• Health Policy and Management
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• v.2 no.2
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• pp.112-130
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• 1992

Patient care services are provided to individual patients in response to their health needs produced by illnesses or injuries. The services are often addressed to very serious conditions, and also they constitute the most expensive component of health care services. Therefore, the importance of quality is emphasized, but there are many indications that patient care quality is far from a satisfactory state in most of the countries. Based upon this observation, it is attempted to examine obstacles and approaches to quality improvement in patient care services. In doing so, following Taguchi's(1986) definition of product quality, quality of patient care services is conceived of as better when the less is the sociental loss attributalbe to variability of intended function and harmful side effects they emhibit after being delivered. Some distinguishing features of medical care sector pose difficulties in implementing effective quality improvement programs in patient care services. Nevertheless, newly proposed method of quality management, based on industrial quality management approach, seems to have a great deal of potential to effectively cope with such difficulties. This method, unlike the traditional approach to quality assurance, focuses on total organisational processes, not individuals, as the obproach to quality assurance, focuses on total organizational processes, not individuals, as the objects of quality improvement; variation, not comparison with standards, in quality measurement; and continuous improvement, not removing only bad quality care, as an ideal. Prerequisite to a successful use of any quality mangement method is motivating providers to improve quality. Conceivable approaches for such motivation are self-regulation, external controls and promotion of competition. Since these approaches are not mutually exclusive, they may be employed in an appropriate combination. In Korea, medical care providers are now functioning under the circumstances where they have little reason for making efforts to improve quality of their services. Once these circumstantial conditions are changed to exert pressures on providers to improve quality, the use of adequate quality management method becomes an issue. In this connection, much attention shoould be directed to the newly proposed method described above. In all these efforts for improving quality of patient care services, health insurance would be able to play a pivotal role. Poviders of medical care, buth indiciduals and organizations, are usually very responsive to the measures that affect their financing, and thus health insurance can be a strong instrument for motivationg providers to improve quality. Also, the insurance continuously acquires data on patient care, which could be processed to produce information required to effective quality control.

• Journal of Korean Clinical Health Science
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• v.5 no.3
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• pp.963-972
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• 2017

Purpose. This study uses Ajzen's theory of planned behavior to investigate predictors associated with the intention of smoking cessation in smokers among high school students in a community. Method. The study population consisted of 138 smokers from high school students in a community. Between May to April 2015, Data was collected through questionnaires. Data analysis was performed using the PASW 21.0 program, and one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression analysis. Results. The mean intention of smoking cessation of this study was 3.98/5. The significant correlates of the intention of smoking cessation were attitudes toward smoking cessation (${\beta}=.36$, p=.003), self efficacy for smoking cessation (${\beta}=.44$, p<.001), satisfaction of school life (${\beta}=.22$, p=.009), number of friends smoking (${\beta}=.76$, p<.001), and previous experience of smoking cessation (${\beta}=.92$, p<.001). These variables explained 75.6% of variance in the intention of smoking cessation. Conclusion. The study suggests that various factors including previous experience of smoking cessation, number of friends smoking, self efficacy for smoking cessation and attitudes toward smoking cessation were important variables in explaining the intention of smoking cessation among high school students. Therefore, these variables are crucial in determining the promotion and intention of smoking cessation among high school students.

• Journal of Korean society of Dental Hygiene
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• v.12 no.6
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• pp.1193-1202
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• 2012

Objectives : The purpose of our study was to examine the relationship of oral health status such as dental caries and the performance of dietary action guides with six items. Methods : Oral examination and self-administrated questionnaire were conducted on 87 disabled students, aged 6-19 who were attending special school in the area of the metropolitan Seoul. Two logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association dental caries experience and the performance of dietary action guides after controlling for potential confounders. Results : The proportion of study subjects with caries were 37.9%, 26.9%(male) and 54.3%(female), respectively(p<0.05). There was significantly difference the subjects with caries and perceived oral health status(p<0.01). Among the dietary action guides items, skipping breakfast and not avoiding waste food were significantly higher in the proportion of subjects' caries(p<0.05, p<0.01, respectively). The avoiding waste food groups had more possibility of having caries significantly(p<0.05), even after controlling gender, and perceived oral health status. Conclusions : These results indicate that oral health promotion policy with dietary action guides should be strengthened for support of disabled student's dental health.

