PURPOSE: This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. METHODS: A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. RESULTS: The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. CONCLUSION: Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.
Costs and Cost Analysis ; Female ; Humans ; Insurance, Health, Reimbursement/*economics ; Korea ; National Health Programs/*economics ; Nurse Midwives/*economics ; Pregnancy ; *Relative Value Scales

OBJECTIVES: To estimate the demand and demand-supply balances of occupational and environmental medical specialties (OEMS) in the target year of 2020. METHODS: We adopted a new OEMS demand model based on the situations of periodic workers' health examination (PHE) agencies, health management agencies (HMA), and legal enforcement for health and safety systems in Korea. The model uses data selected primarily from the database of the Korean Society of Occupational and Environmental Medicine (KSOEM), a survey for certified members of KSOEM, statistics and internal documents from the Ministry of Employment and Labor (MOEL). RESULTS: From the data and assumptions, newly demanded OEMS were 193 for workers who had received PHE, and 205 based on total workers for PHE in 2020 for PHE. But no OEMS for HMA area is demanded. Comparing with the calculated numbers of supply estimates, the demand was slightly higher, but could be balanced if MOEL kept consistent and unchanging policies. CONCLUSIONS: The study results suggest that the demand-supply balance of OEMS is mainly influenced by the policy of MOEL. Further studies are needed examining more detailed data and statistics about PHE agencies, HMA and considering MOEL policies are needed to configuring more sophisticated and need-included estimation.
Employment ; Environmental Medicine ; Health Manpower ; Health Services Needs and Demand ; Korea ; Occupational Medicine ; Public Policy

OBJECTIVES: To estimate the supply of occupational and environmental medicine specialties in the target year of 2020. METHODS: We adopted alternative projection models combined with a demographic method as a supply forecasting method. The model uses data selected primarily from the database of the Korean Society of Occupational and Environmental Medicine (KSOEM), a survey for certified members of KSOEM, audit data from the Ministry of Employment and Labor (MOEL) and Hospital Accreditation. We assumed five viable alternatives in supply forecasting. RESULTS: Depending on the assumptions, the total occupational and environmental medicine specialties supply ranged from 706 by low-level supply estimates to 754 by high-level supply estimates in 2020. Among them, approximately 81% were estimated to engage themselves in agency for health management and periodic health examinations for workers exposed to hazards. CONCLUSIONS: The study results suggest that the supply of occupational and environmental medicine specialties is related to the policy of MOEL. Further studies are needed concerning overall policy about health and safety and for the newly demanded market.
Accreditation ; Employment ; Environmental Medicine ; Forecasting ; Korea

OBJECTIVES: To investigate the pulmonary function changes of ozone exposure in Corona and Slitter workers exposed to an ozone level ranging from 0.022~0.061 ppm. METHODS: Forty-two subjects were exposed for 8hrs to ozone every day. We perfomed pulmonary function testing immediately before and after work and self-administered, portable peak flow meter measurements were self-conducted by the workers over a 5-day (Monday to Friday) period. RESULTS: Ozone concentrations in the workplace ranging from 0.050~0.061 ppm at Corona and 0.022~0.023 ppm at Slitter in 2006. A small decrement in forced-vital capacity were observed among Corona workers from 93.9% to 91.3% (p=0.012) and also in employment duration below ten years. We found no significant differences in before and after FVC and FEV1 among Slitter workers. All daily (Monday to Friday) peak expiratory flow rates declined in magnitude after two days of ozone exposure, compared with first day exposure. CONCLUSION: We concluded that daily ozone exposure in the workplace slightly decreased pulmonary function and that PEFR variability is greatest on the 2nd day of ozone exposure.
Employment ; Ozone* ; Peak Expiratory Flow Rate ; Respiratory Function Tests

The purpose of this study is to analyze the cariogenicity of vitamin supplements for children by the Caries Potentiality Index (CPI), pH drop capacity, proliferation rate of Streptococcus mutans.Four vitamin supplements were selected - Noma (NM), Cenovis Kids (CK), Animal Parade (AP), and Character Vitamin (CV).CPI value decreased in the order of AP, CV, CK, and NM. Initial values of all experimental groups showed acidity below pH 7.0. Analysis of the colony forming units of Streptococcus mutans showed that NM and CV resulted a higher proliferation rate (p < 0.05) than CK and AP (p < 0.05). Bacterial activity of the control group was lower than other groups when observed with a confocal laser scanning microscope.Considering the bacterial activity and acidity of vitamin supplements, it is necessary to pay close attention when children taken the vitamin supplements for their oral health.
Animals ; Biofilms ; Child ; Humans ; Hydrogen-Ion Concentration ; Noma ; Oral Health ; Stem Cells ; Streptococcus mutans ; Vitamins

Purpose: This study aimed to identify nursing students’ experience with the Nursing Management Practicum based on the service design concept to provide a basis for an ideal subject design. Methods: This study was a qualitative research that analyzed the experience of students and their clinical instructors based on the blueprint of Nursing Management Practicum. Focus group interviews were conducted with 13 graduates from two nursing schools and 11 clinical instructors from three hospitals. Results: The students went through six stages during the practicum. They met clinical instructors during the ward orientation and learning activities in wards and met school instructors during the general orientation and conference. The students perceived the learning activities and teaching from the clinical instructors in wards as the most important practicum factors. Conclusion This study provided information which helped us to understand nursing students’ experience with the Nursing Management Practicum as the time passed by. This information can be used to improve students’ experience with the practicum and convert the subject into a more learner-centered education.

Purpose: This study conducted a systematic review and meta-analysis to identify trends in nursing ethics education research for Korean nursing students and nurses. Methods: The data search was conducted in July 2020; domestic and foreign academic journals were targeted for the search. A combination of search terms was entered into major databases, and the year of publishing was limited to the last 10 years (2010~2020). Results: The systematic review analyzed 25 experimental and 13 non-experimental studies, and education methods included lectures, discussions, role play, film-use classes related to nursing ethics, action learning, and case-based learning. The meta-analysis of 12 studies revealed that ethical education has significant differences in effect size of biomedical ethics, critical thinking, moral judgment, and moral sensitivity. A subgroup analysis of education methods showed that in addition to traditional lecture and discussion education methods, there were significant differences in the effect size of sense of biomedical ethics between the following two methods: lecture and discussion including additional methods and lecture and discussion only. Conclusion Ethics education for nursing students and nurses has been found to be effective in improving ethics-related competencies, and various teaching methods other than lectures and discussions must be utilized.

Purpose: This study was to identify how a nursing management practicum was operated during the COVID-19 pandemic in Korea. Methods: This study surveyed instructors teaching the nursing management practicum with a questionnaire covering five domains and 42 items. The data were analyzed using descriptive statistics and content analysis. Results: The practicum was performed mainly by mixed methods (40.8% and 38.5%), in hospitals only (30.8% and 60.4%), online only (19.8% and 1.1%) in 2020 and 2021, respectively. The mixed methods were most frequently used for instructor teaching and conferences (43.9% and 58.3%). and the average teaching time per week was 9.40 and 8.69 hours per week, respectively. Taking charge in one to three core nursing skill items, 87.8% and 90.1% of the respondents each year performed face to face evaluation for the skills. Four to six out of 12 POs were covered by 58.2% and 54.9% of the participants, respectively, in 2020 and 2021. The greatest difficulty under the pandemic was securing students’ hospital assignments. Conclusion The nursing management practicum needs to adopt various digital technologies, and create new education models including hybrid ones combining both contact and untact methods to improve the educational effect for the post COVID-19 era.