• The Korean Society of Law and Medicine
• /
• v.18 no.2
• /
• pp.195-218
• /
• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• Asian-Australasian Journal of Animal Sciences
• /
• v.26 no.10
• /
• pp.1379-1387
• /
• 2013

In a majority of mammals, male infants have heavier body mass and grow faster than female infants. Accordingly, male offspring nursing requires a much greater maternal energy contribution to lactation. It is possible that the maternal-fetal immunoendocrine dialog plays an important role in female preparation for lactation during pregnancy. Immune system genes are an integral part of gene regulatory networks in lactation and tumor necrosis factor alpha ($TNF{\alpha}$) is a proinflammatory cytokine that also plays an important role in normal mammary gland development. The aim of this study was to evaluate the influence of the sex of calf and/or the -824A/G polymorphism in the promoter region of $TNF{\alpha}$ gene on milk performance traits in Black Pied cattle over the course of lactation. We also studied the allele frequency differences of -824A/G variants across several cattle breeds, which were bred in different climatic conditions. The G allele frequency decreased gradually over the course of lactation events in the Black Pied dairy cattle because of a higher culling rate of cows with the G/G genotype (p<0.001). In contrast to the genotypes A/A and A/G, cows with G/G genotype showed significant variability of milk and milk fat yield subject to sex of delivered calf. Milk yield and milk fat yield were significantly higher in the case of birth of a bull calf than with a heifer calf (p<0.03). The G allele frequency varies from 48% to 58% in Grey Ukrainian and Black Pied cattle to 77% in aboriginal Yakut cattle. Our results suggest that the $TNF{\alpha}$-824A/G gene polymorphism may have an influence on the reproductive efforts of cows over the course of lactation events depending on the sex of progeny. Allocation of resources according to sex of the calf allows optimizing the energy cost of lactation. This may be a probable reason for high G allele frequency in Yakut cattle breeding in extreme environmental conditions. Similarly, the dramatic fall in milk production after birth of a heifer calf increases the probability of culling for the cows with the G/G genotype in animal husbandry.

• Korean Journal of Human Ecology
• /
• v.18 no.4
• /
• pp.841-855
• /
• 2009

The main objective of this study is to examine the situations of group-homes for the elderly and clarify the problems of them. This study investigates the present conditions of welfare facilities and supply conditions. 4 group-homes were surveyed in Jeonju and Kwangju cities. Data was collected through various ways including the survey conducted by facility operators, the measurement of living space, and photo-takings. The major results of this study are as follows: 1) With the introduction of nursing care insurance in 2008, the increase of the demand and supply to group-home will be expected, due to less cost for recuperation. The care of elderly in homelike atmosphere is effective to the elderly suffering from dementia. Therefore, it is proper that the supply of group-homes for dementia will be needed. 2) Group-homes for the elderly are being supplied under the standards of welfare facilities in the present. Separate supply standards, however, are needed because they are not suitable for small scale group-homes. 3) To supply Group-homes for the elderly on a one-unit basis would cause various problems such as economical unreality, personnel distribution and so on. It is necessary to supply more than two units for more efficient management. 4) The management of group-homes for the elderly is financially unstable because the operating funds heavily depend on the users or people who are connected with the facilities through private networks. Therefore, additional support is needed to settle the financial problem. It would be helpful to build the public networking that provides information about the group-home for the elderly for the public. 5) In case of the increase in the supply of the group-home in a residential area, it could be helpful to promote the group-home to the public. 6) The operators state that the main problems of group homes for the elderly lie in financial difficulties and the shortage of professionals and volunteers. The financial, personnel, and material support for personnel and the supervision of management are required for the transparency and effectiveness of the facility management. In addition, the closer network and cooperation system with the community is required. 7) The present living environments for group-homes for the elderly leave much room for improvement, considering the physical condition of the elderly. The more careful selections in the color, shape, material, and equipment of the facilities should be made for the convenience of the elderly users.

• Korea Journal of Hospital Management
• /
• v.20 no.3
• /
• pp.45-55
• /
• 2015

While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

• Journal of Digital Convergence
• /
• v.12 no.3
• /
• pp.299-308
• /
• 2014

Nowadays, dental tourism becomes phenomenon because of its cost-effectiveness, improvement of quality and technology, dental infrastructure, and attractive tourism. Korea as one of popular destination country had established dental system. On the other hand, Indonesia with high number of population is potential market for dental tourism. The aim of this study is to compare the knowledge, attitude, and experience towards dental tourism among Indonesian and Korean. Two cross-sectional descriptive surveys were conducted to collect the data. This study was used one questionnaire in two different languages due to nature of the study population. Data from a total 923 of Indonesian from 33 provinces in Indonesia was collected during the period from April through July 2010. On the other hand, during May until August 2010 data from a total of 312 Korean were obtained. It was found that the majority of participants in both countries had never heard about dental tourism. Among those who had heard about dental tourism, the most common source was internet. Ownership of dental insurance had significant relationship with knowledge of dental tourism among Indonesian while level of education and monthly internet usage had it among Korean (p<0.05). Attitudes of Indonesian and Korean people about dental tourism were negative due to assumption that dental services in their home country were satisfactory. 100% of Korean had no experience on dental treatment in other countries while 2.4% of Indonesian had experience with it. In conclusion, regarding all these evidences, comprehensive and positive information about dental tourism is needed to enhance people's knowledge, attitude, and experience.

