No abstract available.
Diagnosis-Related Groups* ; Korea*

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview survey performed by the korean Institute of Health & social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions; There were more elderly people over the age of 65; unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionally, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.
Aged ; Causality ; Education ; Health Resources ; Humans ; Inpatients ; Korea* ; Length of Stay ; Marital Status ; Models, Statistical ; Primary Health Care ; Public Health ; Sample Size

Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negatively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1 cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.
Appendectomy ; Cesarean Section ; Female ; Hernia ; Humans ; Inpatients ; Length of Stay ; Pregnancy ; Pulmonary Disease, Chronic Obstructive ; Tonsillectomy

PURPOSE: The purpose of this study was to investigate predictors of nurses' patient safety behavior during inter-hospital transfer. The study was based on the Theory of Planned Behavior (TPB). METHODS: A descriptive survey design was used. Data were collected with a self-administrated 39-item questionnaire completed by 111 nurses from a university hospital in Seoul, South Korea. The questionnaire was developed based on the Theory of Planned Behavior (TPB) guideline and included measure of self- reported past patient safety behaviors, intentions, attitudes, subjective norms and perceived behavioral controls. Ethical approval was granted by the hospital review board. Hierarchical regression analyses were carried out. RESULTS: The average score of patient safety behavior was 4.21±0.63 (5 point scale). The TPB variables explained 49.9%of the variance in patient safety behavior. Intention and subjective norm were the most significant predictors of nurses' patient safety behavior. Attitude was related to nurses'patient safety behavior. CONCLUSION: TPB variables predicted the nurses'patient safety behavior during inter-hospital transfer of patients except for perceived behavioral controls. The results of this study suggest that better strategies for subjective norms and intentions related to patient safety behavior will be helpful in safety culture reform.
Financing, Organized ; Humans ; Intention ; Korea ; Patient Safety* ; Safety Management ; Seoul

PURPOSE: Smoking is the leading cause of death and smoking initiation rarely occurs after adolescence. Thus research on adolescent smoking is crucial. A consistent definition of smoking is important because inconsistent definitions make comparisons across studies an arduous task. Thus, the aim of the study was to suggest future research directions for smoking definitions after examining pitfalls in the literature. METHODS: In this study the literature on adolescent smoking in the U.S. and South Korea was examined, and three types of smoking definitions were identified. Limitations in the studies are identified and future research directions are suggested. RESULTS: In the U.S. literature, smoking definitions can be categorized into three groups: definitions based on stage models, smoking trajectories, and definitions derived from specific data. In the South Korean literature, various levels of smoking have not been differentiated. CONCLUSIONS: While the literature does not provide a definitive answer regarding the definition of smoking, it suggests three issues to consider for future research. First, multiple measures of smoking are more desirable than a one-time measure. Second, theory- or trajectory-based smoking definitions are more desirable than definitions derived from available data. Finally, regularity and amount of cigarette use should be incorporated in defining smoking behavior.
Adolescent ; *Adolescent Behavior ; Behavioral Research ; *Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Models, Psychological ; Motivation ; Smoking/*prevention & control/*psychology ; *Terminology as Topic ; United States

We report a case of glomerular disease with both mesangial IgA and subepithelial IgG deposits in the allograft kidney. The patient was a 36 year-old man who had received a renal allograft 1 year previously. Fifteen days before admission, he discovered a microscopic hematuria without clinical evidences of allograft rejection. Light microscopy showed diffuse increase of mesangial matrix without mesangial cell proliferation. Capillary walls were diffusely and mildly thickened. Immunofluorescence microscopy demonstrated both granular deposits of IgA in the mesangium and IgG along the capillary walls. On electron microscopy, electron-dense deposits were identified not only in the mesangium but also on the epithelial side of the glomerular basement membrane.
Adult ; Case Report ; Glomerulonephritis, IGA/*immunology/pathology ; Human ; Immunoglobulin A/*analysis ; Immunoglobulin G/analysis ; Kidney/*immunology/pathology ; Kidney Transplantation/*immunology ; Male ; Transplantation, Homologous

