The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.
Recognizing the lack of empirical study that evaluates the influence of social care services on care sufficiency of individuals with disability, we have focused our study on the following research questions: What is the level of care sufficiency for individuals with disability?, What is the profile of care for individuals with disability from both formal and informal providers?, What are the service use conditions and determinants of social care service use?. This study analyzed data of 1204 individuals with disability who needed daily assistance from 5th wave of Korea Welfare Panel Study. Results showed that 50% of the respondents experienced care deficit. 77% of the respondents received no care from informal care providers and 90% from formal care providers. Despite social care services brought by the expansion of socialization of care, the average number of social service use on care was less than 1, which suggests that socialization of care did not significantly contribute to care sufficiency. In addition, for people who are 64 or younger, social care services was substituted by care from informal care providers and for those who are 65 or older, social care services supplemented care from informal care providers.
The purpose of this study was to verify the moderating effects of optimism on the relationship between depression and willingness for self-sufficiency in self-sufficiency program participating workers. For this study, a sample of 775 self-sufficiency program participating workers completed depression questionnaire, optimism scale and willingness for self-sufficiency scale. The data was analyzed using the Baron & Kenny's moderating effect verification method. The results of the analysis showed that depression had a significant negative effect on willingness for self-sufficiency, and optimism had a significant positive effect on willingness for self-sufficiency. The results verified the moderating effects of optimism on the relationship between depression and willingness for self-sufficiency. On the basis of the results, We discussed that optimism can reduce the negative effect of depression on willingness for self-sufficiency and improve willingness for self-sufficiency. We discussed the optimism promotion program as an intervention method to improve willingness for self-sufficiency in self-sufficiency program participating workers.
Self-sufficiency has been recognized as one of the most important welfare goals for women in the domestic violence field since the welfare reform in the U.S. A qualitative research design was conducted to explore the self-sufficiency experience of Korean-American single mothers with the history of domestic violence in poverty. The meaning of 'self-sufficiency' to participants is that a continuing task or process in life to move toward being independent mentally as well as economically. Their challenges toward self-sufficiency include the period of restoration of their potentials for self-sufficiency destroyed by domestic violence victimization and divorce, and the period of developing their sustainability for self-sufficiency. Their needs for 'help and support similar to care from the woman's parents' home', 'welfare service of select and concentration', 'mature dependency and self-sufficiency', and 'self-sufficiency from survival to dream come true' to cope with the challenges formentioned are reported. Concrete strategies for the development of self-sufficiency polices and services sensitive to immigrant single mothers with the history of domestic violence are suggested.
Park, Jeong-Ho;Yun, Soon-Young;Kim, Mae-Ja;Han, Kyoung-Ja;Hong, Kyoung-Ja;Park, Seong-Ae;Heo, Jeong-Soon
Journal of Korean Academy of Nursing Administration
/
v.8
no.4
/
pp.615-632
/
2002
Purpose : this study was to project demand of home nursing care in Korea for contributing toward the distribution of home nursing care resource. Method : demand of home nursing care is projected according to income level and needed service level of each person. in addition, demand sufficiency of home nursing care is taken by estimating for supply level available. Result : home nursing care service is scarecely provided to people who belong to second area, that is, only $1.6{\sim}2.3%$ out of them are provided and also, supply system comes short of meeting demand of the other people(who belong to one, third area). Conclusion : therefore, for proper provision of home nursing care, different supply system and policy direction for establishment and expansion of home nursing care is to be developed.
This qualitative study is designed for the reconstruction of the experience of single mothers in poverty based on the bottom-up approach. Welfare dependency is identified as vital help to protect their own and children's lives, through their stories telling that welfare services provided by government and community take care of them "in place of their husbands", and "raise them up by hand." What is self-sufficiency to them is more of a process-orientation through welfare dependency than a state out of it, and a way to look through building their self-esteem and working to discover their self-worth except their economic power. Restoring their potential to self-sufficiency through dealing with their psycho-social stresses and expanding services for them related to child-care(education) and occupation ability development for long-term self-sufficiency, rather than hasty focusing on welfare exit, should be built on the foundation of helping them self-sufficient. In order for the self-sufficiency program to overcome the participant's images of "subordination and stigma" and to convey the original meaning of "welfare to work", the performance and evaluation system of self-sufficiency programs that reflects the insider's perspectives on their participation motive and process, and the self-sufficiency program customized for their needs and interests should be encouraged to develop.
