• 대한간호학회지
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• 제18권2호
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• pp.153-161
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• 1988

The purpose of this study was to analyze the level of the services provision of community health practitioners (CHP) and to find out the influence factors on the services provision of CHP. In this study the dependent variables were the level of community health services(CHS), maternal and child health services(MCH), family planning services(FPS), primary care services(PCS) and the ratios of preventive health services(PHS). And independent variables were predisposing, community demographic and task factors. For this analysis, atepwise regression was used. Data collected for the study on reorganization of health centers organization in 1985 was partly used. The findings of this study can be summarized as follows : First, total variance of independent variables for CHS, MCH, FPS, PCS and PHS are shown 62.5 percent, 58.3 percent, 41.8 percent, 17 percent and 61.9 percent respectively. Second, the most important variables which explain CHS, MCH, FPS, PCS and PHS was ratios of household contacted ($R^2$＝0.289), marital status ($R^2$＝0.177), marital status($R^2$＝0.167), ratios of household contacted($R^2$＝0.119) and management of preventive health services($R^2$＝=0.203) respectively. The independent varivbles used in this analysis presented that the explnining for the provision of preventive health service are more influenced than primary care services. In summary this analysis suggests that the level of preventive health services provision of CHP is low and the provision of primary care services compared with preventive health services are occurred independentely. In the future, the strategies for active preventive services by CHP must to be strengthened.

• Journal of Preventive Medicine and Public Health
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• 제43권6호
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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 Preventive Medicine and Public Health
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• 제34권3호
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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.

• Journal of Preventive Medicine and Public Health
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• 제54권1호
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• pp.81-84
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• 2021

The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.

• 농촌의학ㆍ지역보건
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• 제21권1호
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• pp.47-60
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• 1996

Home health care is one of the important components of health care services. Today, the need and demand for the home health care is increasing. To assess the effects of home visit health services by public health nurses in health center on the stat of health, use of medical services and quality of life by elderly people living at home, a randomized controlled trial was implemented for 65 years or more old people randomly allocated to intervention(93) and control(118) group. Intervention group received 2 visits a month over 6 months. Control group received no home visits. The data was collected in a one-year follow-up survey conducted at Kyongju before and after the intervention which composed of health risk assessment, risk factor education and health related behavior counseling. The prevalence rate of chronic illness was more decreased in intervention group than control group after intervention. The intervention group visited medical facilities less frequently than control group. And the home visit health services encouraged the elderly to practice regular exercise. After the intervention, the score of ADL(activities of daily living), LSI(life satisfaction index) and SSI(social support index) in intervention group were more increased than control group. And the increase of scores was more prominent in 70 years or more old people, female, non-smoker and non-chronic illed elderly rather than others. In conclusion, the regular home visit health services provided by public health nurses were beneficial for the elderly in terms of health promotion and quality of life.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.399-407
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• 2001

Objectives : To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. Methods : We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. Results : 100 of 125 hospitals responding (84.8%) had mere than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. Conclusion . Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.

• 농촌의학ㆍ지역보건
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• 제32권1호
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• pp.27-39
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• 2007

Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

• 대한간호
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• 제25권2호통권135호
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• pp.72-79
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• 1986

The present health system with its emphasis on the patient in hospital and with specialized medical services, is not equipped to provide health maintenance and preventive care to society. Community generated medical facilities to provide preventive and lo

• 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.

• 대한예방한의학회지
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• 제2권1호
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• pp.31-43
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• 1998

The ultimate goal of national health promotion services is the improvement of quality of life and health longevity through the implementation of health promotion services. The approach strategy for national health promotion summariged as follows: 1) A model for health promotion should be developed by the level of government. 2) Roles and functions between central government and autonomous local governments should be defined to carry out the health promotion services effectively. 3) New manpower for health promotion such as health educator should be trained and activated at hospitals, health centers, industries, school, and related community agencies. 4) School health education should be strengthened in order to teach: various health subject(smoking & alcohol, drug abuse, accident and safe, nutrition, environmental pollution and preservation, population & family planning, personnel hygiene, physical growth, stress, sex education, communicable disease, physical exercise etc) students through appointing health teachers at school base. 5) Health promotion services in industries should be activated using manpower such as health educator, exercise instructor, dietist and counsellor, 6) Health promotion services for the elderly should be activated. 7) Health screening services in the medical insurance and his/her family should be activated for health promotion services. 8) Health education material development center for health promotion should be established and the materials should be made to distribute to related groups, agencies and institutions (health conte.5, hospitals, schools, pharmacies, industries etc). 9) The pilot health promotion center in each automous local governments(large cities, provinces, Guns and Gu level) should be established and operated for community people. 10) The mass media such as TV, radio, newspapers and magazines should be used effectively. 11) Periodic evaluation of health promotion services should be carried out in order to help effective and successful planning for community health promotion in the future.