• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Korea Journal of Hospital Management
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• v.20 no.3
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• pp.45-55
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• 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 the Korean Home Economics Association
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• v.28 no.4
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• pp.65-86
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• 1990

Living conditions of the rural elderly were assessed in terms of clothing behavior, health and nutritional status, housing and envioronmental condition, and psychological adjustment. The subjects were eighty individuals over sixty residing in the rural community of Iksan-kun, Chollabukdo. The interview method using questionnaires, direct measurement, and observation was used for this study. Data were compared with those obtained from a previous study of the elderly residing in an urban area. Clothing behavior showed that the elderly residing in the rural community were more concerned about plain and conservative design of clothes than their urban counterparts. Special protective clothes for cropdusting with agricultural chemicals had not been prepared. The following urgent needs were pointed out: development and supply of agricultural chemical protective clothing and development and education of appropriate washing and clothing care methods. The health status of the elderly was generally good, but poor eating habits were found more frequently in the rural elderly than among the urban dwellers. Several dietary nutrient intakes were insufficient. Contrasting the urban elderly with the rural group, it was found that the urban group lacked sufficient vitamin A and vitamin C and the urban women had insufficient calorie whereas the rural group was deficient in protein, vitamin A, calorie, and fat. A significant relationship was found between dietary nutrient intake and health index, food habit points, self recognized health status, meal satisfaction, and economic status. Urgent needs of the development of a nutrition education program for the elderly were pointed out. Most of elderly residing in the surveyed rural communities were living alone or with their spouse only, therefore only one room was used among the three or four available rooms. Most of the rural elderly were living either in a traditional Korean house built with differing floor levels or in a modified Korean style house. Minimal modernization had been made for kitchen facilities such as sink and gas range or for heating facilities with the briquette boiler. However, sanitary space such as lavatory and bathroom had not been remodeled. A housing welfare program for rural communities should be implemented at the national level. The comparison of psychological characteristics of the rural elderly with their city counterparts revealed that the rural elderly have a more stable psychological status and optimistic attitude than those living in a city. However, it was found that most of the elderly did not have any future plan. Community programs for the elderly including hobbies or leisure activities or education programs to generate close interpersonal relationships with their children should be developed and provided.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.211-226
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• 2011

Objectives : The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods : Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in "Hwang-je-nae-gyung(黃帝內經)", "Yumun-sa-chin(儒門事親)", "Geum-guei-yo-ryack(金匱要略)", "Eui-hack-ip-mun(醫學入門)", "Gyung-ack-jeon-seo(景岳全書)", "Eui-hack-gang-mock(醫學綱目)", "Dong-eui-bo-gam(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results : 1. Theromtherapy is originated from yu(熨), hot hand, warm, water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self's care and cure inflammatory skin disease. Magnet's matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions : Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy's expectation.

• The Journal of Korean Academic Society of Nursing Education
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• v.8 no.1
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• pp.95-107
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• 2002

