• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.167-174
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• 2018

Objectives: The aim of this study was to analyze the accessibility of dental care services among individuals with precarious employment in South Korea. Methods: We used the $9^{th}$ wave of the Korean Health Panel data (2015) and included 7,736 wage and non-wage earners in our study. We determined precariousness in the labor market as a combination of employment relationship and job income, and categorized individuals based on this into the following four groups: Group A comprising those who report job and income security, Group B comprising those who experience job insecurity alone, Group C comprising those who report a stable job but low income, and Group D comprising those who experience both job and income insecurity. Accessibility to dental care services was determined by experience of unmet dental care needs and unmet dental care needs caused primarily by financial burden. Logistic regression analyses were used to assess the effect of precarious work on access to dental care services. Results: Individuals with job insecurity (Group B; OR=1.445; 95% CI=1.22-1.70) and both job and income insecurity (Group D; OR=1.899; 95% CI=1.61-2.24) were more likely to have unmet needs than the comparison group. Both groups B and D were also 2.048 (95% CI=1.57-2.66) times and 4.435 (95% CI =3.46-5.68) times more likely, respectively, to have unmet dental care needs caused by financial burden. Education status, health insurance, and health status were all also effective factors influencing unmet dental care needs. Conclusions: Unstable employment and low income resulted in diminished access to dental care services. Therefore, governments should consider health policy solutions to reduce barriers preventing individuals with employment and income instability from accessing adequate dental care.

• 한국노년학
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• 제37권3호
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• pp.527-547
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• 2017

본 연구의 목적은 독거노인의 부정적 정서인 우울, 죽음불안과 함께 사회적 지지가 독거노인들이 스스로 회복할 수 있는 탄력성의 매개경로를 통해서 심리적 안녕감에 어떠한 경로의 영향력을 미치는지를 알아보기 위한 것이다. 이를 위하여 대전광역시와 충청남도에 거주중인 65세 이상의 독거노인 988명을 대상으로 설문을 실시한 후, 구조방정식모형으로 분석하였다. 분석결과 첫째, 인구학적 특성에 따른 측정변수 간 차이에서 우울은 성별, 학력, 건강상태, 경제상태에서, 죽음불안은 성별과 학력에서, 사회적 지지는 성, 연령, 학력, 지역, 건강상태와 경제상태에서, 탄력성에서는 성, 연령, 학력, 건강상태, 경제상태에서, 심리적 안녕감은 성, 학력, 건강상태, 경제상태에서 유의미한 차이를 보였다. 둘째, 독거노인의 우울과 죽음불안 및 사회적 지지 변수가 심리적 안녕감에 미치는 경로와 영향력에서 우울은 부적으로, 사회적 지지는 정적으로 직접적인 경로의 영향력이 유의하게 미치고 있으며, 죽음불안은 직접적인 영향력이 유의하게 미치지 않다는 것으로 나타났다. 셋째, 독거노인의 우울과 죽음불안 및 사회적 지지 변수가 매개변수인 탄력성에 미치는 경로와 영향력에서 우울은 부적인 관계, 사회적 지지는 정적인 관계에서 직접적인 경로의 영향력이 유의하게 미치는 것으로 나타났다. 넷째, 독거노인의 매개변수인 탄력성은 심리적 안녕감에 정적으로 유의한 영향력이 미치고 있었다. 또한 탄력성의 매개기능을 통해서 부정적 요인을 감소시키고, 긍정적 요인은 증진시켜서 심리적 안녕감을 증진시키는 것으로 나타났다. 본 연구는 독거노인의 심리적 안녕감에 영향을 미치는 변인들의 관계를 파악하는 기초자료를 제공하고 독거노인을 위한 정서지원 정책을 마련하는 근거자료로 활용될 수 있을 것이다.

