• 농촌의학ㆍ지역보건
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• 제7권1호
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• pp.33-42
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• 1982

It is discussed in a social epidemiology that a symptom would be regarded as an illness or not by the inhabitants' socio-economic status, ages and races, and the aspects of health care seeking are various according to the above-mentioned characteristics. This paper surveyed the symptom recognition and health care seeking following a questionnaire that, of 14 symptom groups presented, which symptom would be regarded an illness necessary for medical treatment, and if it is regarded as an illness, which kind of medical treatment would be thought to be reasonable. As a result, differently from the general theory of social epidemiology, statistical differences according to independent variables was not found in symptom recognition, which indicates that Korean medical culture is similar between urban and rural areas. But in anticipatory health care seeking, various health care seekings were performed following the symptoms. Especially, general hospitals' medical care was thought to be more desirable by the inhabitants in city area than in rural area ; youngers than olders; high-incomers than low-incomers ; new or old middle class or urban laborers than rural farmers ; and the highly educated than the low educated. Conversely, the latters seeked some treatments by pharmacy.

• 한국의료질향상학회지
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• 제8권1호
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• pp.96-106
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• 2001

• 농촌의학ㆍ지역보건
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• 제7권1호
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• pp.25-32
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• 1982

This paper is concerned with the attitude of the Guro inhabiants concerning medical care system in terms of the credibility of hospitals. The credibility may be consisted of three components : availability, friendliness, and expertness. These were considered as dependent variables. Independent variables were age/education/income/perception of differentiation. The questionnaire was administered to 127 stratified samples in Feb. 1982. The results were as follows : 1) The group whose age was above 50 years gave a favor for the medical care system in terms of credibility. This fact implied that cultural influence on the perception and attitude about medical care system was very crucial, and it was noticed that doctor-patient relationship have been changing. 2) The attitude of the inhabitants on the credibility was appeared generally as unfavorable and indifferent. 3) According to $X^2$-test, education, income, and perception of differentiation were identified as having statistically significant trelationships with friendliness factor.

• 보건행정학회지
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• 제27권2호
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• pp.114-120
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• 2017

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.

• Journal of Preventive Medicine and Public Health
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• 제22권2호
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• pp.259-267
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• 1989

The objective of this study was to analyze the influence of the hospital and insurer in causing delayed reimbursement of medical insurance benefits. We analyzed major variables at three different sized hospitals to examine the effect of the hospital and insurer using the two-way ANOVA method. The results were as follows: 1. The time interval between claim by hospitals and payment of the benefit was statistically different according to hospital in both admission and outpatient care. 2. The time needed by the insurer for investigating the claims was statistically different according to hospital and insurer in both admission and outpatient care. There was interaction between the hospital and insurer factors in outpatient care. 3. Although there was interaction between the hospital and insurer factors in admission care, the time interval between claim and payment was statistically different. In outpatient care, the payment interval between claim and payment was also statistically different according to the hospital and insurer.

• Journal of Preventive Medicine and Public Health
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• 제31권2호
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• pp.323-334
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• 1998

대구지역 지체장애인들을 대상으로 만성이환시 의료이용에 영향을 미치는 요인을 조사하기 위하여 1997년 4월부터 7월까지 등록된 재가장애인에서 20세 이상의 지체장애인 1,307명 중 만성질환이 있다고 대답한 337명 전원을 대상으로 자기기입식 설문지와 면접을 통하여 자료를 수집하였다. 만성질환으로 인한 의료기관 이용률은 81.9%로 병의원이용이 69.1%, 약국이용이 12.8%였다. 단순분석 결과, 소인성 요인에 따른 의료이용실태에서는 기혼이고 직업이 있는 경우에서 의료기관 이용률이 유의하게 높았다(p<0.05). 건강관심이 높은 군에서 의료기관이용이 유의하게 높았으며(p<0.01), 필요성 요인인 평소 아플 때 대처하는 방식이 의료기관 이용과 유의한 관련성이 있었다(p<0.01). 경로분석결과 직업, 경제적상태, 의료보장상태, 평소 아플 때 대처방식이 직접적인 영향을 미쳤으며(p<0.05), 건강관심도, 단골진료기관 유무 등의 변수들도 간접적인 영향을 미쳤다. 의료기관 미이용 이유에서는 '돈이 없어서'가 31.1%로 가장 많았고, '별 증상이 없어서'(18.0%), '불편하거나 같이 갈 사람이 없어서'(14.8%), '그냥 있으면 나을 것 같아서'(14.8%), '시간이 없어서'(8.2%), '치료해도 소용이 없을 것 같아서'(6.6%)의 순이었다. 이상에서 만성질환을 가진 지체장애인들의 의료이용을 높이기 위해서는 장애인 스스로 건강과 질병에 대한 관심을 가질 수 있는 보건교육을 강화하고 장애인 고용촉진을 위한 정책을 마련하여 전반적인 경제적 수준을 향상시키고 의료보호의 확대를 통해서 의료이용의 형평을 추구하여야 겠다.

• 근관절건강학회지
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• 제20권1호
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• pp.43-51
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• 2013

Purpose: The purpose of this study was to investigate attitudes and preventive practice of pressure ulcer among hospital nurses and identify factors affecting their preventive practice of pressure ulcer. Methods: Data were collected at April, 2011 in a university hospital in Korea. A total of 140 hospital nurses completed a questionnaire including attitudes and preventive practice of pressure ulcer. Data were analyzed with descriptive statistics, Spearmans rho, and stepwise multiple regression via SPSS/WIN 20.0. Results: Levels of attitudes and preventive practice of pressure ulcer were average 3.65 out of 5 and 2.19 out of 3 respectively. There was significant difference in preventive practice of pressure ulcer by area of practice ($x^2$= 43.35, p<.001), frequency of pressure ulcer care ($x^2$=10.72, p=.013), and experience of wound care education (Ζ=4.73, p=.030). The attitudes toward pressure ulcer prevention were positive correlated to preventive practice among nurses (rho=.190, p=.049). Area of practice, attitude toward pressure ulcer prevention and experience of wound care education explained 48% of variance in preventive practice of pressure ulcer. Conclusion: For improving quality of care, it is important to provide educations to change nurses attitudes toward preventive practice of pressure ulcer.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.437-445
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• 1994

The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE III scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE III score rised (p<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. When the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. When we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (p<0.05).

• 보건행정학회지
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• 제30권4호
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• pp.433-437
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• 2020

Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor's quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor's quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.

• 농촌의학ㆍ지역보건
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• 제47권1호
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• pp.1-13
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• 2022

Objectives: This study aimed to establish a linkage model involving regional responsible medical institutions after analyzing the existing conditions and deriving problems through qualitative analysis within the community care system. Methods: A total of 14 participants of this study were selected through the snowball sampling method, including 7 community care service providers and 7 service users. As for the research data, primary data were collected through interviews, and as a result of analyzing according to Aday&Anderson' model, a total of 5 catergories, 8 topics, and 22 sub theme were derived. Results: The problem derived from the interview is that division services are provided for each institution due to the absence of a key central institution of community care system, and users' commercial institutions is unclear. The second is the inconsistency between the needs and supply for community care, resulting in a possibility of delay in returning to the community after discharge. Based on these problems, it is necessary to unify it as an community care window of the Dong-community center. In addition, there is a need for public health centers to play an active role, and to establish a public-private joint system with the Health and Living Support Center to establish a model that can play a certain role. Conclusions: Therefore, based on the results of this study, it can be used as basic data when constructing community care model and applying it as an expanded model in the future.