The purpose of this study is to determine the clinical nurses' knowledge of DM and diabetes patient education aptitude so as to provide a basis for clinical nurse training with respect to diabetes patient education program. The data has been collected through the questionnaires of 42 items from the Knowledge on DM and each 16 item from the Importance on the elements of diabetes patient and the Recognition for clinical nurses, respectfully. 166 nurses from a general hospital who had participated in clinical nurse training in Sep. 28 and Oct. 4, 2001 were subject to respond the questionnaires. Analysis has been done by using statistical method such as percentage, average, standard deviation, t-test, ANOVA, Duncan test and Pearson correlation coefficients. The findings are as follows: 1. Clinical nurses' knowledge levels of diabetes 1) The average level of nurses' knowledge about diabetes is 29.37 (right answer- finding rate: 70%), which is intermediate. 2) Amongst the nurses classified by their knowledge levels about diabetes, the group with less than one year career and that with more than 5 year careers are found to have higher knowledge levels. The item with the highest right answer-finding rate was 'Please find the wrong out of the following examples about foot care'. Meanwhile, the item with highest incorrect answer-finding rate was 'what does blood sugar control aims for amongst gestational diabetes?'. 2. Clinical nurses' importance and perception levels of educational training about diabetes 1) There were no differences amongst nurses' importance level about diabetes. 2) Nurses usually had high scores(4.30) in terms of the items related to the importances about educational training. 3) There were quite high recognitions of general characteristics and symptoms about diabetes, amongst the nurse cohorts working more than one year and less than 5 years, and over 5 years, the group belonging to the internal department, that having the previous experiences of dealing with diabetes, and that having their diabetic relatives and other close people. Meanwhile, strangely, the group who identified themselves as 'not good at treating diabetes' had a high recognition level of educational training about diabetes. 3. Relationship between knowledge levels and importance & perception levels of diabetes 1) The higher knowledge about diabetes nurses had, the more importance they recognized. 2) It is found that there was no relationship between knowledge and perception of diabetes. 3) The more importance about diabetes nurses had, the higher perception they obtained. In conclusion, there is an urgent need for systematic educational programs about diabetes including technical aspects, in order to upgrade and improve nurses knowledge levels. In addition, re-educational training should be provided at regular intervals. Further, we believe the nurses with high knowledge about diabetes and interests in the provision of educations for patients can be far more confident, and in return, patients can have better self-management about diabetes obtained through educations. Based on the above-mentioned findings, we would like to make the suggestion: re-evaluation about nurses' knowledge and cognition levels should be carried out after job training programs about diabetes.

• The Journal of Korean Academic Society of Nursing Education
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• v.8 no.1
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• pp.120-130
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• 2002

This study was attempted to identify and compare in developing a health promotion program for extending healthy life expectancy of the middle-aged women and protecting health of women in the vulnerable class by comparing and researching life-style and actual conditions of health for the middle-aged women in rural and urban areas. Subjects of this study were 160 middle-aged urban women in Seoul city and chongju city and 155 middle-aged rural women in rural community goisangun. For collecting data, questionnaire was performed with structured questionnaires was used to know their actual conditions of health and life-style. Findings of this study were as follows. 1. In comparing life-style of the urban middle- aged women with the rural community, the percentage of regularly checked-up were higer urban women (46.4%) than the rural women (35%); women who have not checked up were 21.3% and 11.4% in the rural community and cities respectively, but it had a statistically significant difference (p=0.009). For the types of checkup, the rate of uterine cancer checkup than that of breast cancer self-examination or cholesterol test was higher both in the rural community(75.6%) and cities(77.4%). 2. The results of comparing actual conditions of the middle-aged women in the rural urban area were as follows; the recognition of health of the urban women was 'Very healthy (7.2%),' 'Healthy (35.5%),' 'Moderate (46.5%),' and 'Not healthy (10.3%), while the recognition of the rural women was 'Very healthy (2.5%),' 'Healthy (30.0%),' 'Moderate (36.3%),' and 'Not healthy (30.6%)'. These results showed a statistically significant difference (p=.000). Women having any problems in health were 48.1% and 36.8% in the rural and the urban respectively and it had a statistically significant difference (p=.042). For the most of health problems, arthritis accounted for 29.4% in the rural community and arthritis and constipation accounted for 21.3% in the urban. According to findings of this study, it can be concluded that rural women had more health problems, felt they were not healthy themselves and were checked up regularly less than the urban women, and their health care was poor. Therefore, more effective nursing intervention plans should be designed to enhance the performance level of health promotion for rural women.