OBJECTIVES: To investigate the information searching behavior of health care consumers according to sociodemographic characteristics. METHODS: A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling of the Republic of Korea, excluding the province of Jeju-do. Personal were conducted through a door-to-door survey between 27 July and 10 August 1999. RESULTS: 80.5% of respondents used more than one source of information and those 40~59 years of age, female, a housewife or student and those who claimed a religion demonstrated more active information searching behavior. A personal informer was used significantly more in those 20~39 years old, female, and those who claimed a religion. Clerical workers, those with post-secondary education and a monthly income greater than 2,000,000 won ($1500) were more actively used a public informer. Low socioeconomic status and older persons used an experimental informer when they chose a health care institution. CONCLUSION: Regardless of the sociodemographic characteristics, personal and experimental informers were the most useful source of information. Because appropriate information was not easy to obtain, the health care consumer was dependent upon word-of-mouth communication(personal informer) when using health care services.
Appetitive Behavior* ; Data Collection ; Delivery of Health Care* ; Education ; Female ; Humans ; Jeju-do ; Questionnaires ; Republic of Korea ; Social Class

PURPOSE: In the present study, an analysis of the life of adolescents with complex congenital heart disease (CHD) was done using grounded theory. Consideration was given to the socio-cultural context of Korea. METHODS: After approval from the institutional review board of Y hospital, 12 patients ranging in age from 14 to 35 were recruited. Data were gathered using in-depth interviews. Theoretical sampling was performed until the concepts were saturated. RESULTS: The results confirmed the life of adolescents with complex CHD as a 'journey to finding uniqueness of oneself as a person with CHD'. The life consisted of 3 stages. In the crisis stage, participants had a feeling of threat to self-existence, and made an effort to be the same as others. In the self-recognition stage, participants who had sufficient role-performance built self-esteem while those who did not fell into self-accusation. In the self-establishment stage, participants who reached sufficiency in independence and knowledge planned the future, whereas those who did not conformed to the realities of life. CONCLUSION: The results of present study provide help in understanding the experiences of adolescents with CHD and provide a basis for developing nursing intervention strategies for these patients.
Adolescent ; *Adolescent Psychology ; Adult ; Female ; Heart Defects, Congenital/*psychology ; Humans ; Interviews as Topic ; Male ; Perception ; Quality of Life ; Self Concept

PURPOSE: This study was done to identify the causes of burnout among South Korean counselors for North Korean refugees. METHODS: Data were collected using open-ended questions in a survey from 85 South Korean counselors for North Korean refugees, and a content analysis of the textual data from the questions was conducted. RESULTS: A total of 192 statements were selected from the data and those were categorized into 3 domains, 8 categories, and 24 sub-categories. Institutional, client, and social recognition domains emerged. Findings indicate that the causes of burnout were derived from the following categories: 1) the categories for the Institutional domain were physical environment, work conflict, and work overload, 2) for the client domain, lack of cooperation, selfish attitude, and limits to interventions, and 3) for the social recognition domain, lack of rewards and identity confusion. CONCLUSION: The results indicate that community mental health professionals need to understand these causes of burnout among the counselors working with North Korean refugees. It is also necessary to do further research to develop strategies to prevent burnout and potential mental health problems for these counselors.
Counseling ; Humans ; Mental Health ; Refugees ; Reward

PURPOSE: This study was designed to identify the differences of individual disease related characteristics, behavior-specific cognitions and affect, health promoting behavior between colorectal cancer patients and the general public. METHODS: Seventy newly diagnosed colorectal cancer patients and 72 healthy adults from the general population were recruited and asked to complete a questionnaire on their disease related characteristics, behavior specific cognitions and affect, health promoting behavior from April to September 2011. Independent two sample t-test analysis was used to compare the two groups. RESULTS: There were significant differences in family history of colon polyps or colorectal cancer, history of colon polyps lifetime tobacco usage, amount of daily smoking, frequencies of alcohol consumption over a year, constipation, interval of bowel movements, perceived benefits, perceived barriers, self-efficacy, self-esteem, perceived health status, health locus of control, and health promotion behaviors between the two groups. CONCLUSION: This study suggests that nursing professionals need to consider family history of colon polyp or colorectal cancer, history of colon polyps, tobacco usage, alcohol consumption, constipation and frequency of bowel movements in developing a colorectal cancer prevention program. Strategies to increase health promotion behavior and behavior-specific cognitions and affect factors including perceived benefit, perceived barriers, self-efficacy, self-esteem, perceived health status, health locus of control should be included in colorectal cancer prevention programs.
Adult* ; Alcohol Drinking ; Cognition ; Colon ; Colorectal Neoplasms* ; Constipation ; Health Promotion* ; Humans ; Internal-External Control ; Nursing ; Polyps ; Smoke ; Smoking ; Tobacco