• Journal of the Korean Society of School Health
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• v.16 no.1
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• pp.81-90
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• 2003

This study was conducted to contribute to the basic data for decisions on environment policy improvement in health promotion for students in elementary, middle and high schools. This study was carried out to investigate the extent of indoor air pollution in elementary, middle and high schools in residential, traffic congestional and industrial areas. The concentrations of major indoor air pollutants(carbon monoxide, carbon dioxide, respiratory particulate, radon) and thermocircumstance (temperature, relative humidity, intensity of illumination) indices were observed from June to August 2000. As results of the survey, the mean values of thermocircumstance in school were $26.94{\pm}1.15^{\circ}C$ of temperature, $68.88{\pm}5.31%$ of humidity and $268.26{\pm}164.60$ Lux of intensity of illumination. The mean concentrations of carbon monoxide, carbon dioxide, respiratory particulate were $8.36{\pm}0.29\;ppm$, $547.66{\pm}175.58\;ppm$, $36.23{\pm}48.39\;{\mu}g/m3$, respectively. These values were lower than those of the indoor environmental standard on the first clause of Article 45 of public utilization service notified public hygiene of the Ministry of Health and Social Affairs. The mean concentration of radon was $20.07{\pm}17.95\;Bq/m3$. Which was below the U.S. EPA radon action level.

• Korean Journal of Occupational Health Nursing
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• v.9 no.2
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• pp.121-131
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• 2000

This study was conducted to acquire data in order to institute an effective industrial accident compensation insurance(IACI) system. The subjects were employers and employees in small scale industries which have less than 5 employees. The questionnaires consisted of questions on perception and need for IACI. A total of cases were 181 employers and 105 employees participated in the study. Perception and need of employers and employees were assessed using the ANOVA, t-test. The results were as follows ; 1. Workplaces examined mostly in manufacturing(78.9%), industries with one employee(44.1%). Beneficiary rate of IACI 4.4%. 2. 60.0% of employees had experienced an industrial accident and in most cases employers paid the cost of medical treatment. 45.0% of employers nd 50.0% of employees were not aware that IACI had been put into effect starting July, 1, 2000. 52.0% of employers had no type of industrial accident compensation. 3. The need of outcome measures, especially of employers and employees who had an IACE, were higher than those without an IACI. Employers and employees who had experienced an industrial accident outnumbered those who hadn't. The results of this study reveal that there is a great need for the institution of an IACI and health promotion policy in small scale industries.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.38-47
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• 2015

Objectives: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. Methods: This cross-sectional study analyzed data from 653 Koreans aged ${\geq}60years$ who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Results: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). Conclusions: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

• Journal of Convergence for Information Technology
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• v.10 no.3
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• pp.134-140
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• 2020

The aim of this research was to analyze the differences for the oral health status of the elderly people living in the long-term care facilities and the non-resident elderly. The study was conducted on 469 elderly people of the same age, gender and basic living conditions. Elderly residing in long-term care facilities had higher dental caries prevalence(p=0.019), DT(p=0.001), and MT(p=0.047) than non-resident elderly, and had lower FT(p<0.001) than non-resident elderly. The elderly living in facilities were 1.93 times more likely to be caries than non-residents, and 0.73 times more likely to have a filled tooth. The probability of denture use was 0.15 times for the maxillary and 0.13 times for the mandibular. The probability of denture needs was 5.61 times for the maxillary and 5.65 times for the mandibular. All of these results showed significant differences. As a result of this, it can be used as basic data for establishing oral health policy for oral health promotion of the elderly living in Long-term care facilities.

• Journal of the Korea Convergence Society
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• v.12 no.9
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• pp.261-271
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• 2021

Recent accidents in school environment involving violence, and bullying indicate that school safety is exposed to a serious threat to community well-being. Such incidents come as big problem because various policies and programs have widely long been implemented in order to protect the school environment. Thus, it is critical for the local community and goverment to develop measures for prevention. However, some of the incidents are misrepresented because school environment still remains as one of the safest settings. The current study discusses successful case studies of education, policies and projects regarding school violence and safety that are enforced in many other nations. One of the most practical and concrete means of pursuing an improved level of school safety is for the local community to be actively involved in the process. And one of the key factors for the success of international programs was that it was very much an integrative approach involving a joint effort with the local communities, accompanying a strong tie between the school and its surrounding context.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2005.09a
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• pp.3-32
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• 2005

