Determinants of Healthy Living Practice: County Approach / 보건행정학회지

Background@#The purpose of this study is to investigate the factors affecting the healthy living practice rate such as non-smoking, moderate drinking, walking, and low-salt diet by elementary municipality (so called, ‘si-gun-hu’). @*Methods@#The 2016 Korean Community Health Survey was used for the analysis. The theoretical model is founded upon the Anderson model, and both the multiple linear regression analysis and the beta regression analysis was performed for estimation. @*Results@#As a result of the beta regression analysis, healthy living practice rate was found to be significantly higher in the areas with a less number of cigarette retailers, participating in healthy city projects, a low proportion of people who perceive their body type as obesity, a higher proportion of women, and a lower proportion of spouses. @*Conclusion@#In order to improve healthy living practices, the regulations on health risk businesses, the spread of Healthy City project, and policy efforts awaring obesity are recommended.

A Survey on the Level and Related Factors of Health Literacy in Korean People / 보건행정학회지

BACKGROUND: The purpose of this study is to measure the Korean health literacy level and to analyse its gaps according to the factors of socioeconomic and health status and health behaviors. Based on this, policy implications were reviewed to improve the understandability on health information and to reduce the gap among socioeconomic groups. METHODS: HLS-EU-Q47, a tool developed by the European Health Literacy Project, was used to conduct a face-to-face interview survey on the health literacy for the samples from general population. RESULTS: The public general health literacy (HL) index was 34.5 out of 50. HL is consisted of three sub-dimensions: healthcare (HC-HL), disease prevention (DP-HL), and health promotion (HP-HL). And a HL analysis found scores of 34.7 points for HC-HL, 35.4 points for DP-HL, and 33.3 points for HP-HL. The level of all HL was different according to socioeconomic characteristics and health behavior. CONCLUSION: Based on the results of this study, more research activities on health-related literacy need to be conducted, and monitoring system on the HL level needs to be developed and implemented. In addition, a program to improve HL levels needs to be developed in order to strengthen the basis for a more sustainable healthcare system as an agenda with national health policy priority.

Role of Healthcare in Korean Long-Term Care Insurance

With the rapid aging of the population, Korea introduced public long-term care insurance for older people in 2008. The long-term care insurance was designed as a separate scheme from the national health insurance, with eligibility qualifications and the certification process based on functional disability, benefits and coverage of community-based and institutional care, and a financing structure through multi-party contributions. Delivering appropriate health services to long-term care beneficiaries who manifest a high prevalence of comorbid chronic conditions with rising healthcare costs, however, presents a particular challenge. The lack of coordination between the health and long-term care sectors, limited consideration of physicians' assessments in the certification process, inadequate provision of health services in long-term care facilities, and overlapping and inefficient use of care resources act as barriers to providing comprehensive healthcare for older beneficiaries. Through active participation in the long-term care system, health professionals can help older patients navigate through the complex long-term care terrain to obtain quality healthcare.

Occupational Stress in Relation to Cerebrovascular and Cardiovascular Disease: Longitudinal Analysis from the NSDSOS Project / 대한산업의학회지

OBJECTIVES: This prospective study was performed to investigate the association between occupational stress and the development of cerebrovascular and cardiovascular diseases. METHODS: A total of 8,429 employees were selected from a nationwide sample, proportional to both the Korean Standard Industrial Classification and the Korean Standard Occupational Classification. A structured self-reported questionnaire was used to access the demographic and socioeconomic characteristics, health behavior and work related characteristics. 43-items of the full version of Korean Occupational Stress Scale (KOSS) were used to access the participants occupational stress. New cases of hospitalization due to cerebrovascular and cardiovascular diseases were evaluated using medical utilization files received from the National Health Insurance Corporation for the period of March 2004 to December 2005. A logistic regression analysis was performed to investigate the association between occupational stress and cerebrovascular and cardiovascular diseases. RESULTS: 43 new cases of hospitalization due to cerebrovascular and cardiovascular diseases were found. According to the results of the logistic regression analysis, job stressors were related with circulatory diseases after adjustment for gender, age, number of workers, employment type, shift work, smoking, alcohol intake, and regular exercise. Of the 8 subscales, insufficient job control (Adj. RR 2.802; 95% CI 1.038-7.564) and occupational climate (Adj. RR 2.365; 95% CI 1.087~5.143) were significantly associated with cerebrovascular and cardiovascular diseases. However, no significant relationships were found between the 6 KOSS subscales and cerebrovascular and cardiovascular diseases. CONCLUSIONS: Despite the short-term follow-up of about two years, the KOSS subscales of insufficient job control and occupational climate were significantly associated with cerebrovascular and cardiovascular diseases.

