• 제목/요약/키워드: Clinical preventive services

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Prevention in the United States Affordable Care Act

  • Preston, Charles M.;Alexander, Miriam
    • Journal of Preventive Medicine and Public Health
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    • 제43권6호
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    • pp.455-458
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    • 2010
  • The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.

예방의학의 발전 방향 (Preventive Medicine in Times of a Rapid Epidemiologic Transition in Korea)

  • 박정한
    • Journal of Preventive Medicine and Public Health
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    • 제39권1호
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    • pp.2-6
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    • 2006
  • Ever since the foundation of the Korean Society for Preventive Medicine in 1947, members of the Society had made remarkable contributions to the public health development and national health promotion. They had played key roles in establishing national health system, improving environmental hygiene, controlling infectious and chronic diseases, promoting family planning, improving industrial and environmental health, and developing health service management. However, the Society had less actively responded to the changes in health service needs of the population that were caused by a rapid epidemiologic transition in last a few decades. Early detection and treatment of chronic diseases including cancer and cardiovascular diseases and risk reduction by the life style modification are major approaches to the contemporary national health problems and they are the core contents of preventive medicine. The author proposed to develop the clinical preventive medicine specialist who will have additional training in clinical medicine for health screening and life style modification to the current preventive medicine training program and thus will be able to provide comprehensive preventive medical services. Another area that the Society may take the initiative is training preventive medicine specialist in the disaster, including bioterrorism, preparedness and management. The Society should be more active in proposing health policy and health service program and also participate collectively in a large scale health research project of the government. These approaches may not only contribute more effectively to the national health promotion but also improve the identity of the Society.

일부 응급구조(학)과 학생의 병원임상실습 실태 및 만족도 관련요인 (Current status of clinical practice and associated factors with satisfaction among students in the department of Emergency Medical Service)

  • 최성수;박종;류소연;한미아
    • 한국응급구조학회지
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    • 제16권2호
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    • pp.9-22
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    • 2012
  • Purpose : The purpose of this study was to investigate the current status of clinical practice and associated factors with satisfaction among students in the department of emergency medical service. Methods : The study subjects were 498 students who finished clinical practice course in 9 universities. General characteristics, current status of clinical practice, frequency of some medical procedure and practice satisfaction were collected using self-administered questionnaire. The association between clinical practice and satisfaction was tested by t-test, ANOVA and multiple regression analysis. Results : Of 498 students, 257 (51.6%) subjects were male and the mean age was $22.1{\pm}2.01$. The overall satisfaction score of clinical practice was $96.76{\pm}18.04$. Male students had higher satisfaction scores than that of female. The students who were satisfied with the emergency room practice wanted to work in hospital or fire station and they had a tendency to take paramedic as their lifelong career. The students preferred to practicing in the emergency department that hire the paramedic. Conclusion : Gender, grades, future jobs, occupational views, practical places, agency orientation, departments, and educators were associated with educational satisfaction. The practice program considering the results of this study will help to increase the educational satisfaction in students of emergency medical service.

임상전문분야별 의사 설문조사를 통한 병원서비스 평가 방법 연구 (A study on a hospital services evaluation method by physician survey)

  • 장원기;문옥륜
    • Journal of Preventive Medicine and Public Health
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    • 제29권4호
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    • pp.815-829
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    • 1996
  • A physician survey was done by mailing for the purpose of performing hospital services evaluation and ranking. A slightly over one thousand samples were drawn from the list of professional societies, and 324 physicians(about 32 percent) replied. This study has focused on developing easy and simple method to evaluate hospital services, and providing patients with useful information. Hospital service structure and process were evaluated without outcome evaluation, because it is difficult to obtain reliable data regarding health services outcome indicators. Clinical specialty was targeted to evaluate, and three specialties were chosen, that is obstetrics & gynecology, cardiology, and proctology. Among 16 structural indicators, four indicators were finally chosen in each specialty by respondent specialists. And then using these indicators, structural score was calculated for study hospitals. For process evaluation, physicians were requested to nominate five most famous hospitals. The nomination score and structural score were summed up to produce final score and hospital ranking. This method is very easy to conduct rather than other hospital services evaluation methods prevailing in Korea. And it is more useful for patients to choose hospitals, according to his/her own purpose, because it gives high ranking hospitals with specific clinical specialty.

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우리나라 예방의학교육의 미래: 희망과 도전 (Future of Preventive Medicine Education in Korea: Hopes and Challenges)

  • 맹광호
    • Journal of Preventive Medicine and Public Health
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    • 제39권1호
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    • pp.7-12
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    • 2006
  • Throughout the century, based on the precedent set by Flexner in the United States, almost every subsequent report on the reform of medical education has pointed out the need for more prevention-oriented teaching in the curriculum. This has been particularly so in countries like Korea where the basic public health services have been so important for the improvement of health of the people. And, in fact, preventive medicine and public health have contributed a great deal to the prevention of communicable diseases and prolongation of life expectancy. Recently, however, along with the educational reform that emphasizing the interdisciplinary teaching, integration of basic science and clinical education, and centralization of responsibility for the medical education curriculum, concerns are being voiced by preventive medicine educators. These concerns are primarily centered around the fear that the implementation of interdisciplinary, centrally administered courses would result in a weakening of content and teaching expertise as well as a loss of departmental power and control. This paper foresees that preventive medicine and public health will be more important in Korea in the future and proposes that preventive medicine educators will have to step forward and turn the challenges of curricula restructuring into opportunities to expand the role of preventive medicine in the curricula of their institutions.

