• Title/Summary/Keyword: Community Health Centers

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Effects of the Out-of-pocket Payment Exemption in the Public Health Center on Medical Utilization of the Korean Elderly

  • Nam, Kiryong;Park, Eunhye;Chung, Yuhjin;Kim, Chang-yup
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.6
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    • pp.455-464
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    • 2020
  • Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments' regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions: The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

Case Manager's Perception and Practices of Case Management Process at Community Psychiatric Rehabilitation Centers -Focused on the community psychiatric rehabilitation centers in Busan- (사회복귀시설 사례관리자의 사례관리 과정에 대한 인식과 수행에 관한 연구 -부산지역 사회복귀시설의 사례관리를 중심으로-)

  • Kim, Sun-Joo;Kim, Gyo-Jung
    • The Journal of the Korea Contents Association
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    • v.13 no.1
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    • pp.221-233
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    • 2013
  • This study aims to explore how to cognize and perform case management process to community psychiatric rehabilitation center in Busan area. The case of case manager for 12 people obtained by conducting focus group interviews were in-depth analysis. Many commissioned by a variety of human service organizations in the contract and the client-centric intake has been received. Assessment, rather than a function of mental disabilities center service needs, planning difficulties in securing resource discovery and felt. Intervention phase focuses on direct service and when several agencies responsible for the case management approach. The possession of responsibility was unclear. Mainly monthly facilities within the checking step checks are being made, there was a desire for the realistic-supervision. Completion stage expectations showed a performance evaluation oriented, and individualized case management that can be represented well on the rating scale.

Utilization and Improvement of 8 Principle TKM Public Health Services in Rural Areas of Korea (일부 한국농촌지역의 8대 한방공공보건사업에 대한 주민의 이용실태 및 개선방향;강원도 홍천군을 중심으로)

  • Shin, Heon-Tae;Lee, Sun-Dong;Chu, Chae-Shin;Han, Sang-Baek;Han, Yong-Joo;Park, Hae-Mo
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.1
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    • pp.23-34
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    • 2007
  • Health promotion program utilizing traditional korean medicine(TKM) is very unique modality uncommonly conducted throughout the world. Korea's TKM public health services went through initial stage from 2001 and spread throughout the country by 2003. 35 public health centers in the nation is appointed as 'TKM health promotion HUB' and in operation from 2007. But the program is still in the early state and evaluation of usage, satisfaction, and community service is still in demand. This study aims to verify current situations of TKM public health service by examining public awareness, usage, and satisfaction and suggest improvements based on findings. 2.5% of local residents were sampled and 1739 were chosen as subjects. Knowledge, attitude, satisfaction and others for TKM public health service were examined. TKM treatment service was most widely utilized(13.2%), followed by CVA prevention program(5.2%). For satisfaction level, CVA prevention program showed highest satisfaction(73.3%), closely followed by (Qi-gong program 63%). In general, awareness and utilization of TKM public health service were low but compensated by high satisfaction level. More active promotion and development of community specific programs should become available in the future.

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A Study on Dietary Behaviors, Health-Related Lifestyle of Adult Visitors at Public Health Centers in Gyeonggi Urban Area (경기 도시 지역 보건소 성인 방문자의 식생활과 건강 관련 라이프스타일 조사)

  • Kwon, Jong-Sook;Kim, Kyungmin;Seo, Hyun-Chang;Lee, Yoonna;Lim, Seunggeon;Choi, Young-Sug
    • Korean Journal of Community Nutrition
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    • v.18 no.6
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    • pp.611-625
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    • 2013
  • The purpose of this study was to investigate dietary behaviors and health-related lifestyles of adult visitors at a public health center in Gyeonggi urban area. A survey using questionnaire was conducted with 949 visitors at Seongnam public health centers from June to August, 2012. The data from 905 respondents were analyzed by gender, consisting of 322 males and 583 females, and age group, consisting of 243 low-age group (LA), 312 middle-age group (MA), 350 high-age group (HA), aged 20 to 30 years, 31 to 50 years, and 51 to 69 years, respectively. Average Body Mass Index was 23.0, which increased with age, and education level was high in LA. 59.0 percent of the subjects had various diseases, and the incidence of hypertension was the highest, followed by allergy, hyperlipidemia, diabetes mellitus, joint rheumatism. Incidence rates of chronic disease increased with age, which were lower than those from 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Weekly drinking frequency rate and smoking rate decreased with age, and exercise performing rate was high at male and HA, which showed the same tendency as KNHANES. Female and HA showed more healthy dietary behaviors such as restricting salt, sugar, oily foods, foods containing food additives, calorie, caring for balanced diet, and referring to nutrition label. Subjects chose stress as the first factor, followed by diet, exercise, etc., among 13 suggested factors which strongly influence on human's life-span. In general, public health center visitors, especially female and HA, showed better dietary behaviors and health-related lifestyles compared with KNHANES.

Health promotion services of health care center at some universities in California, the U.S. (미국 대학보건실의 건강증진 서비스 제공체계 - 캘리포니아 주에 소재한 일부 대학의 운영사례를 중심으로 -)

  • Kim, Young-Bok;Park, Chun-Man
    • The Journal of Korean Society for School & Community Health Education
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    • v.12 no.2
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    • pp.113-127
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    • 2011
  • Background: University health services have provided comprehensive medical care, counseling, health promotion, and public health services to their students and several other local institutions. To their faculty and staff, university health care centers have served occupational health services and employee assistant program. Purpose: We performed this study to review the health promotion services on two kinds of health care center with different style of university formate. Methods: We tried to collect the data by literature review and interview with executive and provider at health care center in University of California at Berkeley and San Jose State University. Results: Our results were as followed. First, students could use the medical services just as they would their regular doctor's office and urgent care center. Second, the health promotion unit offered programs and services for keeping students healthy and safe, including many opportunities for students to get involved in shaping the public health of the campus. Third, the health promotion recommendation offered from ACHA was useful guideline to improve health status of their member in university campus. Finally, the student satisfaction surveys were used for evaluation and quality improvement. Conclusions: The systematic approach to improve health status of students, faculty and staff can use to maintain a state of optimum health among the diverse student community in support of academic excellence. Coupled with health promotion and public health programs, university health service have to reach all segments of the healthy campus community. To achieve study goals in university, the health care center contributes to promote accountability and responsibility for the health and well being of the members in their campus.

