• Title/Summary/Keyword: 보건 의료서비스

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Policy Implications of the Long-term Care Insurance System Revitalization Process for Establishing Integrated Care System in Japan (일본의 지역포괄케어시스템 구축과 개호보험제도 개정과정의 정책적 시사점)

  • Yoo, Ae Jung
    • 한국노년학
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    • v.39 no.1
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    • pp.1-20
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    • 2019
  • Recently, the Ministry of Health and Welfare has emphasized the necessity to build community care, and the interest of health care- long-term care-social welfare system continues. In order to examine the future vision of long-term care for elderly people, which can be a core system in establishing community models for elderly people in the future, we will implement aging in place as a national policy project. It is meaningful to analyze in depth the case of Japan's policy implementation through the amendment process of long-term care insurance system. The purpose of this study is to examine the concept definition, operating system, and major promotion process of the Integrated Care System in Japan and to suggest policy implications for the future Korea long-term care insurance system. As a result of reviewing the operation status and revision process of the long-term care insurance system for establishing the Integrated care system in Japan, it is necessary to clarify the basic principles and construction of community care system, diversification of residence type and upgrading work, establishment of linkage network of health care-long term care-social welfare, expansion of support for family and self-mind.

Structuralization Expected Outcome of Social Welfare Program Based on Community Network : Using Concept Mapping Method (지역사회네트워크를 기반으로 한 사회복지프로그램 기대성과 구조화 : 컨셉트 맵핑(concept mapping)을 활용하여)

  • Kwon, Sunae
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.107-116
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    • 2014
  • The purpose of this study is to verify the applicability of concept mapping in the process of planning social welfare program based on community network. Concept mapping is a kind of decision-making method that structuralized complex ideas and presented visually. Already, concept mapping is widely utilized in counseling, nursing and public health area to plan and evaluation their program and service. For recent, effectiveness of concept mapping has been reported. Concept mapping is a effective decision-making method that they recognize outcome gap between service provider and client, reach the outcome's consensus in counseling and nursing, medical area. In this study, we conceptualized 3rd year outcomes of Community Impact Project that was supported from Busan Chest using concept mapping. This CI project intervenes children and youth who lives in Buk-gu, Busan. Concept mapping has six stages-preparation, collecting ideas, structuring statements, representing statement, interpreting the results of the analysis, applying the results. We followed these steps. The participants were working at social welfare organizations, total 11 persons. We obtained 60 statements and analyzed using multidimensional scaling. we collected 5 clusters, cluster 1 'awareness and attitude change of children and youth', cluster 2 'social system change of children and youth', cluster 3 'friendly community formation', cluster 4 'community people change', cluster 5 'service provider change'. As a result, among total 5 clusters formed, 'awareness and attitude change of children and youth' came to the strongest outcomes. When concept mapping was applied to the program planning, the consensus of the opinion came easily in the decision-making process, and the participants were empowered. In addition, clear conceptualization on each element of the program planning was made.

An Analysis of Single-person Households' Expenditure Pattern (1인가구의 품목별 소비지출 분석)

  • Park, Moon-Soo;Chong, Hogun;Kim, Hwa-Nyeon;Koh, Dae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.2
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    • pp.987-994
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    • 2015
  • This study examines how single-person household expenditure patterns are different with respect to age and income groups using Tobit model. The expenditure data of the national household survey from 2006 to 2012 were used. The results show that income elasticities of all items are greater than 1 except for food & beverage, housing, water, electricity & gas, and Communication. Income elasticities are significantly different among consuming items. Additionally the income elasticities are also different between various age and income groups of single-person households. Therefore governments and businesses have to take this into account when devising their policies or strategies regarding single-person households. Especially, businesses need to adopt a strategy targeted at single-person households with high income and buying power such as unmarried professional people. As the number of single-person household increases the proportion of expenditures on necessities such as beverage, food, and energy is expected to decrease while that on services increases. Consequently policy responses are required to prepare for the expansion of service industries such as health, hospital, and housekeeping services.

