Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.
Intestinal parasitic infections are a public health burden and a major cause of illness in developing countries. The diseases lead to various health threats, including growth retardation and mental health-related disorders, especially in children. We assessed the risk factors for intestinal parasitic infections among children aged 12-59 months residing in Nyamasheke District, Rwanda. A cross-sectional descriptive study was conducted using secondary data from 1,048 children aged 12-59 months whose stool samples were examined for the presence of intestinal parasites and whose results were registered in the laboratory information system in 2020. The prevalence of intestinal parasites in children aged 12-59 months was 53.2%. The dominant parasites were Ascaris lumbricoides (13.1%), followed by Giardia lamblia (10.9%), Entamoeba histolytica (7.9%), Trichuris trichiura (6.5%), hookworms (1.7%), and Taenia species (1.4%). A significant association was observed between intestinal parasites and the literacy of mothers or children's caregivers (odds ratio (OR)=5.09, P<0.001). Children from farming households were 2.8-fold more likely to contract intestinal parasitic infections than those from nonfarming households (OR=2.8, P<0.001). A significant association was also observed between intestinal parasites and food safety (OR=4.9, P<0.001). Intestinal parasitic infections were significantly associated with hand hygiene practices after using the toilet and washing fresh fruits before eating (P<0.001). The information gathered will help public health providers and partners develop control plans in highly endemic areas in Rwanda.
Public health system and public health practice have changed over the past decades as the result of social and epidemiologic changes. New public health concept emphasizes leadership, strategical thinking, systematic planning and effective performance to identify and solve complex health problem In Korea, the role of Health Center has been expanded rapidly. However there is strong suspicion that Health Center can achieve their mission. This paper aims at understanding what is the needed functions of Health Center and which of its aspects needs improvement. The main results of this study are summarizes as follows. District Health Law does not address the core functions of Health Center. The staffs of Health Center have difficulties in prioritizing their services. The recent attempt to restructure Health Center and change delivery pattern of public health services ended with only limited success. To effectively confront threats to the public's health, the three major function of Health Center must be ${\circled}1$ modifying individual behavior and lifestyle, ${\circled}2$ improving social and economic conditions, and ${\circled}3$ reforming health policies. Better results do not come from setting new functions only; they come from understanding and improving the processes that will then leads to better outcome. We recommend that policy-makers focus economic evaluation of public health programs, building and spreading of the scientific evidence of programs, linkage of public health research and public health program. The criteria of delegation of public health service to private sector is urgently needed. Making community health information data available on a routine basis to providers, managers and researchers of public health services helps promote the efficiency of the overall operation of public health system.
Journal of agricultural medicine and community health
/
v.19
no.2
/
pp.159-173
/
1994
Since the establishment of health centers in the 1960s, the centers have been played an important role in providing basic health care for the people. Although the health centers made a great effect to prevent diseases and promote the health status of the people for the last three decades, the function of health centers should be strengthened to meet the health care need of individual, family and community. Over the last ten years, there have been great changes and developments in health related environments, such as population size and age, rapid urbanization, up-grading of the educational level, increase of income, health care demand for promotive health care measures and practical measures for chronic diseases and also practicing healthy life. According to the great changes in health related environments, the health centers should be reformed. The following policy options are recommended as a summary; First, the function of health centers should be converted from providing basic health services into promotive and preventive health care services, to meet changing needs of people. Second, the health center personnel should be reinforced for their competency to provide a qualitative services to people and also the operation of health center should be reactivated. Third, a close linkage of health centers with the private sector is an essential requirement for the operation of the health care delivery system within a health district in order to improve the health status of people. Fourth, type of manpower mix, scope of organization and health care program should be varied, based on the health care needs of people, geographical characteristics and size of population etc. Fifth, a comprehensive health care delivery system should be developed, for maintaining healthy life style of people and also the health and welfare services should be integrated in order n ensure an effective service.
The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.
Journal of agricultural medicine and community health
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v.21
no.1
/
pp.97-105
/
1996
This study conducted to determine the evaluation and improvement for enforcement of the waste recycling system in Pohang city and surveyed 4 areas at the southern and northern districts respectively by a team of two officials during the period 6 February 7 February 1995. The rates of the use for waste recycling system's envelope from home trash were 94.2% at the northern district and 92.8% at the southern district by areas, 95.6% at the group houses (apartments and tenement houses) and 91.3% at the separate houses by patterns of house, the low economic class 96.4%, the middle economic class 96.3% and the upper economic class 87.5% by the economic levels, and the bell method 96.5%, the container method 95.6%, door take method 86.1% in order, respectively. The trash from houses were garbage 57.4%, paper 18.7%, plastic 10.3%, fiber 7.9%, bottle 2.7%, metal and can 1.4%, and wood and rubber 0.7% in order. The rates of the reuse trash(reuse possible paper, plastic, bottle, can and metal) were 20.2% of the total, 21.8% at the southern district and 18.5% at the northern district by areas, 25.7% at the separate houses and 14.7% at the group houses(apartments and tenement houses) by patterns of house, and the door take method 34.3%, the bell take method 17.1% and the container take method 14.7% in order, respectively. There were the double envelopes of the plastic bag from stories 46.3% and the clear plastic bag 29.5% in the waste cycling system's envelopes. There were 1.9 double envelopes in the waste cycling system's envelopes. Garbage occupied more than half of the total trash, so it is need to be compost and provender.
