• Quality Improvement in Health Care
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• v.3 no.1
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• pp.104-124
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• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.3
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• pp.29-43
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• 2015

Objective : The purpose of this study was to identify characteristics of patients' self-perceived health in traditional Korean medical facilities. Method : This research was conducted based on the survey on patients whom have visited traditional Korean medical facilities in 2011 by the Ministry of Health and Welfares and Korean Institute for Health and Social Affairs. Using a sample of 3,931 (1,180 male and 2,751 female) outpatients' self-perceived health based on the data from usage and consumption of Korean Medicine. 'Healthy', 'Fair', and 'Poor Health' were used to measure patients' self-perceived health status. The data was analyzed by frequency, t-test, cross correlation analysis and multiple logistics regression analysis using the SPSS program package. Results : Sex(P<0.001), age(P<0.001), marital status(P<0.001), education(P<0.001), employment status(P<0.001), occupation(P<0.001), health insurance(P<0.001) and income level(P<0.0001) showed statistical significance. Main Treatment Facilities(P<0.001), experience of taking Korean medicine(P=0.032), experience of receiving acupuncture treatment(P<0.001), number of visits(P<0.001), medical expense (P=0.005), and subjective health status after the treatments showed statistical significance for Korean herbal medicine(P=0.038), acupuncture (P=0.001), cupping therapy(P=0.006), oriental physiotherapy(P=0.003), and treatment satisfaction(P<0.001). For subjective health status based on suffering disorders in the past three months, the response of poor health was higher in the group suffering recent illnesses. Statistical significance was seen in hypertension (P=0.002), arthritis(P<0.001), lumbar pain(P<0.001), diabetes mellitus(P=0.001), stroke(P<0.001), hwa-byung (P=0.001), gastric disorders(P=0.021), common cold(P<0.001), ankle sprain(P<0.001), muscular injury(P<0.001), lumbar sprain(p=0.009) and fracture(P=0.03). Also the number of diseases during the past three months showed statistical significance(P<0.001). Statistical significance was also seen in Level of knowledge(P<0.001), route of information(P<0.001), reliability of Korean medicine(P=0.003), insurance coverage(P=0.005), medical costs(P<0.001), and future willingness to use Korean medicine(P<0.001). As a result of the multiple logistics regression analysis, risks of subjective poor health statistically increased in female population, elderlies, medicaid beneficiaries, less educated, higher medical expense, and more disorders during the past three months. Conclusion : Patients' self-perceived health status has significant differences with each variables such as sex, age, marital status, education, health insurance, medical expense, number of diseases.

• Journal of agricultural medicine and community health
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• v.35 no.3
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• pp.239-248
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• 2010

Objective: Despite the increasing number of female participation in employment, blue-collar women have been exposed to higher health risk. This study is to describe the prevalence of chronic diseases, health behaviors, and medical service utilization of female blue-collar workers. Methods: Data were derived from the 2001 Korea National Health and Nutrition Survey (KNHANES). The sample was made up of 37,108 male and female participants aged 20 or over selected nation-wide by probability sampling from Korea. This study applied the logistic regression for nominal variables such as disease prevalence and health behaviors and with the regression for continuos variables such as the length and costs of medical services. Results: In general, women's prevalence of chronic illness and uncured rate were significantly higher than male, and especially female blue-collar workers had the highest prevalence, uncured rate, unhealthy status, and perceived stress. However, the medical care cost was the lowest in female blue-collar workers. Conclusions: The findings suggest that female blue-collar workers were more likely to experience health problems, and that despite the highest health risk, health service is not effectively utilized, and health policy maker should take consider of special status of female blue collar workers who are in health inequality.

• Journal of the Korean BIBLIA Society for library and Information Science
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• v.30 no.2
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• pp.117-144
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• 2019

Today, interest in health information has risen overall due to the aging society, increased public interest in the quality of life, and the increased state's interest in reducing medical costs. Accordingly, efforts have been made across the library and information science in terms of academic research, libraries in terms of providing health specialized services, and the state, yet policies and strategies for providing the health related information in an integrated and systematic manner through the libraries have not been proposed with clarity to date. Thus, this study aimed to propose a method to provide the health information in an integrated manner by the libraries through the previous studies, policy studies, and case studies. Consequently, it proposes to build a system to integrate the health information, build an overall database of the health related information, develop and operate a health specialized library program, operate a general support center for the health information service, and build a cooperative network among the related departments and institutions for the health information service. The details proposed by this study is likely to contribute to developing services for improving the health of the citizens of this country.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.16-30
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• 2004

Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.35-41
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• 2010

Objectives: In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. Methods: Subjects (n=2,211) selected were ${\geq}18$-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. Results: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(￦), inpatient payment of ￦359,000, and outpatient payment of ￦183,000. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (￦82,000), elementary school or lower educational level (￦64,000), residence in a small city (￦82,000), lack of family support (￦61,000), kidney disability (￦673,000), intellectual disability (￦151,000), and multiple disabilities (￦119,000). Conclusions: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.

