• The Journal of Korean Physical Therapy
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• 제10권1호
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• pp.105-125
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• 1998

We are confronted by increase in old people due to the improvement in medical science, public hygiene and socioeconimic status in 20th century. But our medical security system for old people dees not meet the need for medical service of old people. Current medical insurance system restricts term and extent in allowance although the characteristics of the disease of the aged people need medical care of Bong duration and high cost. And in the medicaid system the speciality of the aged people is not recognized and the budget of the government is scanty. In addition many old people to our country are in economic distress due to low income. But the government authority does not give sufficient consideration for eld people in law, policy and budget. To improve social security system for old people it is necessary to increase the budget for the security of old people, to enhance the traditional respect for the aged, to improve medical security system by improving the accessibility to medical service and by expanding the allowance of medical insurance, and to expand the public welfare institutions. And these are roles for all the family. the society and the nation as well as the aged people themselves.

• 보건교육건강증진학회지
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• 제15권2호
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• pp.199-215
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• 1998

The health care environment exerts tremendous influence on community health practices. Here the author mention several major factors that will influence the future plan for health service and health education; that is, economic problem, the issues of decrement of infectious disease, increment of chronic degenerative disease due to natural increase of the elderly, increased frequency of traffic and industrial accidents and the issues of medical-technological advances etc. Therefore, special efforts by health personnel should be made to develop health education and health promotion strategies on a community-wide basis. Accordingly, the flexible accessibility, convenient availability, guaranteed medical service, sufficient supply of health information, and rapidly available medicaid service for special population such as the elderly, the handicapped, the disabled and the poor are considered. Also, the financial support from the central government and local self-government and active participation of health consumer to health service are needed in Korea, The role of the health personnel is to elicit, facilitate and maintain health promoting behavior with his and her assurance for health consumers being competent and supported in the voluntary choice of their health promoting activities. The health promoting activities such as the above mentioned will be produce escalation of their life Quality among Koreans.

• 한국보건간호학회지
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• 제28권1호
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• pp.32-45
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• 2014

Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

• 한국보건간호학회지
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• 제34권1호
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• pp.112-124
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• 2020

Purpose: This study aimed to explore the perception of medical aid beneficiaries on their experiences of receiving case management. Methods: Data were collected through in-depth interviews with sixteen medical aid beneficiaries who had been receiving medical aid case management from at least one year ago. The data were analyzed using the NVivo software program for its qualitative content analysis. Results: Three categories emerged from the data: "not perceived but come into my territory", "realized the necessity of changes and begin to take care of my own health", and "satisfied passively with some of my changes." With respect to these categories, eight sub-categories were ultimately identified. Conclusion: It would be effective if both medical aid beneficiaries and case managers can set the case management goals and management plans together at the beginning of case management. It is also needed to develop a comprehensive case management model tailored to the characteristics and needs of the beneficiaries.

• 보건행정학회지
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• 제23권1호
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• pp.78-89
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• 2013

This study empirically analyze efficiency and productivity changes of public hospitals of Korea using data envelopment analysis/Window model and global Malmquist indices model. We use the ten-year data from 2001 to 2010 of 30 regional public hospitals listed database from the Association of Korean Regional Public Hospitals. The main focuses are to reveal whether the technical inefficiency are improved as time goes by, and efficiency and productivity are affected by environmental factors. The results can be summarized as follows. First, the efficiencies of public hospitals rise in trend as time passes. Second, regional public hospitals show the different average efficiencies according to their regional type, hospital type, operational type, medicaid type, and demand and supply conditions by Mann-Whitney U-tests. Third, technical efficiency changes mainly contribute to 4.4% annual average growth rate of productivity of regional public hospitals during that period. Our findings have some policy implications. It is confirmed that there exist some environmental inefficiencies, and those inefficiencies can not be overcome through just improving the inner management system. Thus, policy and institutional changes are necessary for regional public hospitals to improve efficiency and productivity overall.

• 지역사회간호학회지
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• 제21권3호
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• pp.351-361
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• 2010

Purpose: This study was done to analyze the effects of tele-care case management services using secondary data. Methods: A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Casemanagement services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test. Results: After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group. Conclusion: The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.

