Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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A New Disability-related Health Care Needs Assessment Tool for Persons With Brain Disorders

  • Kim, Yoon (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Eun, Sang June (Regional Cardiocerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Kim, Wan Ho (Department of Rehabilitation Medicine, National Rehabilitation Center) ;
  • Lee, Bum-Suk (Department of Rehabilitation Medicine, National Rehabilitation Center) ;
  • Leigh, Ja-Ho (Department of Rehabilitation Medicine, National Rehabilitation Center) ;
  • Kim, Jung-Eun (Center for Social Sciences, Seoul National University) ;
  • Lee, Jin Yong (Public Health Medical Service, SMG-SNU Boramae Medical Center)
  • Received : 2013.05.26
  • Accepted : 2013.09.06
  • Published : 2013.09.30
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Abstract

Objectives: This study aimed to develop a health needs assessment (HNA) tool for persons with brain disorders and to assess the unmet needs of persons with brain disorders using the developed tool. Methods: The authors used consensus methods to develop a HNA tool. Using a randomized stratified systematic sampling method adjusted for sex, age, and districts, 57 registered persons (27 severe and 30 mild cases) with brain disorders dwelling in Seoul, South Korea were chosen and medical specialists investigated all of the subjects with the developed tools. Results: The HNA tool for brain disorders we developed included four categories: 1) medical interventions and operations, 2) assistive devices, 3) rehabilitation therapy, and 4) regular follow-up. This study also found that 71.9% of the subjects did not receive appropriate medical care, which implies that the severity of their disability is likely to be exacerbated and permanent, and the loss irrecoverable. Conclusions: Our results showed that the HNA tool for persons with brain disorders based on unmet needs defined by physicians can be a useful method for evaluating the appropriateness and necessity of medical services offered to the disabled, and it can serve as the norm for providing health care services for disabled persons. Further studies should be undertaken to increase validity and reliability of the tool. Fundamental research investigating the factors generating or affecting the unmet needs is necessary; its results could serve as basis for developing policies to eliminate or alleviate these factors.

