• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.315-329
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• 1999

Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

• 보일러설비
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• s.224
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• pp.99-107
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• 2012

• 보일러설비
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• s.228
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• pp.108-113
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• 2013

• Journal of Korea Water Resources Association
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• v.40 no.4
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• pp.299-311
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• 2007

Climatic abnormal phenomena involving El Nino and La Nina have been frequently reported in recent decades. The interannual climate variability represented by El Nino-Southern Oscillation (ENSO) is sometimes investigated to account for the climatic abnormal phenomena around the world. Although many hydroclimatologists have studied the impact of ENSO on regional precipitation and streamflow, however, there are still many difficulties in finding the dominant causal relationship between them. This relationship is very useful in making hydrological forecasting models for water resources management. In this study, the seasonal relationships between ENSO and hydrologic variables were investigated in Korea. As an ENSO indicator, Southern Oscillation Index (SOI) was used. Monthly precipitation, monthly mean temperature, and monthly dam inflow data were used after being transformed to the standardized normal index. Seasonal relationships between ENSO and hydrologic variables were investigated based on the exceedance probability and distribution of hydrologic variables conditioned on the ENSO episode. The results from the analysis of this study showed that the warm ENSO episode affects increases in precipitation and temperature, and the cold ENSO episode is related with decreases in precipitation and temperature in Korea. However, in some regions, the local relationships do not correspond with the general seasonal relationship.

• Journal of Preventive Medicine and Public Health
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• v.28 no.1 s.49
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• pp.207-223
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• 1995

A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospitals could not get any insurance benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992) from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it showed statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary care hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode. and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary care hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.

• 보일러설비
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• s.230
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• pp.146-146
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• 2013

• 보일러설비
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• s.230
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• pp.147-152
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• 2013

• 보일러설비
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• s.258
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• pp.137-147
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• 2015

• 보일러설비
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• s.242
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• pp.138-139
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• 2014

• 보일러설비
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• s.242
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• pp.140-141
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• 2014