• 한국농촌간호학회지
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• 제19권1호
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• pp.44-54
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• 2024

Purpose: This study identifies the factors influencing unplanned readmissions among participants of the medical aid community care pilot program. Methods: This descriptive study analyzed data from 1,013 participants in a medical aid community care pilot program. Data were analyzed using multiple logistic regression analysis. Results: The presence of mental illness, injury-related conditions, long-term care grades, and activities of daily living scores are key factors influencing the likelihood of readmission. In particular, the presence of a mental disorder or an injury-related condition increased the probability of readmission, whereas individuals with long-term care grades 1~2 showed a decreased likelihood of readmission. Conclusion: This study emphasizes the importance of enhancing the management of mental and injury-related conditions, effective utilization of long-term care services, and improvement of ADL scores to reduce readmission. These findings offer crucial insights for enhancing the efficiency of home medical care benefit programs and sustainable expansion of services.

• 지역사회간호학회지
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• 제23권4호
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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.

• Child Health Nursing Research
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• 제16권4호
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• pp.344-351
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• 2010

Purpose: This study was done to examine effects of a discharge education program using on-line community on parenting stress, baby care confidence for mothers of premature infants and health problem of premature infants. Methods: Using a non-equivalent control group pretest-posttest quasi-experimental design, 32 participants were assigned to an experimental (17) or a control group (15). Mothers in the experimental group were introduced to the discharge education program 2 weeks before the baby was discharged. They participated in the on-line community for 4 weeks after discharge. Parenting Stress Index and Baby Care Confidence Scale were utilized for data collection. Data were analyzed using descriptive statistics, $X^2$-test, Fisher's exact test, and Mann-Whitney U test with the SPSS program 16.0 version. Results: In the experimental group, mean scores for parenting stress were lower than for the control group (Z=-3.176, p=.001), while scores for confidence in baby care were higher than for the control group (Z=-3.195, p=.001). Conclusion: Findings indicate that discharge education programs using on-line community have the positive effect of decreasing parenting stress and increasing baby care confidence for mothers and decreasing health problems for infants. Therefore utilization of the internet and online community to educate parents of premature infants is recommended.

• Journal of Preventive Medicine and Public Health
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• 제49권1호
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• pp.69-78
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• 2016

Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

• 농촌의학ㆍ지역보건
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• 제15권1호
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• pp.41-48
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• 1990

In order to find out the status of health care of the old aged people (age of 65 and over) in a rural area, a study was carried out, through analyzing the data of health care clinic for 207 old aged people with geriatric diseases, and of questionnired survey for 84 old aged people with geriatric diseases in a rural community. Su Dong-Myun. Nam Yang Zu-Gun, Kyung Gi-Do, Korea, during the year of 1989. The following results were obtained. 1) The composition rate of population of age of 65 and over was 9.8% in total, and sex-specific composition rate was 9.3% in male and 10.4% in female. 2) Utilization rate of health care clinic for old aged people with geriatric diseases was the highest rate with 37.9%, through individual letters at the first time, and showed gradually decreasing tendency afterward. 3) In the means of utilization advices to health care clinic for the old aged people. the individual letters(37.9%) at the first time were more effective than public information of the old aged hall or/and Myun office(18.4%). 4) In opinion on utilization of health subcenter-health care clinic for the old aged people "will utilize"(59.5%) was the highest and "do not know"(26.2%) "be difficult to utilize" (9.5%) and "will not utilize"(4.8%) were in the next order. 5) Out of 84 respondents, the old aged people With geriatric diseases, 73.8%(about three-fourths) of them answered "their diseases to the aggravated" (29.8%) "not to be changed"(25.0%) and "to be unknown"(19.0%), and the others(26.2% of them) "to be changed for the better". 6) Out of 62 respondents(the old aged people), answered their geriatric diseases not to be changed for the better, "no curative effect" was the highest with 43.5% of them. "could not know" (33.9%), "would not treat"(19.4%) and "could not be treated"(4.8%) were in decreasing order. 7) The old aged people, responded their diseases to be changed for the better, answered that they(patients) should make themselves(68.2%) responsible for basic effort of health care. However the old aged people responded their diseases not to be changed for the better answered that they should impute the responsibility of basic effort for health care to medical facilities or other conditions(63.0%). 8) In the reason of failure that the old aged people responded their geriatric diseases not to have curative effect, mis-control of regular habits of daily life was the highest(57.1%), and failure of taking selected medicine steadily(28.6%), and abuse of medicines(14.3%) were in decreasing order. 9) The reason order of being changed for the better that the old aged people responded their diseases to have curative effect, was keeping and control of regular habits of daily life (46.7%), taking selected medicines steadily(33.3%) and others (20.2%) respectively. 10) The courses of geriatric diseases itself are so chronic, duplicate and uncertain, and the old aged people activities for disease control are so slow, various and uncertain that continuous health education in home or/and community unit must be essential factors for effective geriatric health care.