This study used qualitative data to examine how low-income families confront the child care needs of their children in the midst of changes in public policy. The data were drawn from in-home interviews conducted every 6 months with 22 mothers who were welfare-dependent at the start of the research. This research depicted several life stories of the circumstances of poor children that have not had much previous attention in the literature: the general flows and the special conditions of child care among the low-income families with or without a disabled child were reported. The results in this study suggested that enabling families, through both social support and public funding, find affordable and quality child care would be one pathway to foster self-sufficiency in these families.
The Journal of Korea Assosiation for Disability and Oral Health
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v.2
no.1
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pp.17-30
/
2006
Federal disability law has evolved from several laws geared to protect people with disabilities since the late 1960s and early 1970s. When U.S. Congress passed the Americans with Disabilities Act (ADA) in 1990, no federal statute prohibited the majority of employers, program administrators, owners and managers of places of public accommodation and others from discriminating against people with disabilities. Toward the ends to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with the disabilities, the ADA pursues three major strategies: Title I addresses inequality in employment, Title II, inequality in public services, and Title III, inequality in services and accommodations offered by private entities. The purposes of the study were to analyze the impact of the ADA on health care for persons with disabilities and to review the ongoing health policy reforms at the federal and state governments. Essential remedies that the ADA contemplates are based on two principles, simple discrimination and reasonable accommodation, which significantly improved access to quality care, especially long-term care, by persons with disabilities. However, the ongoing Medicaid policy reforms to control rising health care costs in the U.S. could threaten the access to care by persons with disabilities in optional groups and to optional care services by persons with disabilities in mandatory groups.
Kim, Ji-Hyun;Cho, Byung-Mann;Hwang, In-Kyung;Son, Min-Jeong;Yoon, Tae-Ho
Health Policy and Management
/
v.18
no.4
/
pp.66-84
/
2008
Objectives: This study aimed to. offer some fundamental evidences for the stroke management policy by investigating the trends of medical care utilization and regionalization in stroke inpatients. Methods: We used the National Health Insurance claims and registry data for stroke inpatients from 1998 to 2005. Among all stroke inpatient claims data, self-employed insured and their dependents were only included in this study. The classification of stroke was based on ICD-10(I60-I69) and its subtype was divided by hemorrhage(I60-I62) and infarction(I63-I64) type. To evaluate regionalization of medical care utilization, relevance index was calculated by regions. The regions were classified 8 large catchment areas and 163 self authorized areas. Results: The overall medical care utilization rate of stroke inpatient has been increased, especially infarction subtype. Among medical care institutions, the utilization of hospital has been the most rapidly increased. Although considered annual rate of interest, total medical cost of stroke inpatients has been increased, Totally, more than 84% of stroke inpatient were admitted to medical care institutions in their own large catchment area during 1998-2005. The relevance indices in their own large catchment area (self sufficiency rates) were more than 70% in most areas regardless of stroke subtype except Chungbuk catchment area. Self sufficiency rates of stroke inpatients among 163 self authorized areas in 1998 and 2005 were 84.2% and 83.1% in metropolitan, 46.7% and 45.5% in urban, and 19.5% and 22.6% in rural areas, respectively. Conclusion: Stroke management policy for improvement of distribution at the district level, especially in rural areas, may be helpful for reducing regional inequality in stroke.
Objectives: This study examined the personal, interpersonal and community factors related to food sufficiency and variety among Korean adults using data from the 2017 Community Health Survey. Methods: A total of 228,310 adults aged ≥ 19 years were classified into three groups: food sufficiency with variety, food sufficiency without variety and food insufficiency. Personal factors included sociodemographic characteristics, health behavior and health status. Interpersonal factors included social networking and social activities, and community factors included safety, natural environment, living environment, availability of public transportation and health care services. The association of food sufficiency and variety with interpersonal and community factors was assessed using multivariable logistic regression analyses. Results: Of the total sample, the food-sufficiency-without-variety group and food insufficiency group accounted for 31.5% and 3.2%, respectively. The sociodemographic factors associated with food insufficiency and non-variety were women, ≥ 65 years of age, with low education level, low household income, unemployed, single, and living in areas of small population sizes. There were significant differences in health behavior and health status, interpersonal and community factors among the three groups. Multivariable logistic regression analyses conducted after adjusting for confounding factors showed that lack of social networking and social activities and lower satisfaction derived from community environments were associated with the risk of food insufficiency and non-variety. Conclusions: Our results showed that interpersonal and community factors as well as personal factors were related to food sufficiency and variety. Therefore, public policies to help build social networks and participation in social activities, and improve community environment are needed together with food assistance to overcome the problems of food insufficiency and non-variety.
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