정부의 건강증진사업은 국민의 건강수명 연장과 삶의 질 향상에 궁극적인 목적이 있다. 이는 건강 지지적인 환경을 조성하고 질병을 예방${\cdot}$관리하며 평생 건강서비스를 제공하고 건강한 생활양식을 형성하도록 함으로써 달성될 수 있는 것이다. 건강증진사업을 위한 기반으로 연구와 개발 강화, 법과 규칙의 조정, 기금과 인력과 같은 자원 확보는 필수적이다. 정부의 건강증진전략은 첫째 자원할당의 우선순위를 확보하는 것으로 건강증진, 질병 및 손상의 예방, 재활관련 사업에 더욱 많은 자원을 할당하는 것이며, 둘째로 국가차원의 건강증진 프로그램을 개발하여 실행하는 것이다. 포괄적인 생애주기별 건강증진 프로그램(건강증진종합계획)과 모아보건, 학교보건, 산업보건, 그리고 만성질환예방프로그램 등이 포함된 포괄적인 프로그램을 개발하여 실행하는 것이다. 셋째로, 건강증진기금을 공공보건을 위한 하부기반과 건강증진 프로그램에 투자함으로써 사업의 하부기반을 정비하는 것이다. 건강증진사업을 위한 하부기반으로는 정책과 위임사항을 들 수 있는데, 국민건강증진법과 국민건강증진종합계획, 2005년 6월에 서울시 의회를 통과한 건강도시추진위원회를 들 수 있다. 정부의 건강증진사업의 법적 기반은 1995년에 제정된 국민건강증진법이다. 국민건강증진법은 국민들이 건강에 대한 가치를 인식하고 책임의식을 함양하며, 올바른 건강지식을 갖고, 국민들이 건강한 생활양식을 실천할 수 있는 환경 조성을 목적으로 하고 있다. 건강증진사업은 대중을 위한 보건교육과 건강상담, 영양관리, 구강보건관리, 질병의 조기발견과 치료를 위한 건강검진, 지역사회 건강문제에 관한 조사와 연구, 담배소비 감소와 건강증진부담금 부과를 통한 국민건강상태의 향상을 위한 사업이다. 훈련과정으로는 보건복지부에서 2005년부터 수행하고 있는 시와 지역을 위한 현장관리 프로그램과 서울시가 수행예정인 지역수준의 지도자 훈련과정이 있다. 건강증진사업의 원활한 진행을 위한 기금조성은 건강증진기금이 담배세로부터 조성되고 있으며 2004년 12월 31일 현재 담배 한 갑 당 500원으로 인상되어 부과되고 있다. 기금의 관리와 운용은 보건복지부가 담당하며, 기금은 건강한 생활양식형성에 대한 지원활동, 국민을 위한 보건교육과 교육자료 개발, 건강증진과 만성질환에 대한 연구, 질병의 조기발견을 위한 건강검진, 구강보건관리활동에 사용되고 있다. 향후 건강증진사업 투자계획은 1단계 (98-02년)에는 사업기반조성기, 2단계(03-06년) 보건소사업발전기, 3단계(07-11년)통합사업정착기로 구성되고 2단계의 인프라구축에 사용될 투자 비율은 30%에서 3단계에 15%로 감소될 예정이며, 사업실행 영역은 50%에서 65%로 확대될 계획이다. 2005년 건강증진사업의 중점목표는 건강증진사업의 지방 분산화, 건강증진사업의 근거마련, 사회적 형평성의 달성에 있다. 건강증진사업의 지방분산화를 위해서는 중앙에 관리센터가 설치되어 기획과 평가, 연구와 개발, 현장관리 훈련을 담당하게 되고, 지역관리센터에서는 자치적인 보건소 중심 건강증진사업의 수행과 평가를 진행하게 된다. 건강증진사업의 근거마련을 위해서 효과가 입증된 사업에 우선순위를 두며, 기획과 평가위원회를 설치하고, 건강증진사업의 평가결과를 환류 할 수 있는 체계를 마련하는 것이다. 또한 건강증진포럼을 구성하며 현 건강조사 체계를 수정한다. 한편 형평성 제고의 측면에서는 저소득층, 노인, 장애인들과 같은 취약계층의 건강상태 향상을 위한 중앙정부와 지방자치단체의 역할을 강화하고, 지역간${\cdot}$사회적 집단 간의 건강증진사업관련 형평성을 제고한다.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.113-131
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• 2000

Transtheoretical model of change has been proven very effective in explaining both the acquisition and cessation of many health related behaviors. The objectives of this study were to describe the distribution of smokers by stage of change of smoking, alcoholic drinking, and exercising in rural residents and to develope health promotion strategies. This study was done in Okchun County of Chungbuk Province. The representative sample were 892 residents over 30 years old. The questionnaires of interview included socio-demographic, the six stage distribution of smoking, alcoholic drinking, and exercising. In male, 50.6% of smokers were in the precontemplation stage, 32.5% in the contemplation. In female, corresponding figures were 60.6% and 28.8%. Precontemplation and contemplation stage of drinker were 72.8%, 19.3% in male and 80.3%, 15.5%. Distribution of exercise were 80.6%, 1.8% in male, 87.6%, 1.2% in female, respectively. The stage distribution of smoker, alcoholic drinker, and exerciser was shift to left of the distribution. And the stage distribution was slightly differ with each health behavior. The stage of change with smoking, drinking and exercising was correlated with each other but not concordant. So interventions in rural residents need to take into account the large proportion of precontemplators repeatedly observed among smoker, drinker, and non-exerciser. And intervention strategies of each risk behavior should be different approach. Result of concordance analysis suggest reconstruct validity of the transtheoretical model in our country due to ethnic and sociocultural difference. This results and theory should be tested in prospective intervention studies for seeking the possible gateway of health behavior.