• 대한가정학회지
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• 제43권8호
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• pp.55-68
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• 2005

The purpose of this study is to examine the effects of negative life events on mental health and to explore possible main and moderating effects of spousal support on mental health with a focus on gender differences. The data for this study were taken from a nationwide random sample of 1,504 married men and women ranging in age from 30 to 59 through structured questionnaires. The data were analyzed using the SPSS WIN program which was used to calculate frequency, mean, 1-test, multiple regressions. The main results were as follows: First, by examining mental health of Korean men and women, women were more likely than men to experience higher levels of depression. Second, there was no gender difference in the sum of experience of negative life events, therefore the date of this study did not support the differential exposure hypothesis. In addition, men perceived more support from their spouses than women. Third, results show that especially the event concerning with job/financial problems has negative impacts on mental health of both men and women, and vulnerability to undesirable life events was not found. Fourth, spousal support is associated with better mental health regardless of gender, and it reduces the harmful effects of life events concerning with job/financial area for both men and women. Also, spousal support reduces the magnitude of the harmful effects of life events concerning with health of men. This study focused on the impact of negative life events and the couple process. It was possible to explore the strength of social support provided from spouse of most importance to the individuals. These results affirm the importance of supportive relationships between couples as a buffer, mitigating harmful effects of negative life events on mental health.

• 한국농촌간호학회지
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• 제3권1호
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• pp.34-43
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• 2008

Purpose: The purpose of this study was to suggest new direction for domiciliary care for elders provided by public institutions in rural areas. Method: The participants in the study were elders using one of 11 public health care institutions, of which 8 operated day care services exclusively, and 3 operated both day care and short-term respite care services. A survey was conducted using a structured questionnaire that included items on general characteristics of the service users, conditions of the services, personnel, financial status, facilities, and perception of the tasks of the staff. Result: The service content of the day care centers included Western and Chinese medical service, physical services, activities of ADL, nursing care services, meal services and transportation services. Domiciliary care centers provided a wide variety of health and social welfare service for elders. Personnel consisted of 3 to 8 staff for day care centers and 7 to 10 for domiciliary care centers. Both types of centers rely on financial support from local government for operation. The perception of the staff was the need for operation of these centers by public health facilities such as public health centers and sub-centers. Conclusion: The result suggest a need to activate the function of public institutions to provide domiciliary care for elders. For this new change, the role as a social support system must be developed.

• 보건행정학회지
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• 제28권4호
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• pp.352-359
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• 2018

Background: The purpose of this study is to propose an analysis of trends and characteristics of high-cost patients who take over 40% of total national health insurance medical expenses. Methods: It has been analyzed the tendency of high-cost patients by open data based on the medical history information of 1 million people among national health insurance subscriber from 2002 to 2015. To conduct detailed study of characteristics of high-cost patients, multiple regression has been performed by sex, age, residence, main provider, and admission status based on the top 5% group. Results: The amount of medical expenses and the number of high-cost patients have gradually increased in decades. The number of high-cost patients for Korean won (KRW) 5,000,000 category has increased by 7.6 times, KRW 10,000,000 category has increased by 14.1 times in comparing of year 2002 and 2015. Top 5% medical expenses have increased by 4.6 times. In consideration of the characteristics of patients, the incidence of high medical expenses has been higher in female patients than male ones, the older patients than in the younger. Patients residence in Gyeonsang or Jeonla province have had a high incidence of medical expenses than other area. The disease including dementia, cerebral infarction, and cerebrovascular disease for high-cost patients has been also increased. Conclusion: The major increase factor for high medical expenses is the aging of population. The elderly population receiving inpatient care residing in the province that increases high medical costs have to management. There is an urgent need to develop a mechanism for predicting and managing the cost of high-cost medical expenses for patients who have a heavy financial burden.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.145-151
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• 2018

Objectives: The purpose of this study was to interpret regional disparities in the number of teeth sealed with pit and fissure sealants, identify the factors that affect these disparities and find solutions for the same. Methods: Data were collected from the National Health Insurance Service and Korean statistical information service using metropolis-city-rural area dental health infrastructure variables, regional health behavior variables, and local finance-related variables. Results: In 2015, the number of teeth sealed with pit and fissure sealants per 100 people was higher in the metropolis or city than in the rural area. There was a positive correlation between the number of teeth sealed with pit and fissure sealants and the number of dentists, dental hygienists, dental institutions, standardization rate of subjective awareness of well-being, standardization rate of brushing after lunch, and the proportion of welfare budget in the general budget. There was a negative correlation with the annual standardization rate of health institution use, the standardization rate of unused medical services, and the local government's financial independence. According to the final model of the multiple regression analysis, while the impact of infrastructure on dentistry was not statistically significant, the statistical significance of standardization rate of brushing after lunch, the local government's financial independence, and the proportion of welfare budget in the general budget were maintained. Conclusions: To reduce regional disparities in the volume of use of pit and fissure sealants, it was concluded that it may be effective to select regions with a consideration of the level of regional economic power, implement separate and appropriate policies and projects, and improve the awareness in residents.