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References

  1. Dejong G, Palsbo SE, Beatty PW, Jones GC, Knoll T, Neri MT. The organization and financing of health services for persons with disabilities. Milbank Q 2002;80(2):261-301. https://doi.org/10.1111/1468-0009.t01-1-00004
  2. Sutton JP, DeJong G. Managed care and people with disabilities: framing the issues. Arch Phys Med Rehabil 1998;79(10): 1312-1316. https://doi.org/10.1016/S0003-9993(98)90283-0
  3. Beatty PW, Hagglund KJ, Neri MT, Dhont KR, Clark MJ, Hilton SA. Access to health care services among people with chronic or disabling conditions: patterns and predictors. Arch Phys Med Rehabil 2003;84(10):1417-1425. https://doi.org/10.1016/S0003-9993(03)00268-5
  4. Park JH, Lee JS, Lee JY, Gwack J, Park JH, Kim YI, et al. Disparities between persons with and without disabilities in their participation rates in mass screening. Eur J Public Health 2009; 19(1):85-90.
  5. DeJong G. Primary care for persons with disabilities. An overview of the problem. Am J Phys Med Rehabil 1997;76(3 Suppl): S2-S8.
  6. Lee BS, Kim YI, Kim WH, Park KD. The development of health care system for disabled people. Seoul: National Rehabilitation Center; 2003, p. 57-136 (Korean).
  7. Kim KY, Lee YS, Park KS, Son JH, Kam S, Chun BY, et al. Determinanats of health care utilization of the physically disabled. Korean J Prev Med 1998;31(2):323-334 (Korean).
  8. Byun YC, Seo DW, Lee SW, Kim SH, Hong JH, Kwon SJ, et al. Survey on disabled persons in 2000. Seoul: Korea Institute for Health and Social Affairs; 2001, p. 139-230 (Korean).
  9. Hwang B, Chun SM, Park JH, Shin HI. Unmet healthcare needs in people with disabilities: comparison with the general population in Korea. Ann Rehabil Med 2011;35(5):627-635. https://doi.org/10.5535/arm.2011.35.5.627
  10. Bien B, McKee KJ, Döhner H, Triantafillou J, Lamura G, Doroszkiewicz H, et al. Disabled older people's use of health and social care services and their unmet care needs in six European countries. Eur J Public Health 2013. doi: 10.1093/eurpub/cks190.
  11. Armstrong K, Kerns KA. The assessment of parent needs following paediatric traumatic brain injury. Pediatr Rehabil 2002; 5(3):149-160. https://doi.org/10.1080/1363849021000039353
  12. Kersten P, George S, McLellan L, Smith JA, Mullee MA. Disabled people and professionals differ in their perceptions of rehabilitation needs. J Public Health Med 2000;22(3):393-399. https://doi.org/10.1093/pubmed/22.3.393
  13. Wright J, Williams R, Wilkinson JR. Development and importance of health needs assessment. BMJ 1998;316(7140):1310- 1313. https://doi.org/10.1136/bmj.316.7140.1310
  14. Kim SH, Byun YC, Sohn CG, Lee YH, Lee MK, Lee SH, et al. Study on the disabled 2011. Seoul: Korea Institute for Health and Social Affairs; 2011, p. 93-110 (Korean).
  15. Berg AO, Atkins D, Tierney W. Clinical practice guidelines in practice and education. J Gen Intern Med 1997;12 Suppl 2: S25-S33. https://doi.org/10.1046/j.1525-1497.12.s2.4.x
  16. Shekelle PG, Woolf SH, Eccles M, Grimshaw J. Clinical guidelines: developing guidelines. BMJ 1999;318(7183):593-596. https://doi.org/10.1136/bmj.318.7183.593
  17. Shin S. The development of clinical practice guideline. J Korean Soc Qual Assur Health Care 2003;10(2):266-277 (Korean).
  18. Clancy CM, Andresen EM. Meeting the health care needs of persons with disabilities. Milbank Q 2002;80(2):381-391. https://doi.org/10.1111/1468-0009.t01-1-00008
  19. Jordan J, Dowswell T, Harrison S, Lilford RJ, Mort M. Health needs assessment. Whose priorities? Listening to users and the public. BMJ 1998;316(7145):1668-1670. https://doi.org/10.1136/bmj.316.7145.1668
  20. Wilkinson JR, Murray SA. Assessment in primary care: practical issues and possible approaches. BMJ 1998;316(7143): 1524-1528. https://doi.org/10.1136/bmj.316.7143.1524
  21. Bowling A. Research methods in health: investigating health and health services. 2nd ed. Philadelphia: Open University Press; 2002, p. 406-409.
  22. Fink A, Kosecoff J, Chassin M, Brook RH. Consensus methods: characteristics and guidelines for use. Am J Public Health 1984; 74(9):979-983. https://doi.org/10.2105/AJPH.74.9.979
  23. Jones J, Hunter D. Consensus methods for medical and health services research. BMJ 1995;311(7001):376-380. https://doi.org/10.1136/bmj.311.7001.376
  24. Murphy MK, Black NA, Lamping DL, McKee CM, Sanderson CF, Askham J, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess 1998;2(3):1-88.
  25. Sung TJ. Validity and reliability. Seoul: Hakjisa; 2002, p. 1-146 (Korean).
  26. Won CW, Yang KY, Rho YG, Kim SY, Lee EJ, Yoon JL, et al. The Development of Korean Activities of Daily Living (K-ADL) and Korean Instrumental Activities of Daily Living (K-IADL) scale. J Korean Geriatr Soc 2002;6(2):107-120 (Korean).
  27. Won CW, Rho YG, Kim SY, Cho BR, Lee YS. The validity and reliability of Korean Activities of Daily Living (K-ADL) scale. J Korean Geriatr Soc 2002;6(2):98-106 (Korean).