• Journal of Convergence for Information Technology
• /
• v.7 no.4
• /
• pp.83-89
• /
• 2017

This study aims to investigate the impact of a mobile-based human coaching healthcare service provided for diabetic patients by nurses on their self-management ability. This study collected data from 311 persons who were diagnosed with diabetes from all over the country, and the collected data were analyzed through SPSS Win 23. The results of the study are summarized as follows: First, it was found that the utilization of a glucose meter by the provision of the mobile-based human coaching healthcare service was men group, and there was a statistically significant difference (${\chi}^2=6.059$, p= .048*). Second, there was a positive correlation in the utilization between the glucose meter and an activity tracker band by the provision of the mobile-based human coaching healthcare service, which was statistically significant (r=.660, p< .001). Third, as a result of checking the changes of the utilization of the glucose meter by the provision of the mobile-based human coaching healthcare service, it was maintained between 79% and 41% from Week 1 through 49. In conclusion, this study partially confirmed that the mobile-based human coaching health service was easily accessible and cost-effective in enhancing the participants'self-healthcare ability.

• The Journal of the Convergence on Culture Technology
• /
• v.5 no.3
• /
• pp.125-130
• /
• 2019

This research is about alternative measure of main components for sprinkler system like automatic wet pipe sprinkler system, dry pipe sprinkler system, pre-action sprinkler system, vacuum sprinkler system, deluge sprinkler system, and so on. By replacing the alarm check valve, dry valve, pre-operated valve, and deluge open valve with a solenoid valve, it be can be simplifed the various processes of the manufacturing process into one process, it creates an environment in which one standardized product can be produced simultaneously on a single machine. Therefore, it could improve the price competitiveness of products, reduce the maintenance cost, and help the adaptability of new sprinkler systems in the future. There is a benefit when it comes to apply to sprinkler system. Only replace the valve which is used to control primary and secondary valve such as wet, dry, pre operated, vacuum, deluge system valve. Other components such as retarding chambers, automatic air compressors, accelerators or adjusters, supervisory panels, vacuum pumps, and manual starters can be used as they are, so they can be easily applied to existing sprinkler system. It is needed to legal and institutional study for solenoid valve applied sprinkler system to commercialize.

• 한국노년학
• /
• v.39 no.2
• /
• pp.305-323
• /
• 2019

In recognition of the increasing social attention paid to the notion of how to die well, this study explored what it is that middle-aged and older Koreans think of as "dying well." Specifically, it was aimed at classifying the perceptions people middle-aged and older have regarding dying well. To this end, we used data from the National Survey on Well-Dying, which was conducted in 2018 by the Korea Institute for Health and Social Affairs, and employed Latent Class Analysis. The demographic characteristics of each of the classified subgroups were identified through technical statistics. The types identified were multilayered depending on the imminence of death, perspectives of the last stages before dying, and the meaning of death in the context of social relationships. These types differed according to gender and subjective health conditions. Based on our findings in this study, we put forward policy suggestions about awareness improvement of personal and social levels, promoting on comprehensive death preparation, providing a system to reduce the cost of medical and nursing expense at the end of one's life, promoting of the right to self-determination regarding death, raising social attention to groups that are least prepared for dying well.

• Journal of Korean Public Health Nursing
• /
• v.3 no.2
• /
• pp.47-76
• /
• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Journal of agricultural medicine and community health
• /
• v.28 no.1
• /
• pp.39-51
• /
• 2003

Objectives: The oriental medical care has been getting popular in community health centers because of uniqueness, changing of disease patterns, and increasing of elderly population. From 1998, oriental medical doctors has been working in several rural community health centers for their military obligations. At this point of time, it is necessary to evaluate the oriental public health doctors system. This study was performed to investigate the utilization patterns, the degree of satisfactions, needs of oriental medical care service provided by community health center in a designated Gun area. This study focused on the need for extending over Myun area of community health center's oriental medical care services. Methods: Person-to-person interview survey method through a structured questionnaire was done by a personnel at a oriental medical care service room in a Gun community health center. The major statistical method used for the analysis were the t-test, ANOVA, and logistic analysis. Results: The total number of responded subjects in this study was 163 residents. Among these 65.0% were aged 61 or over, and only 13.5% recognized themselves were healthy. 73.7% of the respondents demanded establishment of more oriental medical care services provided by community health center to other Myun area. Factors affecting the need for enlargement of oriental medical care service room were education level, subjective awareness of access to community health center, and cost satisfaction of oriental medical service provided by community health center. Thus, a resident who had graduation of middle school achievement or above(OR=3.35), had a long way to center(OR=2.47), satisfied with oriental medical service cost(OR=2.78) had demonstrated increased chance of need by logistic regression analysis.