A Study on the Problems and Improvement of Long-Term Care Insurance for the Elderly (노인장기요양보험제도의 문제점 및 개선방안에 관한 고찰)

  • Ahn, Myung-Sun;Park, Joo-Hyun
    • The Journal of the Korea Contents Association
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    • v.19 no.8
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    • pp.525-534
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    • 2019
  • Korea is facing one of the fastest aging population problems in the world due to the extension of life expectancy and low birth rates due to economic development and the development of health care. It has become difficult to take care of elderly people in need of long-term care at home, and social problems such as dementia and the increase in stroke cases are serious problems. The government is enacting and implementing the Long-Term Care Insurance Act for the purpose of improving the quality of life for senior citizens subject to long-term care and alleviating the burden of family support in order to solve such social structure and problems for senior citizens. However, as a result of the implementation of the long-term care insurance system for the elderly, the privatization of the facilities and the disorder are causing widespread requests for public accountability of the services and the enhancement of the quality of the facilities. In addition, various arrangements are needed for the production of low-wage medical care workers, tasks for quality improvement, problems regarding financing methods, and so on. In order to maintain and develop the long-term care insurance system for the elderly, the government will consider seeking ways to improve the legal and institutional aspects according to changes in the social environment of the age, as well as seeking mental and psychological measures for the stabilization of old life as well as physical health.

Study on the Characteristics and Quality Level of Single Subject Researches in the Stroke Patients : The Field of health care ~ (뇌졸중 환자를 대상으로 한 단일대상연구의 특성과 질적 수준에 관한 연구: 보건의료 분야를 대상으로)

  • Sim, Kyoung-Bo
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.2
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    • pp.15-28
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    • 2018
  • Objective : This study sought to characterize and determine the qualitative level of a single target study for stroke patients. Methods : The National Science and Technology Information Center (NDSL), DBpia (DBpia), RISS (Radical Research Information Service), Korea Research Information (KISS), and the National Assembly Library's original case study from 2002 to 2017. A total of 24 single target research papers were selected through the screening process to analyze the quality level of research methods and research design. Results : ABA design was th most common study design method. One person was the most with 12(50%). and three were the second with 8(33.3%). Imagination was the most used as an independent lawyer. Dependent variables had the highest level of situability and one-sidedness. The study was also conducted with a variety of target behaviors, including 'memory', 'visual attention', 'dysphagia', 'visual-motor coordination', 'balance', 'activity of daily life' and 'edema' behaviors. It also showed a positive effect on all dependent variables. The Qualitative level was found to be above the intermediate level except for one study. Conclusion : It is academic significance that this study analyzes the items to be prepared for in the performance of a single target study and further studies may require the establishment of a weak but good-quality single target study for researchers conducting research in local communities and clinical sites.

Achieving Health Equity Through Health Promotion (건강증진사업의 효율성과 형평성: 건강증진을 통한 건강 형평성 제고)

