• Journal of Digestive Cancer Research
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• v.9 no.2
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• pp.43-49
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• 2021

Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

• Health Policy and Management
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• v.9 no.2
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• pp.40-54
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• 1999

The purpose of this study is to compare the health service utilization patterns between up and myun and to find the determinants of utilization. For this purpose. this study used different versions of utilization rates. such as crude utilization rates. utilization rates adjusted for population composition. and age-sex adjusted utilization rates. Data used in this analysis were the Community Health Interview Survey which was conducted by interviewing 741 households from August 31 to September 11, 1998 in HongCheon-Gun. KangWon-Do. The major findings of the analysis are summarized as follows: 1. There was a statistically significant difference in the level of health service utilization between up and myun. Depending upon the unit of analysis employed (those who were interviewed vs those who were sick). the difference between up and myun was reversed. 2. Determinants of health service utilization are analyzed using logistic regression. The result showed that predisposing factor influenced health service utilization in rural areas, while the enabling factor didn't.

• Journal of the Korean Home Economics Association
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• v.30 no.3
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• pp.193-204
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• 1992

The purpose of this article is (1) to measure the attitudes of health care consumers towards medical service, the physicians' duty to provide information and patient self-determination options, (2) to discover the their related variables. The attitude of health care consumers towards medical service reveals statistically significant corelation with age and education. Among the statistically significant independent variables it is significantly related with age in the multiple regression analysis. The attitude of health care consumers towards the physicians' duty to provide information reveals statistically significant corelation with age, education and the attitude of health care consumers towards medical service. Among these independent variables it is significantly related with the attitude of health care consumers towards medical service in the multiple regression analysis. The attitude of health care consumers towards patients' self-determination options reveals statistically significant corelation with age, the attitude of health care consumers towards medical service and the attitude of health care consumers towards the physicians' duty to provide information. Among these independent variables it is significantly related with the attitude of health care consumers towards the physicians' duty to provide information in the multiple regression analysis.

• Korean Journal of Community Nutrition
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• v.5 no.3
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• pp.529-536
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• 2000

The major purpose of this study was to identify the differences in priorities of nutrition service needs between the service provider and consumers (general population). Identification of the personal characteristics which influence the priorities of nutrition service needs among the general population was also examined. An interview survey using a questionnaire was conducted to collect the data required for analysis. The questionnaire included the priorities of various nutrition service needs as well as the personal characteristics of the study subjects. The study subjects were 300 residents over 40 years of age, and 15 health workers representing health center service personnel in Kyounggi province. Wilcoxon Rank Sums test were adopted to analize the differences in priority between the service providers and consumers. The results showed that priority of nutrition service needs for provider were significantly different from that of consumer. Gender, age, family type, and education levels of the population were the significant factors affecting the differences in priorities for nutrition service needs among consumers (general population). Out of the results, it could be suggested that consumers need should be considered in developing nutrition services to promote nutrition services utilization in health centers. The results may also suggest that one of the causes for the low utilization rate of nutrition services in health centers was the provider oriented program development regardless of the needs of consumers.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.148-155
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• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.228-238
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• 2011

Purpose: The purpose of this study was to investigate parent expectation and satisfaction with respect to pediatric inpatient care and to identify the variables related to parent satisfaction. Methods: The study was conducted in pediatric wards of a tertiary children's hospital in Korea. The participants were 361 parents of children who were inpatients. Data were collected using a structured questionnaire (The Pediatric Family Satisfaction Questionnaire) at the time of discharge. Results: The highest parent expectation domain was medical service. The parents were most satisfied with nursing service and least satisfied with general hospital service and accommodation. The parents expressed lower satisfaction with hospital facilities, equipment, noise, cleanliness, and communication by health care professionals. Parents with younger children reported higher expectation from the complete hospital service and those who had a longer length of stay reported higher expectation from the nursing service. Conclusion: To improve the quality of hospital services, we need to understand parent expectation and improve and provide clear communication. In addition, the general hospital service and accommodation should not be overlooked for improvement.