• 한국보건간호학회지
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• 제17권2호
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• pp.287-298
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• 2003

This study was conducted to identify the health care utilization, health care costs, and potential health care demands of the disabled in the Medicaid Aid beneficiaries. This study focused on the heath care costs not included in the medical aid allowance such as transportation, informal nursing costs, and ambulatory aids etc. Participants were the 864 subjects who were beneficiaries of the National Medical Aid program living in 10 district of Korea. A questionnaires were distributed to the disabled in the Medical Aid beneficiaries during August to September, 2001 through public offices. Data were collected through a home visiting by social workers working in public offices. Direct and indirect medical costs expended for one month by the participating disabled were examined. They expended 110.748 won $({\$}100)$ for heath care costs, which was not included in the medical aid allowance during the month. The disabled with cerebral diseases or who have level 4 disability expended more health care costs compare to those with other diseases. Gradual expansion of medical aid allowance for the disabled is recommended to alleviate economic burden of the disabled and their family.

• 한국농촌간호학회지
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• 제8권1호
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• pp.5-12
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• 2013

Purpose: This research was a survey to ascertain whether there are differences in opinion about designated doctors and hospitals, type of health care service utilized and health behavior between people who have applied to be Medical Aid Beneficiaries, but not using the Designated Doctor System. Method: The participants were from three groups, application for two years, one year and non-appliers. Data collection was done by Medical Care Client Managers through in-depth interviews using a structured questionnaire. Results: The participants expressed no negative effect of the designated doctor system in relation to designated doctor, hospital or health behavior but there was a significant effect in type of health care service utilized. Conclusion: In the future, the commitment of Medical Care Client Managers is important, but the role of health care providers will be emphasized in order to sustain the effectiveness of the health care system under the Designated Doctor System.

• 여성건강간호학회지
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• 제21권1호
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• pp.32-42
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• 2015

Purpose: The purpose of this study was to investigate factors that influence married female immigrants' perceived health status. Methods: This study was a retrospective review of dataset from the 2012 National Multicultural Family Survey in Korea. Data were analyzed using descriptive statistics, t-tests, an analysis of variance (ANOVA), Pearson correlation analysis, and multiple regression with the data of 3,014 married female immigrants. Results: Multiple regression analysis showed that demographic factors (age, education level, nationality, period of residency in Korea, and residential area), socio-economical factors (monthly family income, employment, support from the government for basic living, and Medicaid), social support factors (marital conflict, satisfaction with family relationships, some one to talk about self or family matters, meeting with homeland friend, and participation in community meeting), and immigration factors (life satisfaction, experience of social discrimination, and difficulties with living and using medical care) were associated with perceived health status. Conclusion: It is important to pay closer attention to immigrant women who have low economic status, less social support, experience difficulties with living in Korea and using medical care. An effective support system for this population should be developed in order to help them successfully transition.

• 약학회지
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• 제54권3호
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• pp.205-214
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• 2010

This study aimed to evaluate the patterns of inappropriate medication use and inappropriate dosage in elderly patients in Korea. A retrospective study was performed for the elderly 65 years or older admitted from January 2007 to December 2007 in a medical center, Seoul, Korea. Potentially inappropriate medication (PIM) use in the elderly was evaluated using Beers criteria. Eighteen drugs out of Beers criteria were included in the formulary of the institute. Inappropriate dosage was set using Beers criteria, CMS (the Centers for Medicare& Medicaid Services) guideline, Geriatric Dosage Handbook. As results, the patients with PIM were 2,172 during the study period. The commonly used inappropriate medications were drugs for the nervous system (n=1237, 44.78%), the alimentary System (n=663, 24.54%) and the cardiovascular system (n=494, 18.28%). The elderly patients with prescription of inappropriate dosage were 10% out of patients with PIMs. The commonly inappropriate dosage drugs were digoxin (n=75, 27.27%), diazepam (n=70, 22.55%) and ferrous sulfate (n=66, 24.00%). Logistic regression analysis showed the number of PIM, days of hospital stay as predictors related to inappropriate dosage use. In conclusion, CNS drugs were frequently prescribed as PIM and inappropriate dosages were identified. It is needed to develop a means of decreasing adverse drug events in elderly.