  • Moskowitz, Joel M.
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2005.09a
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    • pp.91-119
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    • 2005
  • 오타와 헌장에 따르면 건강증진은 건강형평성을 성취하는 것이다. 건강격차를 감소시키고, 모든 사람들이 건강잠재력을 달성할 수 있도록 동등한 기회와 자원이 제공되어야 한다. 또한 각 개인들은 자신의 건강에 대한 결정요인들에 대한 통제능력을 가져야 한다. 미국의 조기사망은 40%가 행동양식에 의하여, 30%가 유전적인 문제로, 15%가 사회적 환경에 의하여, 10%는 의료적 치료의 부족으로, 그리고 5%는 환경위해 물질에 대한 노출로 발생한다. 건강불평등을 발설시키는 사회적 요인으로는 경제적 요인을 들 수 있다. 이러한 요인으로 야기되는 건강불평등의 문제를 해결하여 건강형평성을 달성하기 위해서는 절대적 목표들과 평등관련 목표들이 모두 필요하다. 건강형평성은 인구집단의 건강과 함께 향상되는 것으로 나은 건강상태에 있는 사람들의 건강을 악화시키면서 건강형평성을 달성하는 것은 아니다. 각자의 관심이 형평성을 어떻게 규정하는가에 영향을 미친다. 혜택을 받은 사람들은 성과/투입의 정의를 선호하며, 소외계층은 똑같은 성과 또는 요구에 기반한 정의를 선호한다. Healthy People 2010은 미국의 국가적 예방체계를 의미하며, 가장 중요하며 예방 가능한 건강위협들을 파악하고 이러한 위협들을 감소하기 위한 목적들이 설정되어 있다. 궁극적인 목적은 건강한 삶의 질적인 면과 양적인 측면을 향상시키는 것이며, 건강불평등을 제거하는 것이다. 그러나 미국이 유럽의 국가들에 비해서 사회 프로그램에 대한 투자가 적은 이유는 재분배는 소수인종만을 위한 것이라는 믿음과, 우리는 개방되고 공정한 사회에 살고 있기 때문에 가난하다는 것은 가난한 사람들 자신들의 잘못으로 인한 것이라는 믿음 그리고 재분배를 방지하는 정치체계 때문이다. 국가기관인 CDC의 예방연구센터(Prevention Research Centers)는 지역사회 파트너들과 함께 건강증진, 질병예방, 그리고 질병과 상해로 인한 합병증을 관리하게 위한 효과적인 예방 전략을 개발하고 있다. 예방연구센터의 프로그램들은 지역사회 기반 참여연구와 소외된 계층에 중점을 두며, 다학제 간 접근방법을 활용하고, 교육기관, 공공보건기관 그리고 지역사회의 파트너들 간의 네트웍을 형성을 통한 협력관계를 강조하고 있다. 지역사회 위원회가 구성되어 있으며, 또한 근거중심 프로그램을 개발하고 있다. 이들은 건강 결정요인에 관한 연구, 형성적 연구, 개입 프로그램 및 프로그램의 확산에 관한 연구를 진행한다. UC Berkeley의 가족/지역사회 보건센터(Center for Family & Community Health)는 1993년에 설립되었다. 사업의 대상이 되는 주요 지역사회는 한국교민사회이며, 한국교민사회 자문위원회(Korean Community Advisory Board, KCAB)가 구성되어 있다. 1993년부터 2003년까지는 'Health is Strength' 사업이 시범연구사업으로 진행되었는데, 그 내용은 유방암과 자궁경부암 검진 프로그램이었다. 2003년부터 2009년까지 진행될 'Quitting is Winning'이라는 두 번째 시범연구사업은 남성들의 금연에 중점을 둔 사업이다. 'Health is Strength'는 아시아 보건서비스 및 한국교민사회 자문위원회가 함께 협력하여 진행된 사업으로, 주요 목표는 18세 이상 여성의 자궁암 조기 검진(Pap test)과 자가 유방검진 실천을 증가시키는 것이며, 50세 이상여성의 유방 임상검사와 유방 X선촬영 비율을 증가시키는 것이었다. 한 지역의 카운티에 거주하는 한국 여성들은 4년간의 개입프로그램의 대상이 되었으며, 이들을 대상으로 횡단적인 전화조사를 3번(사전, 중간, 사후)실시하였다. 개입 프로그램은 교회에서 워크샵 개최, Tell-A-Friend Form 작성하기, 포스터 및 책자 발행, 신문광고 등과 함께 자궁암 조기 검진(Pap test)과 유방 X선 촬영권을 무료로 제공하는 것으로 구성되었다. 'Quitting is Winning'은 지역사회 기반 참여 연구모형으로 한국교민사회 자문위원회는 흡연을 1순위의 사업으로 선정하였고, 근거에 기반한 금연 프로그램에 대한 연구들을 검토하여, 기존의 보편적 방법이 아닌 인터넷을 활용하는 프로그램을 진행하는 것으로 결정되었다. 이는 무작위 임상실험으로 연구대상으로 미국에 거주하는 한국인 남성흡연자 2300명을 모집하였다. 이들의 1/2은 실험군인 인터넷 프로그램 집단에, 또 다른 1/2은 대조군인 인쇄책자 집단에 무작위 할당되었다. 12개월 동안 11번의 진단이 인터넷을 통하여 진행되었으며, 참여와 참여유지에 대한 금전적인 보상이 제공되었다.