• The Journal of the Korean dental association
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• v.51 no.5
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• pp.265-273
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• 2013

The insurance payment plan for dental implants in Korea has been criticized because the payment priority has not been properly established, and the benefits are concentrated among middle-class citizens. In the current study, the relationship between the oral health condition and socioeconomic status of the elderly was analyzed using data from the Korea National Health and Nutrition Examination Survey (KNHANES). This study aims to determine the reason underlying the criticism of the insurance payment plan. The subjects were >65-year-old individuals in the 2010 and 2011 database of KNHANES. Data from 2,812 subjects were analyzed. The socioeconomic status was determined based on edentulousness, molar tooth loss, and presence of 28 teeth. According to the analysis, the average income was 1,560,000 won for edentulous elderly, 1,811,000 won for elderly who had lost molar teeth, and 1,896,000 won for elderly with 28 teeth (p<0.05). In addition, elderly with a low education level demonstrated a poor oral health condition (p<0.001). In conclusion, the insurance plan currently under examination is not properly designed for economically impoverished elderly because the plan only covers 50% of the costs and is limited to implantation of molar teeth only. This plan will not provide practical benefits to elderly with a poor socioeconomic status; therefore, the insurance payment plan needs to be improved so that the appropriate beneficiaries can be targeted.

• Korea Journal of Hospital Management
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• v.21 no.1
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• pp.32-42
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• 2016

This study is conducted to estimate economic ripple effects of subsidiary services of hospitals. Using the Input/Output Analysis, this study analyzes production inducement effect, added value inducement effect, and labor inducement effect. Also, it assesses potential economic effects of the subsidiary services of which the scope is expanded as the government's proposed in 2014. Data regarding hospital subsidiary services and economic effects are obtained from the hospitals' financial statements on the National Tax Services and the Bank of Korea. The major results of this study are summarized as follows; subsidiary service profits of hospitals are 466 billion won and rent profits of hospitals are 152 billion won. Of these, the rate of subsidiary service profits in tertiary hospitals is about 66% of total subsidiary service profits. Producement inducement effect of subsidiary services of hospitals is higher than that of total industry, service industry and medical service industry. Added value inducement effect of subsidiary services of hospitals is higher than that of total industry, manufacturing industry, service industry and medical service industry. Job position inducement effect of subsidiary service in hospitals is higher than that of total industry, service industry and medical service industry. Also, employment inducement effect of subsidiary service in hospitals is higher than that of total industry and medical service industry. The results may suggest that subsidiary services revenue in medical institutions contribute to improving operating profits. Facing with intense market competition and pressures to control health care costs, hospitals may need to determine whether subsidiary services help boost their profitability and improve customer satisfaction.

• Journal of Korean Clinical Health Science
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• v.2 no.2
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• pp.126-132
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• 2014

Purpose. Because traditional statistics approach had limitations in learning future forecasting and major factors causing occupational injuries in each industry, this paper develops a model forecasting and evaluating occupational injury rate by using a system dynamics model through the analysis of the industry injury statistics and the project for industry injury prevention. Method. The model of this paper consists of 12 total models such as a model of employees, of industrial disaster victims, of injury rate, etc.; In the analysis of firm size, it is classified and developed according to 12 groups on the basis of the number of employees, and in the analysis of industrial classification, it is done according to 10 total business fields such as manufacturing business, construction one, etc. Results. This paper suggests the methodology which forecasts industry injury rate by business field and size on the basis of developed model, and evaluates an industry injury prevention project from various angles. Conclusions. This paper deduced problem through the analysis of an industry injury by business fields and a comparative analysis of foreign cases, and analyzed to affect industry injury prevention by industry. And it also analyzed actual condition of industry injury, and did a difference in the level of safety consciousness according to the general characteristics of workers and occupational safety and health education related characteristics. In result, this paper suggests that analyzing occupational injury related factors, a safety budgetary allocation, and industry injury related factors can reduce illness costs such as employees' injury and medical care, and also assist cost for a disability.

• Journal of Biomedical Engineering Research
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• v.26 no.5
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• pp.343-349
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• 2005

Continuously motivating people to exercise regularly is more important than finding a way out of barriers such as lack of time, cost of equipment, lack of nearby facilities, and poor weather. Our proposed system presents practicable methods of motivation through a diverse exercise aid system. The Health Improvement and Management System (all-in-one system which saves space and maintenance costs) measures and evaluates a diverse body shape analysis and physical fitness test and directs users to automated personalized exercise prescription which is prescribed by the expert system of three types of exercise templates: aerobics, anaerobics, and leisure sports. Automated personalized exercise prescriptions are built into XML based documents because the data needs to be in the form of flexible, expansible, and convertible structures in order to process various exercise templates, BIOFIT, a digital exercise trainer, monitors and provides feedback on the physiological parameters while users are working out in the gymnasium. If these parameters do not range within the prescribed target zone, the device will alarm users to control the exercise and make the exercise trainer adjust systemically the proper exercise level. Numeric health information such as the report of the physical fitness test and the exercise prescription makes people stay interested in exercising. In addition, this service can be delivered through the Internet.