The Emergence of Korean Modern Hospitals: Hospitals in the Late Period of Chosun Dynasty / 의사학

Hospitals are confronting in the transforming or reforming period to cope with the rapid social and environmental changes worldwide. By the researches in the history of Korean health, we could understand the context of the introduction of Western medicine and institutions to Korea. However there have been few studies on the historical review of hospitals in relations to their roles in the modern medicineThis article is to review the issues around the rise of modern hospitals in Korean history of health affairs. The introduction of Western medicine to Korea was on the road with the establishment of Kwanghyewon, the Royal Hospital, which was possible due to favorable conditions under the Korean socio-political background for the emerging and accepting the entirely new medical system. And also the emergence of modern hospitals had transformed the Korean traditional health system from the fundamentals through the corruption of the old dynasty to nowadays. Most national health affairs including medical services, prevention of diseases, health promotion, and the training of health personnels have performed along with the development of modern hospitals, which have the roots in the period after the end of 19th century. Thus the Korean history of health care around the end of 19th century and the beginning of 20th century could be defined as the period of the emergence of modern hospitals. The hospitals also have played core roles in establishing the Korean modern health system and culture. Compared to the cases of Western countries, Korean modern hospitals were emerged with the exogenous factors in the turbulence of political and cultural changes in the world system. In sum, Korean modern hospitals in the period of late Chosun have the great meaning in that they are the beginning point to shape the current Korean health care system and the driving forces or carriers of this new system.

A Study to Develop a Medical Aptitude Test in Korea / 한국의학교육

Medical aptitude tests are usually for screening students in the field of medical science by testing the capability and aptitude to study medicine. There are various medical aptitude tests with powerful predicting validity such as the Medical College Admission Test(MCAT) in the U.S., the Graduate Australia Medical School Admission Test(GAMSAT) in Australia, and the Eignungsprufung fur Medizin Studium(EMS) in Switzerland. However, in Korea, there have been no medical aptitude test developed yet. This study is primarily to develop a medical aptitude test relevant to Korean circumstances, and secondly to suggest devise specific direction in applying the test at individual medical schools. We reviewed the existing medical aptitude test of other countries through literature, and examined the feasibility of those tests by consulting experts opinion. The Medical Education Eligibility Test(MEET) developed in this study consists of four areas including biological and physical science, verbal reasoning, space perception, and writing. The advisory committee will update the contents of the MEET every year. Executing the test will be administered either by a newly established Institute for Evaluating Medical Education(IEME), or by existing institutes like Korean National health personnel licensing examination board Korea or Korean Institute of Curriculum & Evaluation(KICE). A preliminary test should be necessary to examine the validity and reliability of the MEET developed from this study later on.

A path analysis on prisoners' health behavior and medical utilization

In this thesis, Korean prisoners' health behavior and the characteristics of their medical utilization were surveyed and analysed. Because prisoners are inclined to be mediators of communicable diseases or unhealthy behaviors between prison institution and the outside world, health care for prisoners is directly related to the national population. Data were collected through a self-administered survey of 5 Korean prisons out of a total of 38 correctional facilities and analysed in accordance with a causal model based on a path frame, by serial multiple regressions on health behavior, health status, and medical utilization, etc. According to the survey analysis, while prisoners were generally concerned with their health much more than they were before imprisonment, they perceived that their health status had deteriorated after imprisonment, and that their need for health services was increasing gradually during their time in prison. In the path analysis on the causal relations among variables related to the prisoners' health status and medical utilization, the prisoners' characteristics affected their health concern and health behavior, and subsequently affected their health status and medical utilization, respectively. To sum up these exploratory studies on prisoners' health behavior and health service utilization, some efforts to organize a health care system embracing the correctional institution and health care administration should be made on the level of establishing a health care delivery system for special social groups like prisoners.

Job Analyses of Health Care Managers in Group Health Care System / 예방의학회지

For developing the Group Health care system, health managers' job structure were analysed in the aspects of content, amount, and process. As a trial research, data were collected by a standardized job analysis table to 6 doctors, 40 nurses, and 11 industrial hygienists of Group Health Care System. Health care managers were performing complex and intellectual jobs such as health education for workers, managing health care, conference as well as more simple jobs like as filling diary. Especially, job was consisted of general job and health care management job in the proportion of 1:2.18. The major general job were data management related with the health statistics, and major health care management jobs were managing health care, health counselling, environmental management of working sites. Each specific jobs were required differentiated intellectual capacity, creativity, autonomy, psychic stress, and physical work; most respondents perceived that health care management jobs should require more inputs than general jobs Additionally job satisfaction and perceived need on specific job items were analysed. Results of this research, suggested through the field experiences in working sites, should be considered for improving the Group Health Care System.

Current transition of the physician's professionalism and doctor-patient relationship

In recent years, the physician's professionalism seemed to be facing or experiencing a phase of change. To investigate this phenomenon, social perception and attitude toward physicians were surveyed and analyzed. The subjects consisted of three types of sample group, namely, the general public, physicians, and medical students. Data were collected through interviews, mailing, and self-administered questionnaire surveys to each sample, respectively. The results of analysis showed us that social evaluation of physicians in Korean society exhibited ambivalent perceptions toward physicians. The physician's occupational status was generally evaluated by the three samples as being in a higher stratum in the social structure. But there were great gaps between their perceptions of the change in the physician's occupational status. While the general public perceived that the physician's status might improve in the future, physicians and medical students predicted an absolute declination of the status. Although the general public sympathized with the physician's characteristics as a professional group, an apparent tendency to assume the attitude of a fairly equal relationship toward physicians has increased. The transitional change in the physician's professionalism could be observed through the ubiquity in the perception of the patient's rights in doctor-patient relationships. Such phenomena are believed to have caused physicians to think that not only has their status declined in recent years but also that this declination of social status would continue in the future.