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The Oral Health Behaviors for Children and Teachers by Teacher-Supervised Toothbrushing in Community Child Center (지역아동센터 교사의 칫솔질 지도여부에 따른 아동과 교사의 구강보건행태)

  • Shin, Sun-Jung;Jang, Jung-Yoo;Kim, Chang-Hee
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.572-582
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    • 2012
  • The purpose of this research was to compare the oral health behaviors for children and teachers in toothbrushing facilities installed community child center related with teacher-supervised toothbrushing. This research was follow-up study from the Korean Dental Hygienists Association third project '2010 program of making of the diamond tooth'. 266 child support teachers were invited and 201 were included in the study (response rate: 75.6%). Statistical analysis conducted using PASW ver. 18.0 for Windows. The difference on the distribution of independent variables related with teacher-supervised toothbrushing was verified with chi-square test. The results of this research could be summarized as follows: The children in the teacher-supervised toothbrushing community child center, the practice rate of toothbrushing was higher than the children in the non-supervised toothbrushing community child center (p<0.05). Teachers offered children one of snacks and drinks per day independently of teacher-supervised toothbrushing (p>0.05). Most of participated teachers accepted to be responsible for oral health of children (73.4%) and demanded that improve facilities for a toothbrushing in community child center (77.2%). In conclusion, this study suggests that a programme of daily teacher-supervised toothbrushing can be effectively targeted into community child center.

Globalization and Independency of Populist Nations' Welfare Policies: Focusing on the Influences of Multinational Pharmaceutical Companies on the Korean Government's Policy on the Pharmaceutical Industry (세계화와 국민국가의 복지정책 자율성: 다국적 제약자본이 우리나라 제약정책 결정에 미친 영향을 중심으로)

  • Lee, Su-Yun;Kim, Young-Mi
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.5-30
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    • 2005
  • Globalization has conflicting effects on pharmaceutical policies. A change into a 'populist competitive nation' due to globalization strengthens policies to reduce drug manufacturing costs while the WTO's TRIPS Agreement that is affected by multinational pharmaceutical companies increases drug manufacturing costs by bolstering the patent rights on new drugs. Currently, the independency of populist nations' policies to reduce drug manufacturing cost is being compromised because multinational organizations(such as the European Union) which represents the interests of the multinational pharmaceutical companies put restrictions on the pharmaceutical policies of populist nations for purposes of promoting the industrial goals of the multinational companies. Korea is no exception. Up until the late 1990s, the main feature of the pharmaceutical policies in Korea was keeping the drug price at the cost level based on a growth-driven ideology, and this was Korea's unique policy tools as a developing nation. However, the increase in the power of multinational pharmaceutical companies currently infringes on the independency of Korea's pharmaceutical policies. Expensive imported drugs were originally covered by the national health insurance plan, but starting from 1999 such drugs began to be covered by the plan. After separation of medical and pharmaceutical services, the use of expensive drugs was increased, and the Korean government planned to introduce the reference price policy in order to contain the cost of the national health insurance plan. However, due to pressures from the U.S. government as well as multinational pharmaceutical companies, implementation of the policy has been postponed. In addition, due to a pressure from the U.S. government, a working group was created which would affect the health care policy of the Korean government. Discussions so far on globalization was about whether the change into populist competitive nations due to globalization resulted in the reduction of welfare spending. However, this study shows not only the reduction of health care cost through policies to reduce drug manufacturing costs but increase in welfare spending by raising the strengths of multinational pharmaceutical companies that are for-profit providers of welfare service. While focusing on the contradictory effects of globalization on pharmaceutical policies of a nation, this study looked at how these conflicting effects end up promoting the interests of multinational pharmaceutical companies by examining the Korean case.

