• Journal of Preventive Medicine and Public Health
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• v.43 no.6
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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.

• Journal of Community Nutrition
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• v.1 no.2
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• pp.133-139
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• 1999

The purpose of this survey was to investigate eating habits, life styles and nutritional care of diabetic outpatients and to provide basic data for developing individualized nutritional care and diabetic education programs. This survey was carried out by nutritional counseling with a questionnaire and checking medical record. Information about the general characteristics of the subjects, eating habits, health-related life styles and attitude and perception of subjects to diet therapy was gathered from 200 randomly-sampled diabetic outpatients at a University Hospital located in Inchon. All data were analyzed by Statistical Analysis System(SAS) software. The results are summarized as follows : Female subjects were 63.5% of total subjects and 65.5% of total subjects were 50 years or more. The average Body Mas Index(BMI) of male and female subjects were 23.06kg/㎡ and 25.02kg/㎡ respectively and 44% of all subjects wee obese. Among subjects, type II diabetic patients were 81.0% and 82.5% of subjects had suffered from diabetes for more than one year. Also 41% subjects had diabetic history in their family. More than half of the subjects had nutrition education concerning diabetes. Also 75.5% of them thought that nutrition education was effective. The most important guideline in diet therapy was to eat cooked rice with dietary fiber-rich grains. Therefore, it might be necessary to develop nutrition education program adjusted according to diabetic patient's needs and life styles, which may increase feasibility of self-care and implementation of management guidelines.

• Research in Community and Public Health Nursing
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• v.13 no.3
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• pp.444-455
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• 2002

Purpose: This study was performed to develop the case management program that can provide the qualitative health care service to satisfy the increasing needs for health care elderly and prevent the increase in medical cost cased by prolonged and repetitive hospitalization. Method: The survey was completed as follows. First, 290 elderly patients who would be soon discharged in 4 hospitals are participated in the survey on needs of nursing care and case management programs. Second, 70 professionals working at 5 hospitals including doctors, nurses, social workers and so on are participated in the survey on the case management team operation. Result: Level of needs to Nursing care and case management programs showed so high. Professionals suggested on the case management team operation. Finally, based on the survey and literature review, the case management program was developed. Conclusion: In this study, the specific models for the five case management services were suggested. It is thought that the service provision by the case management team based on the multi-disciplinary case management program model suggested in this study would be suggested as a constituent of the effective health care delivery system for the hospitalized elderly patients.

• Research in Community and Public Health Nursing
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• v.24 no.3
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• pp.332-345
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• 2013

Purpose: This study was attempted to provide quality improvement and revitalization of visiting nurse services by Importance-Performance Analysis of persons being provided with the services. Methods: The subjects were 350 people being provided with visiting nurse services from a long term home care institution in the kangwon Province during the period of data collection between Aug. 16 and Sep. 15, 2011. Data analysis was conducted through t-test, ANOVA, and IPA by using the SPSS/WIN 12.0 program. Results: As a result of the Importance-Performance Analysis of visiting nurse services, it turned out that the strength on reliability, assurance, and empathy should be maintained with good work and the aspects of responsiveness appeared to be intensively improved, and the tangibility proved to be subject to improvement. Conclusion: For the activation of visiting nurse services, methods for improving the performance in the intensive care area and management strategy establishment which highlights the advantages of strength maintenance area are needed.

• Journal of agricultural medicine and community health
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• v.17 no.1
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• pp.25-33
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• 1992

Most of oriental medical care resources such as doctors and facilities are distributed in urban areas and approximately ten percent of them is in rural areas. However the aged population of over 60 years old in rural areas is higher than that in urban and these aged population prefer more oriental medical care than the other age group. Therefore, the government planned to carry out the oriental medical care demonstration project in a designated rural areas in 1990. The study was carried out to find out the utilization pattern of medical care and consumers attitude toward oriental medical care treatment provided by health centers. The interview survey was applied to collect the data and 187 patients, who visited to health centers to receive care in 1991, were selected by random sampling. The study results obtained were as follows : 1) Among the 187 respondents, male was 31.6% and female, 68.4%. 2) 73.8% of the respondents were the age of over 45 years old. 3) For the motivation of visiting the health center to receive oriental medical care, 37.4% of the respondents visited purposely according to announcement of oriental medical care and 26.2% of them made a decision by themself 20.3% of them was recommended by the neighbors. 4) The most frequent symptoms surveyed were the disease of the musculoskeletal system and connective tissue. 5) By the subjective judgement of the respondents from the result of the oriental medical treatment, recovered or improved cases represent 69.5%. It is considered that the oriental medical care was acceptable, and also the respondents were satisfied with the oriental medical care in terms of kindness of oriental medical doctors, treatment time and expenses of care.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1195-1206
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• 2000

The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.

