• Health Policy and Management
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• v.15 no.2
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• pp.16-36
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• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.507-517
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• 1999

The purpose of this study is to understand home care needs for parturient women and neonates up to the postpartum period. Methodology : The design of this study is a cross-sectional survey study. The subjects of this study are 88 postpartum mothers who delivered a first baby during the period from December 1996 to July 1997. Data collection was done with a structured questionnaire by mailing. Data were collected at the point of six months after delivery. A structured questionnaire composed of items related to home care needs. Data analysis was done with descriptive statistics. The study results are as follows : .The highest need was personal hygiene(93.2%) for the parturient women, and the peak period was the two week period after delivery. .The most frequent maternal needs regarding neonates were cord care (72.4%) during the first week, elimination(67.9%) during the first two weeks, baby crying(88.3%) and sleeping pattern(71.5%) at one month after delivery, and baby temperament(30.4%) at sixth months after delivery. .The mothers requested home care methods such as written material for self health care (35%) and counseling(34%) and direct home visits (5%) for neonate care. - Conclusion : The most important period for home health care needs was one week after delivery, and the health care needs for neonate temperament, behavior and sleeping pattern rose rapidly at the period of 6 months after delivery. Therefore it could be concluded that the postpartum home care should be done by those, written material should be enhanced for parturient women care, and counseling enhanced for neonate care.

• Journal of Korean Society of Rural Planning
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• v.24 no.1
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• pp.1-10
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• 2018

This study is to evaluate the per capita accessibility to child care facilities using road map in rural village unit considering the supply and demand of child care facilities in municipal (Si-Gun) units. Using these estimated accessibility, the most accessible regions to child care facilities was identifies using Moran's index. Assuming establish a new child care facility in the most accessible region, the sensitivity of child care environment was analyzed. The number of regions are 71 si-gun-gu where supply of child care facilities is insufficient. The average accessibility per capita is 1.09 km to child care facilities and the average accessibility in Myeon unit is approximately 2.2 times higher than accessibility in Eup unit (Eup unit 0.54 km, Myeon unit 1.21 km). Approach tendency from village to child care facilities has positive relationship as 0.451 global Moran's index. The high-high (H-H) accessibility regions are wide as Gangwon-do, Gyeongsangbuk-do, Gyeongsangnam-do, Jeollanam-do and Chungcheongbuk-do. Assumed to be established the new child care facilities in Yangyang-gun (Ganwon-do), accessibility changes of child care environment are up to 2.7 times greater and the recipient population is 77% of Yangyang-gun.

• Journal of the Korean Home Economics Association
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• v.40 no.7
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• pp.1-14
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• 2002

This study investigated infant, mother/famny, and nonmaternal care characteristics contribution to infant- mother attachment through ecological perspective. Participants were forty 12-to 18-month-o1d infants and their mothers. Infants were observed in the Strange Situation to assess the pattern of infant-mother attachment; the Observational Ratings of the Caregiving Environment was used to assess the caregiving environment. Mothers were interviewed with the questionnaires, and observed in the laboratory "living room". There were significant effects of material sensitivity/responsiveness and good quality child care on secure attachment. Infant, mother/family, and nonmaternal care characteristics were mutually related.

• 대한예방의학회:학술대회논문집
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• 2001.10a
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• pp.195-196
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• 2001

• The Journal of Korean Medicine
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• v.36 no.3
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• pp.98-110
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• 2015

Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

• YAKHAK HOEJI
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• v.47 no.4
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

• Journal of East-West Nursing Research
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• v.1 no.1
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• pp.82-98
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• 1997

