• Title/Summary/Keyword: rural population

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Analyses of the Efficiency in Hospital Management (병원 단위비용 결정요인에 관한 연구)

  • Ro, Kong-Kyun;Lee, Seon
    • Korea Journal of Hospital Management
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    • v.9 no.1
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    • pp.66-94
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    • 2004
  • The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

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A Study of Oral Health Impact Profile 14 among the Elderly in Rural Area (일부 농촌노인들의 구강건강영향지수(Oral Health Impact Profile)14 평가)

  • Lee, Ga-Ryoung
    • Journal of dental hygiene science
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    • v.10 no.2
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    • pp.109-116
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    • 2010
  • Objective: The purpose of this study was oral health related quality of life among elderly population in some rural area, Korea. Methods: 546 participants (male 196, female 350) aged more than 65 years (mean $71.4{\pm}4.6\;years$) were surveyed cross-sectionally. All the subjects were examined short-form of Oral Health Impact Profile (OHIP-14) by face to face interview. Categorical responses of strata-adjusted Wilcoxon correlation and Kruskal-Willis test and multiple regression analysis after adjusting for socio-demographic variables were adapted for statistical analysis. Results: 1. As for sub-factors of the quality of living related to oral health, the drop in social ability was 4.61, the drop in mental ability 4.53, the drop in physical ability 3.99, mental inconvenience 3.98, social disadvantages 3.82, physical pains 3.77, and functional division 3.44, on the average. 2. As for the quality of living related to oral health, there were statistically significant differences in functional restrictions by gender, the educational level, and the presence of occupation, in physical pains by gender, the educational level, family members living together. mental inconvenience by gender, the educational level, the presence of occupation. and in the drop in physical ability by gender, the educational level, monthly incomes. There were statistically significant differences in the drop in physical ability by gender, the educational level. in the drop in social ability by the educational level, the presence of occupation, monthly income. and in social inconvenience by age, the presence of occupation, monthly income. 3. There were statistically significant differences in the general quality of living related to oral health by gender, the educational level, the presence of occupation.

The Change of Health Service before and after the Unification of two Health Subcenters in a Rural Area (한 농촌지역 2개면 보건지소 통합전후 보건의료사업 변화 연구)

  • Sul, Sue-Jeong;Park, Hyang;Sohn, Seok-Joon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.427-440
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    • 2000
  • A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

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Studies on the Seroepidemiology of Helminthic Diseases in Korea (우리나라의 주요 기생충질환(寄生蟲疾患)에 대한 혈청역학적(血淸疫學的) 조사(調査))

