• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Journal of the Korea Society of Computer and Information
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• v.22 no.11
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• pp.105-110
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• 2017

This paper is to research the difference of care workers' role in Sanatorium between urban and rural areas. Interviews have been conducted with 100 care managers with structured questionnaires in community care settings. The findings of the study are as follows. In the analysis of working with carers a care manager acting as a counsellor in rural was required rather more than any other role in working with clients' carers. In working with formal and informal networks, an administrative specialist role was also important in both areas. With resource management, there were some regional variances between rural and urban. In the urban area, a care managers as a coordinator was more required than as a broker. In the rural area, a care manager as a broker, selecting service resources for elderly clients was the most suitable role. In conclusion, in general rural care managers' roles were similar to those of many core managers in urban area. Among the many possible roles of care managers that effective continuity of care is to be provided for elderly clients in community care, two have been specified as essential roles. The first is the role of care managers that provides coordination and integration of services at the clients' levels as a care manager as an implementer, a linkman, counsellor. The second is at the system level which is possible role for coordination and linkage of programs as a characteristics of care managers, task with formal & informal network, community resources, available residential & NHS resourcesw.

• The Journal of Korean society of community based occupational therapy
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• v.9 no.3
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• pp.11-19
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• 2019

Objective : The purpose of this study was to investigate the awareness of job task importance and performance of occupational therapists in the community care system for the elderly. Methods : We conducted an online questionnaire survey of 152 occupational therapists nationwide from May 31, to June 24, 2019. General characteristics and institutional awareness, role and performance awareness were analyzed by descriptive statistics. One way ANOVA were conducted to compare the differences of working days, working places, and the field of work. Results : The recognition of the community care system for the elderly was low at 2.93 ± 1.0 but the importance of the community care system was 3.94 ± 0.7 and the importance of the occupational therapist in the system was 4.34 ± 0.7. Fall prevention (4.63 ± 0.7) was the most important in occupational therapist's jobs, and performance was high in instrumental activity daily living training (3.94 ± 0.8) and physical function training (3.94 ± 0.8). Conclusion : This study can be presented as basic data on job task importance and performance awareness of occupational therapists in the elderly community care system. In addition, it is expected to be used as basic data for establishing the role of occupational therapist in the elderly community care system.

• Journal of the Korea Convergence Society
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• v.7 no.6
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• pp.259-266
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• 2016

The purpose of this study is to explore the feasibility of establishing the elderly protection system for the elderly in the local community, and to explore the linkage model and action strategy. In Korea, there is a need to build a comprehensive elderly care system so that elderly people can have appropriate counseling and support programs in the community, as the elderly increase their diverse needs (leisure, housing, employment). In this study, we set up a linkage model of elderly care system and suggested two ways to practice it. First, it is suggested that it is desirable to focus on the formation of the elderly protection system in the community, and divide the practice process into three stages: organization, practice, and organization. Second, it is necessary to apply the long-term care professional manpower which can play a central role such as care manager and nursing care provider in order to apply the community organizing model of the elderly protection system and stable operation of long-term care insurance for the elderly. In addition, a social welfare council and a private network should be established to form a social welfare council, the establishment of related legal provisions, and the education of care managers. Therefore, it is necessary to establish basic data through this study, to establish diverse strategies and plans for the elderly protection system, and to promote it in a phased manner.

• Research in Community and Public Health Nursing
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• v.7 no.2
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• pp.183-202
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• 1996

This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

• Research in Community and Public Health Nursing
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• v.23 no.4
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• pp.415-426
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• 2012

Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

• Research in Community and Public Health Nursing
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• v.14 no.1
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• pp.75-82
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• 2003

The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.180-188
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• 2011

Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.

• Research in Community and Public Health Nursing
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• v.12 no.1
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• pp.22-31
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• 2001

Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.181-199
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• 1998

This study was designed to examine Home Nursing Care in Hospital-based and Community-based programs. This study investigates actual conditions of nursing needs and demands of clients and their family and the state of home nursing services. We hope that this study will improve upon the current home nursing care system. In Korea Home-Nursing Care programs are still developing and only now becoming a part of the health care delivery system. The data was collected by a questionaire the clients developed and modified through literature review by this writer and through 10 nurses who are members of 4 hospital and 3 community- based agencies. In this study 173 clients were selected. The study lasted from Oct. 1997 to March of 1998. The results show that the average age was 64.3, years older than most women clients (63.0%), the average age of a caregiver was 50.9 years old and most were female(77%). Two types of agency clients with a significant difference between social conditions [25.7%] used some form of insurance; 54.3% had the spouse pay expenses; pay 58.5% son and daughters of Hospital-based agencies: patients of social workers were 24.0%, the highest in the community agency. The condition of patients was 63.2% of the foley and nelaton catheter insertion at hospital based agencies. The range of nursing services offered is one of the highest among the 34 kinds of servies including nasogastric tube management basic nursing, ROM exercise, bladder irrigation, wound and sore dressing. For an effective care service factors that disturb each program such as a non-cooperatative family as well as patients themselves need to be lessened. Further more, the following must be emphasized, supportive counsel 27.0%, steady care for patient, 13.3%maintain a sense of security(11.7%), dressing sores and nutrition(10.0%). Although there were a large number of home nursing care services in the community, policy changes have gathered momentum. Fortunately, the scope and level at legal support will be increased in the future. The program should intergrate and link the district or community together. A project to develop a community based home nursing system as soon as possible should be developed. In conclusion, home nursing care nurses training curriculum should be strengthened.