• Journal of agricultural medicine and community health
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• v.6 no.1
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• pp.44-60
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• 1981

In Korea, the position of health among the sectors of everyday life lies behind the others. The inhabitants don't consider health so important and immediate as food and shelter. Primarily, it seemed more important for them to eat something and to educate their children than to secure health. Under this situations we must take into consideration their health status and health problems in terms of the social system. Health cannot be maintaned by itself. It inter acts with a set of social conditions such as income, knowledge about health, health institution, health insurance, social class, culture and etc. But the community health projects which have carried out in Korea since the beginning of 1970s focused mainly on the medical care and medical delivery itself regardless the background of health care. According to the existing results of socio-epidemiological and medico-sociological researches, a set of social conditions has a great effect on the inhabitants' health status and health care. So, such conditions will be considered primarily in Korea University Health Project. This paper is prepared as a preliminary step for such a program. In this paper we mainly inquired into the relationship between health and the attitudes of inhabitants.

• The Journal of Korean Physical Therapy
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• v.35 no.2
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• pp.37-42
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• 2023

Purpose: Compared to cities, rural areas are in a medical blind spot and face difficulties in accessing medical services due to inconvenient transportation facilities, lack of medical facilities, and the heavy burden of medical expenses. This study was carried out to identify the problems relating to the musculoskeletal system of the elderly in rural and fishing villages, which are medically vulnerable areas, and sought to present a regionally differentiated healthcare model. Methods: The study was conducted in 80 elderly people in two rural villages and two fishing villages after seeking inputs regarding medically vulnerable groups in the Gyeongnam Province. Postural balance and muscle flexibility were assessed and postural evaluation was conducted to identify musculoskeletal problems and gait stability. Strength and range of motion for each body segment were assessed for evaluating functional motion. Results: The elderly in both rural areas showed forward head posture characteristics. The strength level of the elderly in both rural areas was higher than the average, but their flexibility and balance ability were lower than the average. Conclusion: The musculoskeletal problems of the elderly in rural and fishing villages in this study did not show regional characteristics according to the area of residence. However, overall flexibility and balance ability appeared to be reduced. Therefore, a new management model connecting the region and the university is necessary in preparation for the coming era of community care.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2013.10a
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• pp.747-749
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• 2013

Aging our country is facing now is seeking qualitative and quantitative expansion of social welfare services. In particular, the rapid increase in the aging population is an urgent need to resolve the problems of inducing demand for medical care and various welfare related to the elderly, In addition, IT technology in Korea is improving daily, in particular, fields of ubiquitous have been studied actively. In this paper, U-Health Care System model technology for the elderly were studied. Existing residential and senior living environment dedicated to the Care system for the fusion of design, and content designed around the ubiquitous technology that combines the old Care system was studied. Existing community-based model that combines technology and IT systems and mobile elderly Care services in conjunction with other devices by providing an application, the existing Care and medical needs will be able to solve the problems.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.162-168
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• 1989

This study was conducted to analyse attitudes to a new health care system in a rural community. The specific purpose of this thesis was to classify attitudes to the patient referral system in Kangwha county, and to identify factors affecting the attitudes. Sampling was done by a multi-stage stratified cluster sampling method from the population. The data were collected in Kangwha county through a structured interview survey for two weeks in June, 1957. Attitudes to the patient referral system were classified into four types based upon answers to questions about awareness of the system, the recognition for the necessity of the system, and opinions on the improvement of the system. The four types of attitudes were active acceptance(10.2%), partial acceptance (27.2%), refusal(35.8%), and indifference(26.7%). The respondent's age, educational level, age of head of household, medical insurance fee, the number of ill family members, and the percentage of medical utilization by the family were the variables which affected the attitudes. The medical insurance fee, respondent's age, age of head of household, and the percentage of medical utilization by the family were the statistically significant discriminant factors of the four types of attitudes.