예방의학의 발전방향 (Directions for Future Development of Preventive Medicine in Korea)

  • 김준연
    • Journal of Preventive Medicine and Public Health
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    • 제39권3호
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    • pp.185-189
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    • 2006
  • It is the actual state of the medical society in our country that many graduates of medical schools want to be clinicians, and accordingly Korea's medical situation is relatively too focused on curative medicine. However, this situation is changing due to several factors including a growing number of doctors, inappropriate regulations for medical fees, changes in social status of doctors themselves, and excessive competition between doctors. Furthermore, we expect more advances in medical field of Korea since Korean government started to attach great importance to sciences and produced policies to support sciences, and as a result, more and more interest and effort in the fields of basic research including preventive medicine is being attached especially by young doctors as compared against the past. However, decline of clinical medicine fields doesn't always mean bright future for the field of preventive medicine. True future is possible and meaningful only when we prepare for it by ourselves. In other words, as the promising future is closed to one who spares no effort, we shouldn't fear to oppose unknown challenges and simultaneously need to support colleagues who bear such a positive mind. It is the most important thing for our preventive medicine doctors to evaluate the past and the present of preventive medicine and to foster a prospective mind to prepare for the future of preventive medicine. I set forth my several views according to directions for the development of preventive medicine which we already discussed and publicized in the academic circle of preventive medicine. Those directions are recommendation of clinical preventive medicine, promotion of preventive medicine specialty, fostering the next generations, improving the quality of genetic epidemiologic study, participation in control of environmental pollution and food safety, contribution to chronic disease control, and preparation to role in medical services for unified Korea.

한방의료이용의 결정요인과 정책개선방안 (Determinants of Utilization of Oriental Medical Services and Policy Implications)

  • 변진석;이선동;김진현
    • 대한예방한의학회지
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    • 제3권2호
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    • pp.1-23
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    • 1999
  • The purpose of this paper is to survey the current status of service utilization in oriental medicine, to identify the determinants of consumers' decision in the service utilization, and then suggest policy implications for promoting the consumers' utilization. A multiple regression model was adopted to analyze the factors that influence consumer's decision in purchasing the oriental medical services. Data used in this research relied on National Survey Data conducted by Korea Institute of Health and Social Affairs, and sampling survey. The results could be summarized as follows.: 1. the number of visits to oriental medical institutions has shown an overall increase during the last decade since the inception of health insurance for oriental medical services. It still, however, revealed a relatively iow figure to western medical services. 2. the main factors, after controlling demographic variables, that determine consumers' selection between oriental medical services and western medical services are considered to be price, belief in effectiveness of services, waiting time for service. Implications for policy recommendation include 1. to reduce a barrier to service utilization by discounting dramatically the price of herb medicine, which is believed to be crucial in expanding market share, 2. to encourage consumer's belief in clinical effectiveness through a specialization in competitive services compared with wertern medicine, 3. to keep the affirmative image among consumers alive through an active participation of oriental medical doctors in community activities, 4 to change the health care system in favor of oriental medicine in the long run.

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임상실습을 경험한 응급구조(학)과 학생의 임파워먼트 관련 요인 (Factors related to empowerment of paramedic students who experienced clinical practice)

  • 송서영;한미아
    • 한국응급구조학회지
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    • 제20권1호
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    • pp.17-30
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    • 2016
  • Purpose: This study investigated factors related to empowerment of paramedic students. Methods: A total of 208 students in the department of emergency medical services who experienced clinical practice at 5 universities were selected by convenience sampling methods. Differences in empowerment by general and major-related characteristics were evaluated using a t-test and analysis of variance. The association between satisfaction with clinical practice and empowerment was tested using correlation coefficients. Multiple linear regression analysis was performed to investigate the factors associated with empowerment. Results: The levels of overall satisfaction with clinical practice and empowerment were 107.48 and 99.46, respectively. In simple analysis, empowerment level was associated with general characteristics, major-related characteristics, characteristics of clinical practice, and satisfaction with clinical practice. Empowerment level was significantly higher in older subjects (${\beta}=5.282$, p = .023), subjects with very good (${\beta}=8.487$, p = .002) or fair (${\beta}=4.879$, p = .010) subjective health status, and high subjective school record (${\beta}=5.837$, p = .008) in multiple linear regression analysis. Satisfaction with clinical practice was positively associated with empowerment (${\beta}=0.250$, p < .001). Conclusion: Empowerment was associated with major-related factors and satisfaction with clinical practice. Increased satisfaction with clinical practice could positively influence empowerment for paramedic students.