsidy program for the low income patients, such differences in healthcare utilization according to SES seems to result from the burden of out-of-pocket payments for uncovered services of the NHI.

• 한국농촌간호학회지
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• 제12권2호
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• pp.29-44
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• 2017

Purpose: The purpose of this study was to identify community health practitioners' (CHP) perception of barriers to research utilization, current status and competence in evidence-based practice (EBP). Methods: From all over the country, 126 CHP completed an e-mail survey. Results: The items with the highest barrier scores were that it is difficult to understand articles written in English and physicians will not cooperate with implementation. There were statistically significant differences in the scores for attitude toward EBP and knowledge in EBP by education level and nursing academic society membership status. When faced with a problem, the nurses usually use related regulations or asked a colleague for advice. Conclusion: Results indicate an awareness of the necessity of applying EBP, need to improve readiness to use EBP voluntarily and actively, and need to search for various factors that are barriers to research utilization. There is a need to develop and apply EBP training/education programs to find new evidence that might actually support previous practice for which nurses lack confidence. Guidelines that consider CHP task characteristics and barrier factors to research utilization should be developed.

• 환경영향평가
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• 제22권3호
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• pp.265-276
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• 2013

This study assessed documentation status of each environmental assessment items by analyzing the 243 case of marine EIS on the Consultation System of Sea Area Utilization. Observed rate of tidal elevation, current, temperature, salinity in maine environment were below 20%. The EFDC tool is applied substantially in hydrodynamic modeling. The verification process, however, is very insufficient using the recent observed data. Also, in-situ assessment rate of pelagic organism such as phytoplankton was below 50%, and assessment for Chlorophyll a was not accomplished. Ecological index evaluation for zooplankton and benthic ecosystem were not considered in statements. Especially, the rational assessment on the fisheries resources and protected species were very limited. It was necessary that the core assessment items (checklists) were established for environmental scoping. Furthermore, suggestion of information related to development, regional coastal management plan, aquaculture farms, and facilities were enhanced. The redundancy problem of proceedings between Environmental Impact Assessment and Sea Area Utilization Assessment System was improved.

• 지역사회간호학회지
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• 제12권3호
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• pp.582-588
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• 2001

Purpose : This study is to examine the characteristics of the elderly and their family caregivers. to study the main factors affecting Nursing Home utilization, and to help frame a policy about Nursing Home's demand. management and welfare facilities. Method: Data for this present study were collected via questionnaires randomly distributed to family caregivers of the over 60-year-old patients at general hospital and university hospital in Seoul. Kyung-Ki Do and In-Chon from 26 June to 20 July, 2000. Questionnaires were issued to 512 people and 479 were returned. The data was analyzed by frequency, $x^2$-test, t-test, ANOVA. factor analysis. correlation coefficients analysis and Stepwise multiple regression analysis using SPSS 9.0. Result First. Instrumental Activities of Daily Living(IADL), duration of hospitalization, sex, marital status, behavior problems, home ownership, and cognitive disorder about elderly patients affect family caregivers burden. one of need factors. Secondly, marital status. religion. health status, sex, education and age in the family caregiver predisposing factors are main factors on Nursing Home utilization. Third, in need factors, care burden. time burden, family relation burden, physical burden and mental burden have an effect on Nursing Home utilization. Finally, the model the most important factors that affect Nursing Home utilization is composed of six of eleven totally, care burden, religion, time burden, health status, marital status and education. When the family caregivers get care burden and time burden. are highly educated, have no religion, have health problems, and have no spouse, it is possibility for them to utilize Nursing Homes. Conclusion: The government should decrease a family caregivers burden and seek to find how to support Nursing Homes. Furthermore. Social support program for the family caregivers should be required. Thus, the family caregivers need consultation and need to meet to talk about their patients. how to care them, get information, which are the crucial field in advancing the research in nursing science.

• 보건행정학회지
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• 제29권4호
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• pp.513-522
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• 2019

Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

• 사회복지연구
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• 제41권2호
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• pp.35-65
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• 2010

본 연구는 최근에 이루어진 '건강보험 보장성 확대' 정책의 효과를 개인의 의료이용 및 건강수준을 중심으로 평가하였다. 2005년부터 시행된 건강보험 보장성 확대 정책은 암 등의 중증질환자에 대한 본인부담 경감, 입원환자 식대의 급여전환, 비급여항목의 급여전환, 본인부담상한제 시행 등을 주요 내용으로 한다. 이러한 정책 변화에 대해 만성질환을 보유하고 있어 의료욕구가 일반적으로 높은 제도의 주요 수혜집단에 비해 급성질환 등으로 의료서비스를 이용한 집단의 입원이용이 상대적으로 증가한 것과 제도의 직접적인 수혜집단인 중증질환자 집단의 입원이용이 상당 정도 증가한 것을 확인하였다. 또한 이러한 건강보험제도의 변화가 입원이용에서 혜택을 누린 중증질환자의 단기간의 건강평가지표인 2주간 이환경험 면에서 긍정적인 개선을 이끌어내고 있음을 확인하였다. 본 연구는 건강보험제도가 의료이용 및 건강수준에 인과적인 효과를 나타내고 있음을 확인하였고, 이후 건강보험 보장성 확대의 정책설계에 대한 정책적 함의를 제공한다.