• Health Policy and Management
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• v.31 no.3
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• pp.344-354
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• 2021

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 inpatients and 1,550,497 outpatients who received Chuna therapy covered by automobile insurance in oriental medical institutions were included. The analysis period was from July 2018 to December 2019, and a total of 18 months before and after April 2019, when Chuna therapy was covered by national health insurance. Interrupted time series analysis was applied to analyze the impact on the costs and service uses of Chuna therapy in automobile insurance before and after April 2019. Results: From July 2018 to December 2019, for 189,912 inpatients the cost and the number of times for Chuna therapy per capita were increased by 22.0% and decreased by 7.3% respectively right after the implementation of the policy. In the case of 1,550,497 outpatients, the cost of Chuna therapy per capita tends to be increased by 0.4% in overall study periods and increased 28.4% immediately after the implementation of the policy. Meanwhile, the number of times and visits for Chuna therapy per capita tends to be increased by 0.4% in overall study periods but decreased by 0.4% after the implementation of the policy. Conclusion: Results suggest that if the national health insurance coverage of oriental medicine services increases according to the policy stance for benefit expansion in national health insurance, the criteria for providing national health insurance benefits should be considered with the comprehensive impacts on the costs and service uses of automobile insurance.

• Journal of Home Health Care Nursing
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• v.22 no.1
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• pp.22-37
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• 2015

Purpose: This study aimed to compare the health service delivery level and educational needs by work experiences and types of public health center among the nurses who work as visiting health services workers at public health centers. Methods: Data collected from 484 nursing staff for 2 weeks, was analyzed using the SPSS program t-test, ANOVA, and Spearman Rank-Order Correlation. Nurses with more than 2 years experience were 79.1%; and 43.6% of the subjects worked within Gun type public health centers. Results: The health service performance frequency of metropolitan city type public health centers was significantly high in the areas of education, behavior pattern, chronic disease, pregnant women & infants, and multi-cultural family. The health service performance frequency of Gun type public health centers was significantly high in the areas of type of test, fundamental nursing, and basic rehabilitation. In addition, the correlation between the performance frequency and educational needs was positively correlated, and the subjects with greater educational needs performed more. Conclusion: Educational programs should be designed according to the types of public health centers rather than work experiences, especially in systematic training for frequently performed items after reviewing the practice precisely.

• Journal of Information Technology Services
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• v.7 no.2
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• pp.223-242
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• 2008

We assess service delivery system for outpatients of general hospital(A) using service blueprint. Service blueprint for outpatients' service process currently being implemented in general hospital(A) is analysed to improve hospital services and define hospital service delivery system more accurately. In addition, comparative analysis of service blueprint between before and after improvement is conducted to find that health care services Is now more customer-oriented and hospital employees can link their duties to service delivery system. Dealing with the efficiency of health care service delivery system based on service blueprint analysis is expected to pave the way for continual service quality improvement of general hospitals in the future. The analysis of service blueprint of outpatients' service process suggested in this study is useful for setting strategies for health care service. It also helps service process design and service digitalization of other general hospitals in the future.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.125-132
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• 1972

The status of health administration and medicare insurance program of 58 universities and colleges of 4-year course was studyed in 1971 and the following results were obtained; 1. The average number of students of 30 universities was $4,800{\pm}2,600$ and that of 36 colleges was $780{\pm}620$. 2. The types of health service facilities for the students varied widely according to the institutions, from an elaborate one, university health center, to a poor one, first aid room. 3. Thirty-six out of 58 institutions had some sort of health service facilities, either health center or health service room. And 14 out of 36 institutions had elaborate health service facilities such as university health center or student health center 4. The number of full time staff of the health center and that of the health service room were 2 to more than 10 and 0 to 3 respectively. 5. The range of student health service fee varied widely according to the institutions from \50 to \550 per student, per semester. The average cost of student health service fee at the institutions with health centers was $\300{\pm}150$ and that with health service rooms was $\200{\pm}150$ per student, per semester. 6. Utility rate of the student health service facilities at the institutions with health centers and with health service rooms were 1,200 to 1,400 and 3,900 to 4,100 per 1,000 students per year. 7. There was an obvious increasing tendency of tuberculosis prevalence rate in the students. 8. The institutions which had appointed hospitals for student medicare were 24; where the reduction rate of medical expenses for students varied from 10 to 50 per cent. 9. Students medicare insurance program was adopted by six universities which accomodated more than 2,000 students. 10. The range of student medicare insurance fee varied widely according to the institutions from \140 to \800 per student per year. Each of the six universities which had adopted the insurance program had each own's special regulations to apply for pay claims.