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Quality of Life and Related Factors in Caregivers of Attention Deficit Hyperactivity Disorder Patients (주의력결핍 과잉행동장애 환아 보호자의 삶의 질과 관련요인)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.102-111
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    • 2005
  • Objective : The purpose of this study was to investigate the quality of life and it's related factors in caregivers of attention deficit hyperactivity disorder patients. Methods : The subjects were 38 attention deficit hyperactivity disorder patients' caregivers(mean age : $37.5{\pm}6.5$, 38 women). Patients were diagnosed with DSM-IV-TR ADHD criteria. Korean version of WHOQOL-BREF(World Health Organization Quality of Life assessment instrument Abbreviated Version) was used for assessment. Results : 1) No significant differences were found in the score of WHOQOL-BREF, overall QOL, physical health domain, psychological domain, social relationships domain and environmental domain between caregiver and control group. 2) The score of Activity of daily living facet$(3.0{\pm}0.7\;vs.\;3.6{\pm}0.7)(p=0.008)$ and self-esteem facet $(2.8{\pm}0.7\;vs.\;3.3{\pm}0.7)(p=0.049)$ were significantly decreased in caregivers of ADHD. 3) Total score of WHOQOL-BREF(r=0.437, p=0.007) and physical health domain(r=0.370, p=0.024) were correlated with caregiver's educational age. 4) In the psychological domain, the score of self-esteem facet(r=-0.337, p=0.039) and thinking, learning, memory & concentration facet(r=-.341, p=0.036) were decreased with caregiver's age. 5) The score of environmental domain were significantly increased with caregiver's educational age (r=0.482, p=0.003), but decreased with patient's age(r=0.328, p=0.044). Conclusion : Although the quality of life in caregivers of ADHD patient had not significantly decreased than control, the quality of lift were positively correlated with educational age of caregives, and negatively correlated with chronological age of caregivers and children. Above results suggest that physicians should consider integrated approaches for caregiver's subjective quality of life in the management of ADHD.

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Liability for Damages Due to Violation of Supervisory Duty by the Legal Guardian of the Mental Patient (정신질환자 보호의무자의 감독의무 위반으로 인한 손해배상책임 -대법원 2021. 7. 29. 선고 2018다228486 판결의 검토-)

  • Dayoung Jeong
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.133-170
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    • 2022
  • Supreme Court 2018Da228486, on July 29, 2021, ruled Article 750 of the Civil Act as the basis for liability for damages due to the violation of the supervisory duty of the responsible mental patient. This judgment recognizes that the legal guardian is liable for tort due to neglect of the responsibility of supervision under Article 750 of the Civil Act because the duty of protection bears the duty of supervision over the mental patient under the law. However, unlike the case of Article 755 Paragraph 1, which explicitly requires a legal obligation to supervise, Article 750 only stipulates general tort liability. Thus, to admit tort liability under Article 750, it is not necessary that the basis of the supervisory duty by the law. In this case, the supervisory duty may also be acknowledged according to customary law or sound reasoning. The duty of supervision of a legal guardian is not a general duty to prevent all consequences of the behavior of a mental patient but a duty within a reasonably limited scope. Therefore, the responsibility of the burden of care should be acknowledged only when the objective circumstances in which it is appropriate to hold the legal guardian for the acts of the mental patient are admitted. Under the Act on the improvement of mental health and the support for welfare services for mental patients, a legal guardian cannot even be granted the supervisory duty to prevent the mental patient from harming others.