• Journal of Preventive Medicine and Public Health
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• v.53 no.2
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• pp.89-97
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• 2020

Objectives: The quality of life (QoL) of the elderly and elder abuse are growing public health concerns. This study aimed to evaluate the prevalence of abuse and the association between QoL and abuse in older adults. Methods: Multistage random cluster sampling, along with valid QoL (LEIPAD: LEIden, the Netherlands; PADua, Italy; Helsinki, Finland) and abuse questionnaires, were used to assess QoL and elder abuse. Path analysis was performed using Mplus. SPSS and AMOS were used for the other analyses. Results: A total of 386 elderly individuals with a mean age of 68.00±6.10 years were interviewed, of whom 200 (51.8%), 289 (74.9%), and 376 (97.4%) were women, educated, and married, respectively. Moreover, 167 (43.2%) had low-to-moderate QoL, and 108 (27.9%) had experienced a moderate level of abuse. QoL and abuse were inversely associated (r=-0.253), with men (β=-0.24) more affected than women (β=-0.21). Musculoskeletal disorders were also strong determinants of QoL in the elderly. QoL was strongly associated with emotional abuse, while abuse was highly related to the social component of QoL. Furthermore, emotional abuse was the type of abuse most significantly associated with the self-care, depression/anxiety, cognitive, and social components of QoL. Sexual abuse, violation of personal rights, and neglect were the main determinants of the physical functioning, life satisfaction, and sexual domains of QoL, respectively. Conclusions: Nearly half of the elderly individuals lacked a high QoL, and at least one-fourth had experienced some form of abuse. Elder abuse was correlated inversely with QoL. Therefore, preventive interventions are recommended to decrease elder abuse in the family, community, and other settings.

• Journal of dental hygiene science
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• v.13 no.3
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• pp.230-237
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• 2013

In this research, the degree of depression and death orientation of the 332 female students majoring in dental hygiene at colleges located in Gyeongsangbuk-do Province were examined and analyzed through a structured self-administered questionnaire from May to July, 2012, for the purpose of improving their mental health. The results are as follows: 1. The degree of depression of the subject students majoring in dental hygiene was shown that 59.9%, 36.8%, 3.0%, and 0.3% of the students were in the normal group, mild depression group, moderate level of depression group, and severe depression group, respectively. 2. The grand mean and the standard deviation of the subjects'death orientation was $2.09{\pm}0.62$ points. 3. The degree of depression of the subjects whose family's economic level was low, whose satisfaction with their family background was low, whose satisfaction level with their major was low, whose school records was low, who frequently thought about death, and who attempted suicide was high in a meaningful way, and death orientation was meaningfully low. In addition, those in the group with the experience of feeling suicidal were proved to have a significantly high degree of depression, and those without the experience of education about death had a low level of death orientation. 4. The degree of depression and death orientation had a positive correlation. When the study results above are combined, follow-up research needs to be conducted so that differentiated programs linked with the care for mental health for the formation of proper attitudes toward depression and death will be established to help students lead a positive life.

• Journal of Distribution Science
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• v.13 no.12
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• pp.73-84
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• 2015

