• Journal of Preventive Medicine and Public Health
• /
• v.54 no.2
• /
• pp.129-136
• /
• 2021

Objectives: This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand. Methods: The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis. Results: Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors. Conclusions: Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

• Journal of Korean Academy of Oral Health
• /
• v.42 no.4
• /
• pp.152-158
• /
• 2018

Objectives: The purpose of this study was to investigate effective predictive factors of the persistence of unmet dental care needs. Methods: Data were obtained from the Korea Health Panel studies of 2011 and 2015, and 4,406 subjects, aged 18 years or older, were included in this study. Of these subjects, those who persistently experienced unmet dental care needs over the three-year period were identified. Panel logistic regression analyses were conducted to identify socio-demographic and health-related factors associated with the persistence of unmet dental care needs in two groups, those aged between 18-64 years and over 65 years. Results: Approximately 12% of subjects showed a persistence in unmet dental care needs. Marital status, education level, household income, type of health insurance, and self-rated health status all significantly correlated with the persistence of unmet dental care needs in both age groups. Conclusions: Efforts should be made to identify factors related to the persistence of unmet dental care needs in order to improve patient accessibility to dental care services.

• Journal of Korean society of Dental Hygiene
• /
• v.19 no.4
• /
• pp.601-614
• /
• 2019

Objectives: The purpose of this study was to investigate the present conditions and problems of oral health care in senior citizens with dementia using a qualitative research method, through focused group interviews. Methods: Data was collected for approximately one month from May 2019. The subjects were divided into two groups: care workers and family caregivers. Fifteen participants were included in the study. Results: In-depth interviews with the care workers revealed the following three categories: characteristics of senile dementia patients, oral health care in senile dementia patients, and oral health care education. In-depth interviews with the family caregivers revealed the following four categories: characteristics of senile dementia patients, oral health care in senile dementia patients, oral health care education, and burden of care. The central themes common to both the care workers and family caregivers were the challenges owing to the characteristics of senile dementia patients, poor health condition of the senile dementia patients, difficulty in oral health care of the senile dementia patients, the desire to receive oral health care education and related information, and to access the information more easily. Additional central themes specific to the care workers were, the applicability of the intervention programs, variability between the facilities, and the problems of oral health care education. An additional central theme specific to the family caregivers was the burden of care. Conclusions: It is necessary to provide oral health care education and information to care workers and family caregivers of senile dementia patients, and to manage and support the dental health professionals ready to care for senile dementia patients. In addition, support to the family caregivers should not be limited only to the financial aspects, but also consider the psychological and emotional difficulties.

• Journal of Korean Academy of Nursing
• /
• v.34 no.5
• /
• pp.771-780
• /
• 2004

Purpose: The purpose of this study was to explore how older adults kept their health good at a doctorless farm village. Method: Data was collected through in-depth interviews with 32 participants who were over 65 years old and analyzed in terms of Strauss and Corbin's (1990) grounded theory methodology. Result: The Core Category of health care of older adults was identified as 'enduring physical changes by themselves'. The process of this could be divided into 4 stages: the stage of bearing, the stage of managing daily living activities, the stage of passively collecting information and the stage of minimally utilizing health care services. Older adults accepted the aging process positively but health sources limitation passively, so they managed daily living activities and used natural food for health. In addition, they collected information related to health care and used health care services minimally. Conclusion: We found that participants managed their health passively because of negative attitudes toward active health behaviors of older adults by themselves and the difficulty of access to health care services. Therefore, various community health services for older adults need to be developed to empower older adults in the community.

• Health Policy and Management
• /
• v.30 no.3
• /
• pp.399-408
• /
• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• The Korean Journal of Food And Nutrition
• /
• v.22 no.2
• /
• pp.215-222
• /
• 2009

The principal objective of this study was to assess the demands and satisfactions of silver welfare professionals for elderly individuals residing in the Northern Gyeonggi-do area. To this end, a survey was conducted to investigate elderly individuals and employees related with them in terms of their recognition, interest, and involvement in a labor training program. The sources of health information the subjects received included mass media(50%) and health professionals(41%), and they tended to trust the information they received from health professionals(64%) and the mass media(26%). In the case of health professionals working at silver care facilities, the sources of health information to which they had access were: mass media (51%), health professionals(20%), internet(14%), reliable health professionals(56%), mass media(22%), and books related to health(18%). Elderly subjects' reasons for satisfaction with the facilities were as follows: access to meals(32%), elderly communities(24%), and good facilities(22%), whereas the reason subjects reported dissatisfaction with social difficulties(68%), bad facilities(20%), and programs(12%). The degrees of satisfaction of the respondents with the facility's employees were reported as follows: life manager(28%), nurse(16%), and social worker(15%), whereas the subjects reported some degree of dissatisfaction with: nurses(29%), care helpers(17%), and facilities officers(13%). The priorities of the elderly welfare-related information were: disease and health(49%), daily life support(17%), nursing(11%), welfare facilities(8%), and the principal issues they reported as being relevant to elderly individuals were: palsy(16%), arthritis(14%), diabetes (12%), hypertension(10%), dementia(6%). They reported that the most important personnel for elderly in the future would be care managers(44%) and care helpers(21%). Via this developmental program of silver health care professionals, a variety of new job opportunities may be provided in the future, and a program related to the silver service industry must be established as soon as possible.

• Journal of Preventive Medicine and Public Health
• /
• v.55 no.1
• /
• pp.49-59
• /
• 2022

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.17
• /
• pp.7401-7407
• /
• 2015

Cervical cancer continues to be a serious public health problem in the developing world, including China. Because of its large population with geographical and socioeconomic inequities, China has a high burden of cervical cancer and important disparities among different regions. In this review, we first present an overview of the cervical cancer incidence and mortality over time, and focus on diversity and disparity in access to care for various subpopulations across geographical regions and socioeconomic strata in China. Then, we describe population-based cervical cancer screening in China, and in particular implementation of the National Cervical Cancer Screening Program in Rural Areas (NACCSPRA) and the challenges that this program faces. These include low screening coverage, shortage of qualified health care personnel and limited funds. To improve prevention of cervical cancer and obtain better cancer outcomes, the Chinese government needs to urgently consider the following key factors: reducing disparities in health care access, collecting accurate and broadly representative data in cancer registries, expanding target population size and increasing allocation of government funding for training of personnel, improving health education for women, enhancing quality control of screening services and improving a system to increase follow up for women with positive results.

• Health Policy and Management
• /
• v.21 no.4
• /
• pp.617-642
• /
• 2011

The purpose of our study is to analyze the determinants of the benefits of the long-term care insurance in Korea using 2008 and 2009 cross-sectional data. Per capita long-term care insurance benefits can be divided into home care services utilization rate, institutional care services utilization rate, per capita home care services benefits, and per capita institutional care services benefits, which are used as the dependent variables in our regression analysis. Admission rate and the ratio of the admitted to the applicant also used as the dependent variables. The results of our analysis show that the explanatory variables such as income level, needs for care, family type, access to the services, and regional characteristics are statistically significant to explain the dependent variables, the long-term care insurance benefits. The higher is the regional income and the more of the female residents, the more are the long-term care insurance benefits. The easier is the access to the services, the more are the insurance benefits. In the rural area, the level of the insurance benefits is relatively high. We propose that copayment rates of the long-term care insurance should be examined and monitoring on the over-use of the services should be done. Also preventive services and care by the family member should be expanded.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.5 no.1
• /
• pp.97-105
• /
• 1999

Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.