Purpose: This study purposed to analyze the spatial accessibility of mental health institutions in Ganwon-Do using Geographic Information System and to suggest policy implications. Methodology: Network analysis was applied to assess the spatial accessibility of mental health institutions in Gangwon-Do. To perform the network analysis, network data set was built using administrative district map, road network, address of mental health institutions in Gangwon-Do. After building network data set, Two network analysis methods, 1) Service area analysis, 2) Origin Destination cost matrix were applied. Service area analysis calculated accessive areas that were within specified time. And using Origin Destination cost matrix, travel time and road travel distance were calculated between centroids of Eup, Myeon, Dong and the nearest mental health institutions. Result: After the service area analysis, it is estimated that 19.63% of the total areas in Gangwon-Do takes more than 60 minutes to get to clinic institutions. For hospital institutions, 23.08% of the total areas takes more than 60 minutes to get there. And 59.96% of Gangwon-do takes more than 30 minutes to get to general hospitals. The result of Origin-Destination cost matrix showed that most Eup Myeon Dong in Gangwon-Do was connected to the institutions in Wonju-si, Chuncheon-si, Gangneung-si. And it showed that there were large regional variation in time and distance to reach the institutions. Implication: Results showed that there were regional variations of spatial accessibility to the mental health institutions in Gangwon-Do. To solve this problem, Several policy interventions could be applied such as mental health resources allocation plan, telemedicine, providing more closely coordinated services between mental health institutions and community mental health centers to enhance the accessibility.
Risk assessment system which is the point of occupational safety and health management system is recognized to be effective to prevent industrial accident and occupational disease internationally. Ministry of Employment and Labor developed guidance on risk assessment at workplace recently. This guidance presents standard model on risk assessment at workplace. However, enterprises may be confronted with many questions in the process of introducing and operating risk assessment. For risk assessment to be implemented properly and effectively at workplace, there are various questions that need to be considered in advance, including giving shape to standard on risk evaluation and clarifying the implementation system at workplace in advance. Also for risk assessment to be revitalized at workplace, several policy matters need to be settled. First, an administrative agency should present the implementation method of risk assessment more concretely. Secondly, it is necessary for an administrative agency to develop and spread various detailed manual, models and good practices related to risk assessment. Thirdly, a government agency need to apply an incentive & disadvantage policy actively to risk assessment.
This is an underlying study for expanding child growth and developmental screening program, which had been implemented as a part of maternal child health service in a certain public health center located in P City. This study attempted to develop system model to discover, consult and follow-up developmental disabilities in children in early stage. For the purpose of providing groundwork for further development of screening program, the system model was analyzed and evaluated. One of the focuses of this study was developing practical tool that can aid small number staffs of public health center to handle large number of patients. 9 types of developmental checklist by key month was developed to support understaffed public health center. These checklists were also supplied to other public health centers, greatly improving qualitative and quantitative development of screening project. Also, the 4-step program of operating and managing child growth and developmental screening was proved to be quite effective. Total 632 children were evaluated and 21 of them were suspected to have developmental problem. Among these children, 8 children were determined to receive regular supervision of public health center. Other 13 children were recommended to visit professional institution, but only 7 of them actually visited institution. Four of these children who visited professional institution are currently receiving treatment, while the other 3 children were determined to require close observation. Five times of screening education were provided to the staffs in public health center and personnel in charge of children in every district public center in P City. The purpose of this training was to improve individuals' capability to implement project and to establish basis for expanding child growth and developmental screening program. The participants were guided to have continuous attention for the project, and their knowledge, skill and recognition were greatly improved through educational training. Also, professional child consulting and education, including lecture for baby food and baby food menu exhibition, were given to parents. Through this opportunity, parents acquired higher understanding about baby food while the local residents' recognition for maternal child health service was greatly improved.
Purpose: This study was done to investigate factors associated with depression and quality of life (QoL) among the community-dwelling elderly. Methods: This study used a descriptive correlational research design. The subjects were 730 elders aged over 65 living in D district of Daegu. Data were collected using questionnaires for 30 days in April, 2007. The research instruments utilized in this study were a physical function scale of long-term care insurance system, Geriatric Depression Scale Short Form Korea Version (GDSSF-K), and Korean Quality of Life Scale (KoQoLs). The collected data were analyzed by descriptive statistics, t-test, ANOVA, Duncan, stepwise multiple regression, and Spearman correlation. Results: The mean age of the subjects was 72.6, and 68.8% and 57.9% of subjects were, respectively, female and living alone. 12.3% of variance in depression was explained by age, education, economic status, subjective health, alcohol consumption, condition of teeth, and fall experience. 18.2% of variance in QoL was explained by economic status, number of diseases, condition of teeth, incontinence, paralysis, and IADL. Economic status and condition of teeth were contributing factors to depression and QoL of the elderly. Conclusion: Findings of this study may be useful in understanding the health status of the community-dwelling elderly and developing more regionally specific health promotion strategies.
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