• 한국병원경영학회지
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• 제8권1호
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• pp.64-80
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• 2003

The separation policy of prescription and drug dispensing which has been implemented since the 1st of July, 2000, has brought about great changes in patients flow within the healthcare delivery system. The changes in the patients flow, in turn, resulted in the change in the distribution of financial resources among the participating entities in the healthcare delivery system: pharmacies, clinics, small hospitals, general hospitals, and teaching hospitals. The purpose of this study is to shed some light in the change in the financial performance of teaching hospitals under the separation policy that has created environmental changes such as the decrease in the number of out patients visits, the increase in the capital expenditures, the rapid increase in labor costs and so on. For the purpose, this study has compared and analyzed the balance sheets, the income statements and other operational data of three teaching hospitals located in D area. The data include two periods: before(year 1999) and after(year 2001) the implementation of the separation policy. The analysis was conducted with an emphasis on the changes in the financial ratios such as liquidity, turnover ratio, performance ratio. and capitalization ratio. The results show that the financial performances of the hospitals under study were weaker than before the implementation of the separation policy, and that, while the operating expenses have increased remarkably, there was no tendency to corresponding increase in revenue. And the result of analysis of other operational indicators also show that the performance of the hospitals is getting worse. Based on the results, this study has suggested the directions of the healthcare policies. This study suggests to improve the current model of separation of prescription and drug dispensing, to grant subsidies for the training of residents in teaching hospitals, and to lower the rate of patients' out of porket payment in teaching hospitals.

• 한국사회복지학
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• 제57권3호
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• pp.415-435
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• 2005

본 연구는 '계획된 행동이론'과 '계층적 성격모델'을 이론적 근거로, 65세 이상 고령자의 '은퇴에 대한 재정적 준비행동'을 결정하는 개념적 구조를 고찰하였다. '충주지역 고령인구의 보건 복지실태'의 원자료를 이용하여 65세 이상 노인 253명의 자료를 분석하였다. 구조방정식모형을 이용한 분석결과, '은퇴준비를 위한 재정적 지식'과 '은퇴에 대한 재정적 준비행동' 사이의 인과관계만이 유의미한 것으로 나타났으며 가정된 구조방정식모형의 모형합치도는 매우 높은 것으로 분석되었다. 본 연구의 결과는 성격의 표면적 특성이 행동에 영향을 미친다는 계층적 성격이론과 지식은 행동의도가 실질적 행동으로 표면화되는데 결정적 변인이라는 계획된 행동이론의 논지를 실증하였다. 끝으로, 은퇴에 대한 재정적 준비를 위한 사회적 프로그램의 필요성 등 본 연구가 제안하는 사회복지의 실천적 함의가 논의되었다.

• 보건행정학회지
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• 제13권2호
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• pp.101-124
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• 2003

Performance of public hospitals is difficult to define and measure because not only their managerial or financial performance but also their role as a public entity is important. The purpose of this paper is to examine the internal and external factors that influence the performance of local government hospitals. A multiple regression was performed to analyze the effects of the environmental, organizational, operational, and cost-related factors on the return on total assets(ROA), operating margin(OM), and the ratio of Medicaid patients. Empirical results show that financial performance (ROA and OM) are more influenced by operational or cost-related factors, while the ratio of Medicaid patients is more affected by environmental or organizational characteristics. It is noteworthy that competition and the contract with private sector management have negative effects on the ratio of Medicaid patients that local government hospitals treat.

• 한국생활과학회지
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• 제16권3호
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• pp.465-477
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• 2007

The purpose of this study was to investigate factors affecting leisure activities participation in the elderly. The factors considered were leisure opportunities, leisure motivation, leisure satisfaction and some background variables. Subjects were 291 elderly persons who completed the questionnaire assessing the variables in the study. The results of this study were as follows: 1) Leisure activities participation of the elderly was affected by leisure opportunities, leisure motivation, leisure satisfaction, gender, and education. 2) Leisure satisfaction influenced by leisure opportunities, motivation, health, and financial condition. 3) Leisure opportunities and motivation had effects on leisure activities participation indirectly via leisure satisfaction. 4) Also, status of health and financial condition of the elderly had an indirect effect on leisure activities participation via leisure motivation.