Perception and attitude toward group health management and service system for small and medium industries in Inchon / 예방의학회지

To investigate perception and attitude toward Group Health Management and Services System for Small and Medium Industries, a survey using self-administered questionnaire was conducted to a part of industries in Inchon, at October 1992. Major dependent variables were perception, attitude, and practice related with Group Health Management and Service System; these variables were measured by 3-point Likert like scale consisted of 7, 5, and 5 items, respectively. Data were collected in 149 industries, 72.7% out of 205. Perception was slightly high, 1.25; attitude was some positive, 1.46; and practice was some passive, 0.94. Major determinants of perception, attitude, and practice were sex and age of industry's health manager; perception influenced upon attitude, and perception and attitude had positive effect upon practice. To activate Group Health Management and Service System, it is necessary to develop education and promotion programs for industry's health managers of small and medium industries.

A study on statistics used to test the tracking phenomenon of bloodpressure in childhood / 한국역학회지

No abstract available.

Effects of workers' health status to the recognition about their work environment / 대한산업의학회지

No abstract available.

Social Factors in Recruiting Physicians and Dentists / 예방의학회지

This study was designed to investigate whether recruitment of physicians and dentists has been restricted to a social network, such as familial or kinship groups. The data was collected through a self-administered questionnaire survey distributed to a sampling of general physicians, specialists (internists, surgeons, other specialists), and dentists in August 1990. The major findings are as follows: 1) Total number of respondents was 405; of these, general physicians made up 48.9%, internists 10.4%, surgeons 15.8%, other specialists 4.9%, and dentists 20.0%. 2) 38.5% of the respondents had physicians or dentists in their immediate family or were related in some way to one. Those from urban areas, whose parents were highly educated, and whose father was a professional had more physicians or dentists in their family or kinship. 3) Parents of 7.1% of the respondents, brothers or sisters of 10.1%, grand parents of 1.7%, uncles or aunts of 7.9%, and cousins of 22.0% were physicians or dentists. 4) The majority of physicians or dentists in familial or kinship network specialized in surgery, 32.3%, followed by internal medicine ; current worksites were noted as clinics by 30.8%, followed by general hospital, university hospital, and so on. The respondent's major discipline tended to follow familial or kinship example. Consequently, it was concluded that physicians and dentists have been recruited within restricted familial or kinship network.

Changing Patterns of Ambulatory Care Utilization of a Rural Community in a Regional Medical Insurance Scheme / 예방의학회지

This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 ; secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987 ; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug stores visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 ; and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.

A Comparative Study of Two Survey Methods for Health Services Research Modified Self-administered Questionnaire vs. Interview Survey / 예방의학회지

The purpose of this study was to compare the difference of two survey methods for health services research. Data were collected by means of two types of household survey conducted from March 11 to September 19, 1985. A probability sample of 30,613 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. The sample was divided into two groups systematically. One group was surveyed by the self-administered questionnaire and the other group was interviewed. Response rates were 81.4% and 90.6% respectively. The data were analyzed by the ratio of the results of the self-administered survey to those of the interview survey. No difference was observed in sex, age, residence, or occupation between the two groups. However the respondents' characteristics were statistically different between the two groups. The major findings of this study are as follows : 1. The morbidity rate was 142.5 per 1,000 persons during the two week period by the self-administered questionnaire survey and 74.3 per 1,000 persons with the interview survey method. The ratio of the morbidity rate by the self-administered questionnaire to that by the interview was 1.92, and the difference between the two rates were due to the personal characteristics. 2. The out-patient utilization rate was 10.2 visits per person per year by the self-administered questionnaire survey and 5.4 by the interview survey, and the ratio was 1.89; the admission rate was 3.2 times per 100 persons per year by the self-administered questionnaire survey and 1.9 times by the interview survey, and the ratio was 1.68. Differences due to the sociodemographic characteristics were greater in the out-patient utilization rates than in the admission rates. 3. Percentages of effective medical care demand were 90.2% in the self-administered survey and 92.3% in the interview survey; the ratio was 0.98 which was less than that of the morbidity rate and medical care utilization. But, differences of effective medical care demand occurred in persons with no occupation, and aged or low educated respondents. 4. Respiratory illness had the highest frequency in the two survey methods. But there was a slight difference between the two survey methods in morbidity composition. 5. It was concluded that data collected by the interview survey were inclined to be underestimated and this problem can be corrected by a modified self-administered survey.

Health Care Utilization and Its Determinants among Island Inhabitants / 예방의학회지

Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on 5 islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory care utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.