• 한국치위생학회지
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• 제15권5호
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• pp.823-829
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• 2015

Objectives: The objective of the study was to investigate the related factors of non-utilization of dental care among Korean adults. Methods: Korean National Health and Nutrition Survey 2012 was carried out in South Korea. A total of 5,589 adults were interviewed and examined. A multinominal logistic regression model was used to estimate the odds ratio with 95% confidence intervals for the non-utilization of dental care. Results: The non-utilization of dental care was shown to have a badly perceived oral health status, less toothbrushing before sleeping(OR=1.18: 95% CI=1.00-1.39), periodontitis symptoms (OR=1.82: 95% CI=1.50-2.22), toothache experience (OR=2.03: 95% CI=1.75-2.34), TMJ symptom experience (OR=3.31: 95% CI=2.74-3.99), speaking problem (OR=1.87: 95% CI=1.75-2.34) and a partial dentures needs (OR=2.49: 95% CI=1.93-3.19). Conclusions: The non-utilization of dental care tended to have badly perceived oral health status, less toothbrushing before sleeping, periodontitis, toothache experience, TMJ symptom experience, speaking problem, and partial dentures needs.

• 보건행정학회지
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• 제26권3호
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• pp.207-218
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• 2016

Background: This study was performed to identify factors associated with the utilization of tests for diabetes complication and hemoglobin A1c (HbA1c) among diabetes patients in Jeollanam-do, Korea. Methods: The study subjects were 2,310 diabetes patients participated in 2014 community health survey in Jeollanam-do, Korea. Dependent variables were the utilizations of fundus examination, microalbuminuria test, and HbA1c test. The used statistical analysis methods were chi-square test and hierarchical regression analysis with weight in consideration of complex sample design. Results: The utilization rates of fundus examination, microalbuminuria test, and HbA1c test were 25.8%, 27.4%, and 12.3%, respectively. In the results of hierarchical regression, fundus examination was significantly related to age, education level in predisposing factors, residential area in enabling factors and recognition of blood sugar, drug therapy, and subjective health status in need factors. Microalbuminuria examination was significantly related to monthly income, residential area in predisposing and health screening, recognition of blood sugar, drug therapy, diabetic education, number of chronic disease, and subjective health status in need factors. HbA1c examination was significantly related to age, education level, marital status in predisposing factors, residential area in enabling factors and drinking, recognition of blood sugar, drug therapy, and diabetic education in need factors. Conclusion: The results of this study were shown that perception of their disease seriousness, education about diabetes management, and accessibility of tests were important to utilization of test for diabetes complication and HbA1c. It might be necessary to the develop and strength strategies for enhancing the utilization of tests for diabetes complication and management in diabetes patients.

• 교육시설 논문지
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• 제20권6호
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• pp.31-40
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• 2013

The purpose of this study is to understand the meaning of architectural history of designated cultural properties of modern educational facilities through the analysis of its status. This study considerate acceptance and evolution of modern educational facilities during the about seventy years from 1895 to 1965. Also, this study analyzes items that is distribution of construction and designation year, regional groups, and status of main structure material, status of conservation and utilization of facilities, its characteristics of architectural style. In this study, the result of analysis show that most analysis items of investment buildings are tend to biased and concentration to one direction. Accordingly, designated cultural properties of modern educational facilities are weakly express architectural representation and symbolism in the period of modern educational acceptance.

• 한국콘텐츠학회논문지
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• 제17권5호
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• pp.479-490
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• 2017

본 연구는 주관적 건강수준에 따른 독거노인의 사회적 관계망이 의료기관 이용에 미치는 영향을 파악하고, 노인복지서비스 참여의 조절효과를 확인하고자 하였다. 이를 위해 한국보건사회연구원의 노인실태조사자료(2014) 중 독거노인 2,344명을 연구대상으로 선정하였고, 기술통계, 카이제곱 검정 및 포아송 회귀분석을 실시하였다. 연구결과, 독거노인들의 사회적 관계망 확대 및 노인복지서비스 참여는 주관적 건강수준이 나쁜 독거노인들의 의료기관 이용에 영향을 주는 것으로 확인되었다. 주관적 건강수준이 나쁜 독거노인들의 경우, 가족과의 왕래 및 평생교육 참여로 인해 의료기관 이용횟수가 감소하였으며, 이웃과의 왕래가 증가하거나 노인일자리사업을 신청할 경우 의료기관 이용이 증가하는 결과를 보였다. 또한 노인복지서비스 참여의 조절효과를 확인한 결과, 친목시설 및 단체에 참여한 독거노인들의 사회적 관계망이 확대 될수록 의료기관 이용횟수가 증가하는 것을 확인할 수 있었다. 본 연구는 이러한 결과에 근거하여 독거노인들의 사회적 관계망을 대체할 수 있는 노인복지서비스 확대를 제시하고, 의료이용 실태 파악을 통하여 실질적인 건강유지증진 및 예방을 지원할 수 있는 정책적 방향성을 모색했다는 점에서 의의가 있겠다.