• 제목/요약/키워드: Community health service

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지역 보건서비스의 산출에 영향을 미치는 요인 (Determinants of the Community Health Service Utilization)

  • 송근원;강대창
    • 보건행정학회지
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    • 제13권1호
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    • pp.69-97
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    • 2003
  • This study focuses on the determinants of the community health service utilization. Theories suggest seven models for community health service utilization, which are divided largely into two groups such as Health Service Supply Model and Health Service Demand Model: Supply Model includes Medical Implements Model, Personnel and Budget Model, Management System Model, Staffs' Behavior Model, Service Quality Model; Demand Model includes Area Model and Clients' Characteristics Model. This paper tests how the above models influence on the community health service utilization. After interviewing some administrative staffs of the Community Health Service Center at Pusan, questionnaires were made and mailed to the staffs of 198 Korean Community Health Service Center as a universe, among which from 98 centers we got response. Analyzing the data from the questionnaires, we found "the number of personnels in the health service center" and "demands for medical service" as important variables to affect the utilization of the community health service center. These two variables are typical factors representing Supply Model and Demand Model each. However, the variables selected from Management System Model, Administrative Behavior Model, Service Quality Model and Area model are not significant in a statistical sense. The paper suggests that to recruit the personnels, especially nurses, and to make out the demands of the clients for health service be the precedent conditions to increase the utilization of the Community Health Service Centers in Korea.ce Centers in Korea.

요양보호 대상노인의 서비스 요구도 평가 (Needs Assessment of Elderly for Community-based Long-Term Care)

  • 이재창;김은경
    • 간호행정학회지
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    • 제11권1호
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    • pp.67-77
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    • 2005
  • Purpose: Needs of health-welfare-medical service for the elderly is rapidly increasing in Korea. The purpose of this study was to evaluate the needs of health-welfare-medical service for the long-term care elderly in the community and to compare differences by their characteristics. Method: Needs assessment was completed in the homes of 598 persons over 65 years by using the tool of needs assessment, between November and December, 2003. We examined all the health-welfare-medical service of elderly in the community. Data were analyzed using SAS program. Result: The needs of the long-term care elderly in community was largest 'home visiting service of visiting nurse(87.5%)', and then 'religious, psychological and emotional support(73.9%)', 'home visiting therapy of physician(58.5%)', 'social support service(55.7%)', 'health improvement program of public health center and social welfare center(51.8%)', 'health examination(48.8%)' followed. The difference of health-welfare-medical service needs among characteristics(age, medical security, caregiver existence, and regions) was statistically significant by service contents(p<0.05 or p<0.01). Conclusion: We can apply it in the distribution of community resource and the development of service providing programs by figure out the needs assessment for the long-term care elderly in the community, and consequently, through this, realizing the health maintenance and promotion of the long-term care elderly.

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서울시 찾아가는 동주민센터 방문건강관리 사업의 만족도 영향요인 (Factors influencing the community care satisfaction of the urban elderly focusing on the outreach community health service in Seoul)

  • 손창우;서다람;황종남
    • 한국보건간호학회지
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    • 제35권2호
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    • pp.254-267
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    • 2021
  • Purpose: This study aimed at identifying the factors affecting the service satisfaction of urban elderly, focusing on the outreach community health service in Seoul, and suggesting policy directions for the successful implementation of community care. Method: Individuals aged 65 and 70 who used the outreach community health service from July 2017 to June 2019 were eligible for the survey. A total of 2,028 people were sampled using a proportional allocation method for each autonomous district in the survey which covered 25 districts. A multi-level logistic regression analysis was conducted, taking into account the individual's socioeconomic level, health status, type of service provided, and the healthcare-related environment and service provision period of the autonomous district. Result: The results revealed that the health status of the urban elderly, the type of services provided (health screening, linkage to community health center and clinic/hospital, medical checkup results counseling, frailty evaluation), and personal experience of the service were the major factors associated with the satisfaction with the outreach health services. Conclusion: The development of customized health services based on the close relationship between visiting nurses and the elderly may be considered to promote a sustainable community health care model.