  • Rim, Han-Jong;Lee, Joon-Sang;Joo, Kyoung-Hwan;Chung, Myung-Sook
    • Journal of agricultural medicine and community health
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    • v.16 no.1
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    • pp.48-60
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    • 1991
  • In a seroepidemiological study in several areas of Korea, the ELISA technique was performed to determine prevalence of some important helminthic diseases in our nation during March $15^{th}$ to June $30^{th}$. 1991. In this survey the serum antibody positive rates of anisakiasis, toxocariasis, clonorchiasis, paragonimiasis, cysticercosis, and sparganosis were measured. Among, 6,704 cases examined, 19.7% showed positive antibody titer at least one of the six items studied. Overall positive antibody rate was 8.1% in anisakiasis, 5.6% in toxocariasis, 3.6% in clonorchiasis, 1.7% in paragonimiasis, 4.5% in cysticercosis, and 2.6% in sparganosis respectively. In Pusan port southeastern part of Korea, antibody positive rate of anisakiasis was 2.9%, and clonorchiasis was 2.8% among 450 examine. In TaeJ$\check{o}$n city, central part of Korea. toxocariasis(6.7%) and anisakiasis(3.7%) showed high serologic positive rate. Of the 875 persons in Chunche$\check{o}$n gun(=province), northern central rural area of South Korea, anisakiasis was revealed as 3.4% seropositivity. In Tonghae port, eastern coast of South Korea. 9.9% of population examined showed positive antibody titer in anisakiasis. Of the 1,122 persons examined in Southern part of Cholla-Namdo(Southwestern coastal area of Korea), anisakiasis was 16.9%, cysticerocosis was 12.7% and the paragonimiasis was 3.3% respectively. In some localized area of Cholla-Pukdo, anisakiasis was 9.3% and cysticekosis was 4.3% among 702 cases examined. In some localized area of Kyungsang-Pukdo, anisakiasis was 10.6%. and toxocariasis was 16.1% among 900 cases examined. And finally, in Cheju-do, southern island of Korea, anisakiasis showed high positive rate(6.7%). Because cross reactions between related helminth group may disturb the analysis of these data, use of further developed techniques such as EITB(enzyme-linked immunoelectrotransfer blot) was considered as a essential tools for the study. We thought that probably most of the positive cases of cysticerosis were taeniasis cases. We can't rule out taeniasis even though EITB was employed as far as crude worm extract or cystic fluid of cysticercus was used as antigen. It was well Known that toxocariasis and anisakiasis also showed cross reactivity. However, the data presented here focus on seropositive rate of several helminthic diseases in Korea, not true prevalence rate of helminthiases, and to wait for more expensive purified antigen in sufficient amount for epidemiologic use is not necessary because increased immunologic sensitivity had little effect on epidemiologic sensitivity. We, here, suggest that ELISA should be applied as soon as possible to the evaluation of prevalence of tissue invading parasitic diseases, and a review of the antibody positive rate obtained in this study would be a basic data for controlling program of parasitic diseases in Korea.

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Characteristics of Disease and Assistance Required for Bed-Ridden Elderly Patients at Home in Rural Areas (일부 농촌지역 재가 와병노인의 질환 및 개호의 특성)

  • Kim, Jin-Ho;Jeong, Yong-Jun;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.49-59
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    • 2003
  • Objectives: This study was intended to provide basic data available for the establishment of comprehensive and systematic public medical service for older persons about their concurrent pathology and time span for their bedridden state, and thereby, the medical service, and individual cares they have received. Methods: The study subjects included 207 elderly residents of men and women aged over 65, who were in the bedridden state at home at the time of investigation in September of 2002 at 11 'Myon' in Kongju city, Chungchongnamdo Province. They were asked to respond to the questionnaires by using interviews at their homes. Results: Of the elderly population studied, the overall rate of bedridden states was 1.61%(1.46% in men and 1.71% in women) and there was an increasing tendency with age in both sexes. The causes for bedridden states indicated that hypertension and atherosclerosis accounted for 43.6 % of them in men, and lumbago neuralgia spinal disease 40.3% in women as the most frequent cause, respectively. The mean years of bedridden states were greater in men(4.81${\pm}$2.89) than women(4.98${\pm}$2.89). By age groups, both sexes showed an increasing tendency of time span with age. The items of care required for the bedridden showed that bathing was the most frequent and it was followed by toileting, dressing and feeding in a decreasing order of frequency. The number of care per one patient was 3.4 in men and 3.5 in women with the increased tendency with decreasing age Ain both sexes. Conclusions: Though the proportion of bed-ridden patients increased according to the increasing age, there are substantial limitations in reducing the prevalence of chronic diseases. Therefore, it is required to establish the appropriate measures, such as various resources of health care services for dealing with the steadily increasing rate of bed-ridden patients.