The purpose of this study was to determine pattern of the stress perceived by stroke patients over time. The ultimate goal of the research is to provide data to help nurses to design the plan of nursing care of the stroke patients both in the hospital and at home. A total of 57 admitted stroke patients were collected from one general hospital in Seoul from June, 12 to September, la, 1993. The data were collected for three phases(within one week after leaving the hospital). The tools for this study, three scales were used ; Stress scale developed by the investigator. Constitution classifing scale designed by Kho(1984), and Self-care measuring scale by Kang(1984). Data were analyzed in four steps using statistical analysis. First, demographic data were determined by descriptive statistics. Second. the pattern of stress perceived by stroke patients across three phases was measured using repeated measures ANOVA. Third, stress of stroke patients classified by constitution, paralyzed area. and attack frequency were measured using ANOVA or t-test, and the pattern of stress by group over time was determined using paired t-test in post hoc test. Fourth. Pearson correlation coefficients were calculated to determine the relationship between the stress and self-care activities. The results of this study are ; 1. The pattern of stress across three phases ; There was a decrease of the stress across three phases. In general. psychological stress as the highest among three phases(F=36.92. P=.000). There was a statistically significant difference of the physical stress(F=34.55, p=.000), the psychological stress (F=15.49, p=.0005) and the social stress (F=24.71. p=.000) among three phases. There was a statistically significant difference of the stress between the first phase (on admission) and the second phase(before leaving the hospital) and was a decrease of the stress (t =6.36. p=.000). 2. The pattern of stress of stroke patients classified by constitution across three phases ; Stroke patients classified as So-Eum perceived the highest stress among three groups(Tae-Eum, So-Eum. So-Yang). There was no statistically significant difference of stress according to the constitution of stroke patients among three phases. Hence. stress was not influenced by the constitution of stroke patients, but there was a statistically significant difference of stress over time. 3. The pattern of stress of stroke patients classified by the paralyzed area across three phases ; Right paralyzed stroke patients perceived higher stress than left paralyzed stroke patients. There was, however, no statistically significant difference of stress between two groups except 2nd phase. There was no statistically significant difference of the perception of stress bet ween the right and left paralyzed stroke patients. 4. The pattern of stress of stroke patients classified by the frequency of the relapse of the disease across three phases ; Stress was higher in stroke patients who had the relapse of the disease twice more than the first time. There was, however, no statistically significant difference of stress between two groups. There was no statistically significant difference of stress of stroke patients according to the relapse of the disease among three phases. Hence, stress was no influenced by the relapse of the disease. 5. The relationship between the stress and self-care activities ; There was a negative relationship between the stress and self-care activities each phase(on admission, r= -.1563 ; before leaving the hospital, r= -.4030 ; after leaving the hospital, r= -.5291). Hence, the higher the self-care activities, the lower the stress. This study has three important findings. First finding was that psychological stress perceived by stroke patients was the highest among three phases. The second finding was that factors such as the constitution, the paralyzed area, and the relapse of the disease did not have an influence on the stress perceived by stroke patients across three phases(on admission, before leaving the hospital, after leaving the hospital). There was a statistically significant decrease of the stress perceived by stroke patients across three phases. The third finding was that there was a negative relationship between the self-care ability and stress. In this study, these findings have implications for nursing care for the rehabilitation of stroke patients and suggest the need of nursing intervention to promote the self-care ability and to support the psychological self-esteem of stroke patients.

• International Journal of Oral Biology
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• v.35 no.4
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• pp.185-190
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• 2010

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most prevalent pathogens in hospitals. To investigate cross contamination by this bacterium in both dental and medical settings, the pathogens that cause acute pyogenic infection and one of the major microbes responsible for nosocomial infection were isolated from health care providers, nurses and patients. We used VITEK II to measure drug sensitivity, and we further performed biochemical testing, coagulase serotype testing and pulse-field gel electrophoresis (PFGE) for isolated MRSA colonies. The isolation rate of Staphylococcus aureus from nasal swabs was 75.0% from dental health care providers and 18.8% from the medical health care providers. A total of 10 MRSA strains were isolated from 40 health care providers and 2 patients and the prevalent coagulase serotype from patients and health care providers was VII. The antimicrobial drug resistance and partial PFGE types of the isolated MRSA strains showed a similar pattern. These results suggest that MRSA may be one of the principal causes of nosocomial infection in dental and medical hospitals.

• Health Policy and Management
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• v.3 no.2
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• pp.27-80
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• 1993

It is widely known that patients' utilization pattern for medical care facilities and the patientflow are influenced by multi-factors, such as demographic characteristics, structural characteristics of society, socio-psychological characteristics(value, attitude, norms, culture, health behavior, etc.), economic characteristics(income, medical price, relative price, physician induced demand, etc.), geographical accessibility, systematic characteristics(health care delivery system, payment methods for physician fees, form of health care security, etc.), and characteristics of medical facilities(reliability, quality of medical care, convenience, kindness, tec.). This study was conducted to research the mechanism of patient-flow according to changes of health care system(implementation of national health insurance, health care referral system and regionalization of health care utilization, etc.) and characteristics of medical facilities(ownership of hospital, characteristics of medical services, non-medical characteristics, etc.). In this study, the fact could be ascertained that the patient-flow had been influenced by changes of health care system and characteristics of medical facilities.