Purpose - Various social issues have arisen since the beginning of the 21st century therefore, enterprises that disregarded social issues have become unsustainable, and social enterprises have appeared to address these issues. A social enterprise is a social mission-focused organization that uses a market-based strategy and has a vulnerable business structure. To be self-sustainable, a social enterprise should make consumers aware of the value that it provides and secure its profitability through consumer consumption. From this perspective, this study investigates the relationship between perceived value (utilitarian and hedonic) and loyalty, and examines how memory and attitudes play mediating roles between perceived value and loyalty. For these purposes, the author developed a structural model consisting of several variables. In this model, perceived value, which was utilitarian and hedonic, was proposed to affect the memory and attitudes toward social enterprise products, thus increasing loyalty. Therefore, memory and attitudes were proposed as core mediating variables between perceived value and loyalty. Research design, data, and methodology - To analyze the proposed model, data were collected from 582 respondents and analyzed using SPSS 21.0 and AMOS 21.0. To test unidimensionality and the nomological validity of the measures of each construct, we employed a scale refinement procedure. The results of the reliability test with Cronbach's α and confirmatory factor analysis warranted the unidimensionality of the measures for each construct. In addition, the nomological validity of the measures was warranted from the results of the correlation analysis. The result of the overall model analysis demonstrated a good fit (χ²=529.881, df=144, χ²/df=3.680, p-value=0.000, GFI=0.905, NFI=0.948, CFI=0.961, RMR=0.036, RMSEA=0.068). Results - The findings are summarized as follows. First, the hedonic and utilitarian value of social enterprise products had positive effects on memory and attitudes. Second, the hedonic value of social enterprise products more strongly affects memory and attitudes than utilitarian value. Third, memory and attitudes had positive effects on loyalty. Lastly, memory had a stronger effect on loyalty than attitudes. Conclusions - The purchase rate of social enterprises' products increases only if the products are included in the "information search" and "alternative evaluation" processes in consumers' purchase decision-making processes. Therefore, a social enterprise must actively promote the fact that it pursues a social value, and shares both the hedonic and utilitarian values of its products. Accordingly, because hedonic value has a more significant impact on a company and attitudes, a social enterprise should develop hedonic values for product consumption, thereby leading consumers who care about value consumption to purchase its products. Moreover, a social enterprise must maintain good memories and attitudes for consumers because memory does not change over time, although attitude does. The limitations of this study and suggestions for future research are as follows. This study viewed "consumer loyalty" as the success factor of social enterprises, thereby considers an "increase in sales" as the success factor. Therefore, in future studies, diverse factors, including social contribution and word-of-mouth intention, should be regarded. In addition, future studies need to thoroughly review and make assurances about the relationship between memory and attitude.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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• pp.605-622
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• 1996

Needle stick injury, in which blood-borne pathogens including Human Immune-Deficiency virus and hepatitis B virus are transmitted, is one of the major occupational hazards that health professionals face everyday. In order to provide basic data for the development of educational programs for health professionals aimed at preventing and effectively managing needle stick injuries, a retrospective descriptive study was carried out .The subjects of the study were 630 health professionals, 499 nurses and 131 physicians, from two university hospitals in Seoul, Korea. Data on episodes of needle stick experiences over the past is months September 1994 through August 1995, were collected between September 1 and 7, 1995. A Questionaire developed by the researcher was used. The frequencies and the percentile score for episodes of needle stick injuries were calculated using the PC-SAS program. The differences and similarities in reference to the structure, career, and specialty variables were analysed by X$^2$-tests. Results are as follows : 1. Of the sample, 521(82.7%) reported a needle stick injury, 33.4% reported 3 or more episodes of needle stick injuries. 2. The needle stick injuries occured in the following processes : process of percutaneous venepuncture for intra-venous injection and infusion(55.3%), medical examination and treatment(48.9%), per-cutaneous venepuncture for blood sampling (46.3%) and intra-muscular injection(42.2%). 3. The study showed that needle stick injuries occured before(19%), during(25%), and after (56%) client treatment. The major causes of needle stick injuries were perceived to be hastiness(82.2%) and carelessness(48.3%). Of these injuries, 91.8% occured in emergency situations. 4. Follow of care for the injury consisted of : treating the injured site immediately using disinfectants(89.7%), reviewing the clinical records of the patient involved(84.2%), immunological investigation for the status of antibodies(11.1%) and self-medication of antibiotics (10.7%). Only 16.3% of the total episodes were founded to have been reported to the administrative unit. 5. The length of clinical experience of the nurses, clinical specialty and length of clinical experience in physicians were found to have influenced the episodes of needle stick injuries ; nurses with less than 1 year and with more than 6 years of clinical experiences had significantly lower levels (X$^2$=25.04, P=.00), surgeons had significantly higher levels (X$^2$=9.89, P=.02) compared to that of internists and interns, higher(X$^2$=4.54, P=.03)than residents.