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Changes in Quality Characteristics of Wild Root Vegetables during Storage (전처리 근채류의 저장과정중의 품질평가)

  • Kwak, Soo-Jin;Park, Na-Yoon;Kim, Gi-Chang;Kim, Haeng-Ran;Yoon, Ki-Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.8
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    • pp.1158-1167
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    • 2012
  • During the peeling, cutting, and shredding of wild root vegetables, the surface is exposed to air. This results in a rapid deterioration in quality and an increase in the potential of contamination by microorganisms, both of which reduce the shelf-life of wild root vegetables in retail markets. Thus, in this study, the effects of various washing treatments on the quality of wild root vegetables, including lotus root, burdock root, and bellflower root, were investigated at 10 and $24^{\circ}C$. Lotus root, burdock root and bellflower root were washed with 0.2% acetic acid (AA), 0.2% citric acid (CA), 500 ppm acidified sodium chlorite (ASC), and tap water (TW), which was used as a control, and stored at $10^{\circ}C$ and $24^{\circ}C$. The changes in total plate counts, coliform groups, polyphenol oxidase (PPO) activity, color, pH, and exterior appearance of the samples were then evaluated. The pH and initial microbial contamination levels were reduced when the root vegetables were washed with AA, CA, and ASC. In particular, initial population levels of total plate counts and coliform groups were not detected in lotus root and burdock root that had been washed with ASC and their growth was significantly (p<0.05) inhibited during storage at 10 and $24^{\circ}C$ when compared to the control (TW). In addition, the polyphenol oxidase (PPO) activities of the root vegetables washed with AA, CA and ASC were lower than that of root vegetables washed with TW. ASC was determined to be the most effective treatment for preventing microbial growth, tissue softening, and the development of browning and an unpleasant smell. At $10^{\circ}C$, the overall qualities of the wild root vegetables were maintained longer when compared to $24^{\circ}C$.

Comparative analysis of volatile and non-volatile flavor compounds in rice paste made by α-amylase according to cultivars (α-amylase를 이용하여 제조한 쌀 페이스트의 품종에 따른 휘발성비휘발성 향미성분 비교분석)

  • Son, Eun Young;Kim, Hye Won;Kim, Sun Ah;Lee, Sang Mi;Paek, Se Hee;Kim, Sun Hee;Seo, Yong Ki;Park, Hye-Young;Oh, Sea-Kwan;Kim, Young-Suk
    • Journal of Applied Biological Chemistry
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    • v.60 no.3
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    • pp.283-291
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    • 2017
  • Rice that the half of population in the world eats as a staple food is mostly produced and consumed in Asia. However, its consumption is nowadays decreasing mainly due to diet diversity. Accordingly, some attempts are in demand to enhance the utilization of rice. In this study, profiling of volatile and non-volatile flavor components in rice pastes obtained by ${\alpha}$-amylase was performed and compared according to nine different rice cultivars domestically cultivated in Korea using gas chromatography-mass spectrometry combined by solid phase microextraction and gas chromatography-time of flight-mass spectrometry after a derivatization, respectively. In total, 46 volatile compounds identified included 6 alcohols, 6 aldehydes, 4 esters, 4 furan derivatives, 4 ketones, 1 acid, 1 sulfur-containing compound, 7 hydrocarbons, 5 aromatics and 8 terpenes. The non-volatile flavor components found were composed of 12 amino acids, 6 sugars and 4 sugar alcohols. In principal component analysis, rice paste samples could be discriminated according to cultivars on the score plots of volatile and non-volatile flavor compounds. In particular, some volatile compounds such as pentanal and 4,7-dimethylundecane could contribute to distinguish Senong 17 white and Senong 17 brown, whereas ethanol, 6-methylhep-5-en-2-one, and tridecane could be highly related to the discrimination of Iipum from other cultivars. Among non-volatile compounds, some amino acids such as glycine, serine and ${\gamma}$-aminobutyric acid and some sugars such as sucrose and fructose were mainly responsible for the discrimination of Danmi from the other cultivars. On the other hand, galactose, arabitol and mannose were more closely related to Senong 17 white than Senong 17 brown.