지역사회 재가 만성정신질환자 가족의 부담감과 정신보건서비스요구와의 관련성 (The Relationship between Family Burden and Mental Health Service Needs of Family for Home-based Chronic Mental Patients in Community)

  • 김인홍
    • 농촌의학ㆍ지역보건
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    • 제33권3호
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    • pp.269-278
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    • 2008
  • = ABSTRACT = Objectives: This study was carried out to identify the relationships of family burden and mental health service needs of chronic mental patients in community. Methods: Objects of the study were 153 chronic mental patients in community of P. city in korea. Data were collected from December, 2007 to February, 2008 using structured questionnaire. Research tools of this study were family burden tool developed by Pai & Kapur (1981) and mental health service needs tool developed by Kim (2003). Results: The average grades for family burden was 1.62 points. And the biggest part of family burden was economic burden(1.74), followed by interrupt of daily life(1.67), interrupt of family relationship(1.64), interrupt of family leisure (1.57), effects of mental health(1.50), and effects of physical health(1.43). The average grades for mental health service needs was 2.72 points. And the biggest part of mental health service needs was rehabilitation service(3.09), followed by social service(2.87), and Psychiatric medical service(2.21). Positive correlation showed between all parts of family burden. And, positive correlation showed between psychiatric medical service and interrupt of daily life(r=.281, p<.01), psychiatric medical service and effects of physical health(r=.355,p<.01), social service and effects of mental health(r=.213,p<.01). Conclusion: The family burden for care giver of mental patients was related with all parts of family burden and mental health service needs of family. Thus, these results should be considered to reduce family burden for care giver of mental patients in community.

일 도시지역을 대상으로 한 지역사회 간호과정 사례연구 (Application of Community Health Nursing Process to an Urban Community)

  • 이정렬;김의숙;조원정;권명숙;임은선;유미애
    • 한국보건간호학회지
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    • 제11권2호
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    • pp.121-130
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    • 1997
  • The community health nursing process is essential in providing community health nursing service to the community. It helps to identify community health problems. to prioritize problems, to provide service. and to evaluate service results. However. it is very rare to find a study which applies the community health nursing process. This study intended to apply the community health nursing process to a urban community. The focus of the study was a community consisting of 533 families in a region of Seoul. The study process was as follows: 1) The data was collected by conducting interviews with community leaders and by collecting surveys from the people of the community. 2) The data was summarized and analyzed. 3) The community nursing diagnosis was identified. 4) The nursing diagnosis was prioritized. 5) The general and specific objectives for service were identified. 6) A specific nursing plan was set up. 7) A detailed evaluation plan was established. Four community nursing diagnoses were identified from the community. 1) The utilization rate of health center was found to be low due to lack of knowledge about the health center and low accessibility. 2) High trafic accident rate due to narrow roads. 3) High prevalence of chronic disease due to inappropriate health behavior. 4) High noise level and foul smell due to inappropriate waste management. Among the four community nursing diagnoses. 'High prevalence of chronic diseases was identified as a priority community nursing problem. The criteria for prioritizing community nursing problems were as follows: number of people involved, fragility of clients. severity of the problem. availability. of resources. concern of the people. readiness of nurses. relevance to the national policy. This study describes the general and specific objectives to solve the high prevalence of chronic health problems. nursing plans. and an evaluation plan.

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Does Community Participation Work? : A Study on the Impact of Health Care Reform in Chile

  • Park, Yun-Joo
    • 이베로아메리카
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    • 제12권1호
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    • pp.149-186
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    • 2010
  • Community participation in health has been praised as a new way of improving health inequality in developing countries for many decades. This paper is an attempt to evaluate community participation programs in health focusing on two intercultural health hospitals in IX Region of Chile. After exploring the process of program building and its impact on the quality of service, this paper concludes that a community participation program with stronger participation resulted in higher patient satisfaction. The author expects such finding to contribute to more comprehensive understanding of the impact of participation in health programs.

일개 지역사회 중심 가정간호사업소의 운영실태 및 운영방안 (A Study on the Operating Status of Community-based Home Health Care Centers)

  • 이은희;박성애
    • 간호행정학회지
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    • 제17권2호
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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.

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

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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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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일개 보건소 방문간호사업의 업무 분석 (A Study for Reorientation of Home Care Service at Community)

  • 이홍자;김춘미;윤순녕
    • 지역사회간호학회지
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    • 제9권1호
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    • pp.163-180
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    • 1998
  • The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

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A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • 대한간호학회지
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    • 제11권2호
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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.

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