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The Effect of Vitamin D and Calcium on Cognitive Function and Depression in the Elderly Living in a City

  • Lee, Yu-Jin;Kim, Yun-Su
    • Research in Community and Public Health Nursing
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    • v.28 no.3
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    • pp.251-259
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    • 2017
  • Purpose: This study aims to examine the influence of vitamin D and calcium on depression and cognitive function of the elderly living alone in a city. Methods: The participants were registered in eight senior centers in S city and they had lived alone. Data were collected between November 28, 2014 and March 7, 2015. A total of 155 people participated in data collection to measure the serum vitamin D, the serum calcium, depression, and cognitive function. The data were analyzed with t-test, ANOVA, Pearson's correlation and multiple regression analysis. Results: There were significant differences in depression according to gender and perceptions of health status. Depression correlated significantly with the serum calcium and perceptions of health status, and a stepwise regression analysis showed that the perceptions of health status were significant. There were significant differences in cognitive function according to education level and age. Cognitive function correlated significantly with the serum vitamin D and a stepwise regression analysis showed that education level and age were significant. Conclusion: Consequently, elderly people with poor perceptions of their health status need a depressive intervention program and those with a higher age and lower level of education need a cognitive function intervention program.

Effects of Perceived Health Status, Self-esteem and Family Function on Expectations Regarding Aging among Middle-aged Women (중년여성의 지각된 건강상태, 자아존중감, 가족기능이 노화에 대한 기대에 미치는 영향)

  • Kweon, Yoo Rim;Jeon, Hae Ok
    • Journal of Korean Academy of Nursing
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    • v.43 no.2
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    • pp.176-184
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    • 2013
  • Purpose: The purpose of this study was to investigate expectations regarding aging by middle-aged women in the community, and identify factors contributing to their expectations about aging. Methods: Participants in the survey for this study were 303 middle-aged women from community health centers and religious facilities in Seoul, Gyeonggi Province, and Chungcheongbuk Province. Data were collected from March 2 to April 17, 2012 using self-report structured questionnaires. The instruments were the Health Perceptions, Rosenberg Self-esteem Scale (RSES), Family APGAR, Expectations Regarding Aging (ERA-12). The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and hierarchical multiple regression with IBM SPSS/WIN 20.0 program. Results: Perceived health status (${\beta}$=0.16, p=.009) and self-esteem (${\beta}$=0.20, p=.001) of middle-aged women were identified as significant predictors of expectations regarding aging, after adjusting for age, education, occupation, monthly income and menstrual status. Conclusion: These results suggest that nurses should make an effort to improve expectations about aging among middle-aged women. Ultimately, community health programs for middle aged women need to be developed to achieve successful aging.

Development and Evaluation of the Reliability and Validity of the VSSS-82 Korean Version for Measuring Satisfaction with Community-based Mental Health Services in Psychiatric Patients (지역사회정신보건서비스 이용자의 만족도 측정을 위한 한국어판 Verona Service Satisfaction Scale-82 (VSSS-82)의 개발 및 신뢰도와 타당도 평가)

  • Yoo, Weon-Seob;Moon, Ok-Ryun;Nam, Jung-Hyun;Shin, Young-Jeon
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.3
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    • pp.211-218
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    • 2001
  • Objectives : To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. Methods : The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. Results : A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56(overall satisfaction) to 0.90(skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. Conclusions : The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.

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Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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AA Study of Spatial Composition and Area Distribution by Function in Public Health Centers of Busan (부산도시보건소의 기능별 공간구성 및 면적배분에 관한 연구)

  • Cho, Heeyoung;Yoon, Sohee;Kim, Suktae
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.21 no.2
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    • pp.55-65
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    • 2015
  • Purpose: Korea is increasing in the demand for medical services due to rapid economic growth and population aging in modern society. Thus, the importance has been emphasized for the health promotion in the community and the publicity and substantiality of public health centers. However, the environment is insufficient, compared to required functions and developed services as a urban public health center. The purpose of this study is to analysis the plane type and area composition of public health centers in Busan and to identify the property of their spatial configuration Methods: Eight public health centers in Busan, were classified, which had been selected as a medical tourism city. Subsequently, space requirements were analyzed, facilities were typed, vertical, horizontal spaces were reviewed, and area ratios by business function were calculated. Results: A review of the property of spatial configuration and an analysis of the area ratio revealed the three findings. 1)The horizontal analysis found various types: a single type, a multi-type, a radial type, and a circular type, 2)The vertical analysis showed that since a care function (general practice), and a task function (maternal and child health) were concentrated in lower level spaces, the lobby and core were closed located for providing quick medical services. 3)The analysis of the area ratio in public health centers in terms of their function indicated that each public health center' programs had the greatest influence on the area. Implications: This study attempted to present spatial structural problems and improvements for city public health center by identifying their state and classify their functions and types and by calculating the ratio of their area configuration according to the spatial composition. It was thus aimed to presenting implications in establish public functions and roles by activating business through in connection with the number of municipalities in many ways, such as regional health. medical welfare, etc. to improve the health of local residents, and by providing differentiated programs in accordance with local characteristics.