• 지역사회간호학회지
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• 제27권3호
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• 보건의료산업학회지
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• 제7권3호
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• pp.95-109
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• 2013

The objective of this study is to assess the utilization and satisfactions about public health centers in Korea. For the analysis, the study utilize the nationwide data of 229,229 person on '2010 Community Health Survey' of Ministry of Health & Welfare. The statistical methodology used in the study is ${\chi}^2$, ANOVA, logistic regression model and multiple regression model. This study have four major findings. First, the significant affecting socio-demographic factors in utilizing public health center were gender, age, region, national basic living secured, married, income, education, job, state of health, chronic disease, unmet medical needs and utilization reason. Second, the most serviced category of health center user was vaccination both city and rural area and the next was certificate, primary care, health screening, other use, the mother and child in city area, primary care, health screening, certificate, home visiting health in rural area. Third, the significant affecting socio-demographic factors in satisfaction degree on health center service were age, region, national basic living secured, income, education, job, state of health, utilization degree and reason. Fourth, the most satisfied service of health service center was home visiting health in city area and mental health service in rural area and the next was nutritive control and the lowest satisfied service was user of certificate. The utilization and satisfaction on health center service were identified as different with residental area and user's characteristics. The politic effort are needed to support socially disadvantaged class and to narrow regional gap.

• 한국농촌간호학회지
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• 제12권2호
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• pp.29-44
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• 2017

Purpose: The purpose of this study was to identify community health practitioners' (CHP) perception of barriers to research utilization, current status and competence in evidence-based practice (EBP). Methods: From all over the country, 126 CHP completed an e-mail survey. Results: The items with the highest barrier scores were that it is difficult to understand articles written in English and physicians will not cooperate with implementation. There were statistically significant differences in the scores for attitude toward EBP and knowledge in EBP by education level and nursing academic society membership status. When faced with a problem, the nurses usually use related regulations or asked a colleague for advice. Conclusion: Results indicate an awareness of the necessity of applying EBP, need to improve readiness to use EBP voluntarily and actively, and need to search for various factors that are barriers to research utilization. There is a need to develop and apply EBP training/education programs to find new evidence that might actually support previous practice for which nurses lack confidence. Guidelines that consider CHP task characteristics and barrier factors to research utilization should be developed.

• 보건행정학회지
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• 제3권2호
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• pp.159-176
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• 1993

The utilization of outpatient care services involves two steps of sequential decisions. The first step decision is about whether to initiate the utilization and the second one is about how many more visits to make after the initiation. Presumably, the initiation decision is largely made by the patient and his or her family, while the number of additional visits is decided under a strong influence of the physician. Implication is that the analysis of the outpatient care utilization requires to specify each of the two decisions underlying the utilization as a distinct stochastic process. This paper is concerned with the number of physician visits, which is, by definition, a discrete variable that can take only non-negative integer values. Since the initial visit is considered in the analysis of whether or not having made any physician visit, the focus on the number of visits made in addition to the initial one must be enough. The number of additional visits, being a kind of count data, could be assumed to exhibit a Poisson distribution. However, it is likely that the distribution is over dispersed since the number of physician visits tends to cluster around a few values but still vary widely. A recently reported study of outpatient care utilization employed an analysis based upon the assumption of a negative binomial distribution which is a type of overdispersed Poisson distribution. But there is an indication that the use of Poisson distribution making adjustments for over-dispersion results in less loss of efficiency in parameter estimation compared to the use of a certain type of distribution like a negative binomial distribution. An analysis of the data for outpatient care utilization was performed focusing on an assessment of appropriateness of available techniques. The data used in the analysis were collected by a community survey in Hwachon Gun, Kangwon Do in 1990. It was observed that a Poisson regression with adjustments for over-dispersion is superior to either an ordinary regression or a Poisson regression without adjustments oor over-dispersion. In conclusion, it seems the most approprite to assume that the number of physician visits made in addition to the initial visist exhibits an overdispersed Poisson distribution when outpatient care utilization is studied based upon a model which embodies the two-part character of the decision process uderlying the utilization.

• 농촌의학ㆍ지역보건
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• 제16권1호
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• pp.3-9
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• 1991

In order to find out status of health care for community residents with special reference to organization and man power in a rural health subcenter, a study was carried out, through analyzing the data, operated by health subcenter during 1973~1990 in a rural area, Su Dong-Myun, Nam Yang Ju-Gun, Kyung Gi-Do, Korea. The following results were obtained : l) The Number of Population in Su Dong-Myun is decreasing and household is increasing chronologically. 2) In 1989, the characteristics of population composition rate in Su Dong-Myun were shown : the groups of Age, 65 and over was high rate(9.8%) and 0~4 was low rate(5.3%) decreasing chronologically. 3) Since 1972, services of Su Dong-Myun health subcenter have been carried in the 3 functions(medical treatment, health care management and clerical work) with supports of Ewha Woman's University through the participation of community residents organization. 4) The Number of Su Dong-Myun health subcenter personnel in 1990 was 5 persons(public health doctor l, public health dentist l, health worker l, dental technician l and assistant nurse l) and of these, health worker who must have the huge charge of health care management, has been worked at Myun-office as a public official, in condition, decreased from 3 in 1980 to 2 in 1981 and from 2 to 1 in 1985. 5) Health service Activities of Su Dong Myun health subcenter obtained good results in it's achievement during 1975-1985, but since 1986, it has been in condition of lower stepping. 6) Since 1977, annual medical utilization rate showed decreasing tendency such as 900 per l,000 population in 1977, 846 in 1979, 723 in 1981, 343 in 1973 and 34l in 1987. 7) A proposal : (l) Organization of health subcenter must be unified and systematized by government, so that health subcenter can carry out primary health care for community residents through responsibilities and authorities. (2) Teaching programs in educational process must be reorganized, according to periodical request. considering relative importance to primary health care in health care needs of community residents.