Spatial Characteristics of Travelling Merchants and Consumers in Chongsan Periodic Markets of Okchon County, Korea (충북(忠北) 옥천군(沃川郡) 청산(靑山) 정기시(定期市) 출시자(出市者)의 공간적(空間的) 특성(特性))

  • Han, Ju-Seong;Kim, Bong-Kyeum
    • Journal of the Korean association of regional geographers
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    • v.2 no.1
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    • pp.133-150
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    • 1996
  • This study is to clarify the market cycle of travelling merchants and the spatial behavior of consumer's commodity purchasing. its reasons and purchasing region of each commodity in Chongsan of Chongsan Myun(village) periodic markets, that is one of the lowest central places in Okchon county. The data used are the results of interviews with 58 travelling merchants on June 22 and July 17, 1994, and questionaire survey taken to parents of students of Chongsan middle school of Chongsan Myun in Okchon county. Study area is typical agricultural regions taking the role of central places to provide rural service and is comparatively important periodic markets. Some of findings are summarized as follows: (1) Until 1980's. appearance of closed periodic markets is caused by the population decrease in rural region, income increase, and rising of living level according to the Five Years Planning of Economic Development, appearance of chain stores of agricultural co-coperative and of supermarkets,. changes in distribution mechanisim by increasing consignment volume of agricultural products through agricultural co-coperative, and the development of transportation in Okchon county. These, too, became the reasons for the decline of the Chongsan periodic markets in Okchon county. (2) Most of the travelling merchants visiting the Chongsan periodic markets are in their 50's of age, and they sell the miscellaneous commodities and agricultural products. And about one-fourths of travelling merchants reside in regions with periodic markets and in Okchon of higher order central places. (3) Travelling routes visting periodic markets can be simplified to five types. Major types of travelling routes are Chongsan periodic market$\rightarrow$Wonnam$\rightarrow$Boun, and Chongsan periodic market$\rightarrow$Yungdong$\rightarrow$Yongsan. The patterns of travelling merchants visiting periodic markets are classified into the type of everyday visiting of periodic markets over three days of five days from merchant's residence to market, and the type of merchants or consumers visiting one day's of five days. On days that travelling merchants don't visit periodic markets they purchase the commodities in Seoul, Taejon and Chongju. (4) Consumers who use periodic markets are from thirties to fifties years of age and most of them are employed in agriculture. Consumers visit periodic markets on foot or by bus, and visit two or three times in a month, and mainly purchase the commodities for one or two hours from about ten o'clock in the morning. (5) Consumers purchase the necessaries of life in periodic markets, and other commodities are purchased in Taejon city, Youngdong, and Boun Eup(town). But consumers purchase the goods(convenience goods, shopping goods, and specialied goods) largerly in Chongsan, because additional expense and disadvantage after service with poor transportation service for purchased goods in others regions. Therefore, the hierarchies of central places by the consumer's purchasing behaviour can not be seem in dewellers in Chongsan and Chongseong Myun.

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A Study on the Attitude of the Consumers and the ″Referees″ toward the Community Health Nursing Service of a General Hospital in Rural ]Korea (일종합병원의 지역 사회보건 간호사업에 대한 지역 사회 간호써비스 수혜자 및 의뢰자의 태도 조사 연구)

  • 이정렬
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.131-138
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    • 1978
  • The change of society has brought about various health problems which have become to demand comprehensive health services not only for individuals but also for families and communities as the unit. To meet the societal needs W Hospital in a rural Korea established a Department of Community Health Nursing Services and provided nursing services to patients under a early discharge program. This study is to evaluate the community health nursing services carried out the department in general, and has following specific objectives : 1. To learn attitude of the consumers and the "referees" toward early discharge program. 2. To find out attitude toward home care and cure services. 3. To find out the consumers and the "Referees" attitude toward the 15 selected home cue and cure activities by public health nurse. 4. To investigate possibility of charging fee for the 15 selected home care and cure activities by public health nurse. Three different study population were chosen: namely the consumer, the "referee" I and II. Excluding families moved out and not able to be contacted, the total families (77) referred to the department during the study period of September 1974 - December 1975 are defined as the consumer. Thirty seven nurses among 81 nurses who have been working in W Hospital since the inception of the Community Health Nursing Service Program were randomly selected. Thirty two nurses were defined as the "referee"I, because 5 questionnaires were not able to be collected. Twenty four doctors out of 37 who have been working since the Community Health Nursing Service Program started, and who were able to contact were called as the "referee" II. Data collection method employed for the consumers was direct interviewing with preposed interview schedules, and for the "referees"questionnaire method was utilized. x$^2$test and 100-percentage were employed in analyzing the data. The study findings are follows: 1. Attitude toward early discharge: Above 85% of the consumers and the "referees" approved the early discharge: Above 85% of the consumers and the "referees" approved the early discharge program. 2. Attitude toward the home care and cure services: Above 75% of the consumers and the "referees" showed positive attitude toward the home care and cure services by public health nurses. 3. Attitude toward 15 selected home care and curative activities by public health nurses: On the average more than 50% of the consumers and the "referees" expressed an affirmative attitude to perform 15 selected home care and cure services by public health nurses. 4. Attitude toward charging fee for 15 selected home care and curative activities by public health nurses: Above 85% of the consumers thought that they would pay for the services. Only 12.8% of the consumers and 5% of the "referees" what to have the services for nothing. Based upon the findings of this study; That is, the home care and cure services to be given by public health nurse were positively responded by the consumers and the pro-fissionable, one can conclude that the services provided by the Department of Community Health Nursing Service of W Hospital have been well accepted, and that early discharge program of hospital is believed to be a means to lessen the expenses of patients from hospitalization and to promote recovery from illness. It is recommended that hospital centered cure services should be reconsidered and scrutinized to meet community health needs. NOTE : "referees" are nurses and doctors who refer the early discharged Patient to the Department of Community Health Nursing Service.

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Falls among Community Dwelling Elderly People: Prevalence and Associated Factors (일부 농촌지역 노인들의 낙상발생과 관련된 요인)

  • Cho, Young-Chae;Yoon, Hyun-Suk
    • Journal of agricultural medicine and community health
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    • v.29 no.2
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    • pp.223-235
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    • 2004
  • Objectives: This study was to evaluate the actual condition of falls among community-dwelling elderly people and its related factors to prepare for the establishment of comprehensive prevention programs of senior population. Methods: The study subjects included 460 home residents over 65 years in a district of Chungnam Province and interviews were given to all of them, asking about experiences of falls and their related factors. The analysis of study results came to the following conclusions. Results: The rate of falls among total subjects was 35.5%. With the percentage by age and sex, over 70's and female were significantly higher than male(p=0.000) and under 69 (p=0.008). The groups with poor visual acuity and hearing ability had higher rate of falls than the normal groups based on their health status. In terms of place they experienced falls, out-door occurrence accounted for 53.4% of total falls, which was higher 46.6% of in-door. By season when falls are experienced, "winter" showed the greatest rate, and by time of the day, evening had the highest rate. By causes of falls, "Slippery ground"accounted for 30.5% and "Tumbled over" 23.5% of total falls, respectively, showing the major role of environmental causes for falls. For individual factors, "Irritability" and "Carelessness" occupied 11.3%, 10.8% of total falls, respectively. The Odds Ratios for falls in women was 2.19 times higher than in men, and those in 70's are 2.01 times higher than in 60's, and those with abnormal BMI was 3.68 times higher than in normal groups, and those with perceived symptoms was 1.94 times higher than those without. Conclusions: It is suggested that more consideration should be directed toward taking comprehensive and systematic prevention measures ranging from setting-up the injury-protective environments to allowing senior citizens to have competence in ADL activity as well as proper general health conditions, considering the higher rate of falls for elderly persons in a rural part of this country than that of western countries and the greater proportion of falls which can be ascribed to environmental factors.

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