• Title/Summary/Keyword: Health Care Accessibility

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The Experience and Competence of Physicians Who Provide Emergency Health Care at Public Health Sub-Centers on Remote Islands in Korea (도서지역 보건지소 공중보건의사의 응급의료 경험 및 대처능력 고찰)

  • Seo, Je-Hyun;Lee, Su-Jin;Ha, Jeong-Hoon;Kwon, Duck-Geun;Kim, Jung-Ho;Lee, Jae-Hyuk;Na, Baeg-Ju;Kang, Yoon-Hwa
    • Journal of agricultural medicine and community health
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    • v.36 no.1
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    • pp.36-46
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    • 2011
  • Objectives: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. Methods: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. Results: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. Conclusions: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.

An Investigation of Current Status of the Clinical Practice Guidelines in Korea (국내 임상진료지침의 개발 현황)

  • Chun, Pusoon;Lee, Young Sook
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.178-186
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    • 2015
  • Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.

Analysis of the Space Planning Guidance about the Temporary Shelter Emphasizing Habitability for Disaster Victims in U.S. (거주성 관점의 미국 이재민 임시대피시설 공간계획 관련 지침분석)

  • Kim, Mi-Kyung;Choi, Seon-Mi;Choi, You-Ra
    • Korean Institute of Interior Design Journal
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    • v.26 no.5
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    • pp.42-51
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    • 2017
  • The purpose of this study was to analyze the information about the disaster temporary shelter space planning guidance described in the U.S. shelter guidelines in terms of the habitability for disaster victims and to address the implications and potential impacts of its findings for the improvement of the shelter design standards and guidelines in Korea. The researchers reviewed four federal and non-governmental organization shelter field and design guidelines and attributes regarding the shelter space planning were classified in accordance with four habitability categories: Safety, Health, Convenience, and Comfort. Three major findings emerged from this study: 1)A total of 72 items about the shelter space planning were extracted from guidelines, and the majority of items are concerned with dormitory areas and sanitary spaces. Other items were about accessibility, children respite care area, signage, health service areas, food preparation and serving areas, parking and drop-off areas, registration and waiting areas, shelter manager and staff areas, lounge and storage areas, and household pets area. 2)Most of these items are strongly related to the convenience category(66.7%), followed by comfort(40.3%), safety(30.6%), and health(25.0%). 3)The habitability of the disaster temporary shelter can be established with considerations on the needs of disaster victims and vulnerable people, minimum occupancy space per person, separate sanitary spaces for the privacy, safe and convenient access routes to the shelter, and the provision of children areas for safety and comfort. The study findings will contribute to the development of the disaster shelter guidelines in Korea by suggesting shelter space planning indicators related to the habitability for the governmental and non-governmental organizations' immediate and systematic responses to the disaster.

A Plan to Improve Consumer Satisfaction and Reliability of Opticians by Analyzing Consumers' Spectacles Purchasing Behavior (소비자의 안경 구매 행태 분석을 통한 만족도 및 신뢰도의 향상 방안)

  • Park, Jee-Hyun;Lee, Eun-Hee;Koo, Eun-Hye;Kim, Hee-A;Song, Da-Hye;Hyun, Jin-Hee;Kim, Hyojin
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.1
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    • pp.1-7
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    • 2010
  • Purpose: To plan and improve consumers' satisfaction by analyzing consumers' purchasing behavior of spectacles. Also this will show the need of improvement in reliance of an optician. Methods: A total of 307 people (10 to 60 years) participated in individual questionnaires. Questionnaires comprised of general characteristic of surveyed people, purchasing spectacles behavior, satisfaction after purchasing spectacles, reliability of optician, and improvement points of optician. Results: Most important points in selecting the product were the design and the price of the spectacles. 142 people (46.3%) replied "average" and 140 people (45.6%) replied "satisfying" out of maximum point of satisfaction level which was 5 points. 72.3% of people have regularly visiting optical shop due to the high accessibility, after-sales care, and courteous optician. On the contrary, 27.7% replied "never visit same optician shop again" because of the low accessibility, minimal range of products, and high price. Data showed that people had high re liability about the opticians' knowledge of product, and their technique of eye refraction. Data revealed that people did not show high satisfaction about opticians' knowledge of ophthalmology, and price of products. Most important improvement points were accurate spectacle prescription by Opticians rating 42% of reply. Factors most considered during spectacle selection among the 10 to 20 age group were design by 34.8% and price by 10.1%. Among the 40 to 50 age group, most considered factors were design by 14% and spectacle frame material by 10.1%. Conclusions: Satisfaction rate of purchasing spectacles for the total participant group was 4.2 average grades. Reliability of opticians' eye refraction result and prescription was 50.5%. However consumers wanted to obtain more accurate eye refraction result and prescription with more comprehensive explanations. Also, consumers wanted opticians to be sensitive and have appreciative eye in select spectacles for customers, and to offer precise spectacle dispensing services and courteous after-sales care.

A Study on Small Area Variations of Hospital Services Utilization in Heart Diseases (심질환의 지역간 입원의료이용 변이에 관한 연구)

  • Kwon, Young-Chae;Chang, Dong-Min
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.207-218
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    • 2012
  • The purpose of this study is to provide preliminary data for political measures to minimize the variations by understanding the regional variations and trends of hospital services for heart diseases, and analyzing the factors that could occur any variations. The various data collected from nation-wide inpatient services conducted separately by small region show that there have been some differences in income level, supply of medical resources, standardized rate of hospitalization by sex and age, health level in the residence, and the length of stay per head. Then it indicated that the number of special medical equipment per 10,000 people and the rate of vigorous physical activity have the highest influence over the regional variations in using hospital services. On the other hand, the number of sick-beds per 10,000 people, the number of special medical equipment, and the present smoking rate have significant degree of influence on the length of stay per head. Thus, it is imperative for the authorities to set aside health promoting policies and to distribute the medical resources equitably throughout the country and to enhance the accessibility of local residents to the health care services.

How to Implement Quality Pediatric Palliative Care Services in South Korea: Lessons from Other Countries (한국 소아청소년 완화의료의 발전 방안 제언: 국외 제공체계의 시사점을 중심으로)

  • Kim, Cho Hee;Kim, Min Sun;Shin, Hee Young;Song, In Gyu;Moon, Yi Ji
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.105-116
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    • 2019
  • Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.

The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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Horticultural Therapy Programs Enhancing Quality of Life and Reducing Depression and Burden for Caregivers of Elderly with Dementia

  • Kim, Yong Hyun;Park, Chul Soo;Bae, Hwa-Ok;Lim, Eun Ji;Kang, Kyung Heui;Lee, Euy Sun;Jo, Su Hyeon;Huh, Moo Ryong
    • Journal of People, Plants, and Environment
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    • v.23 no.3
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    • pp.305-320
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    • 2020
  • Background and objective: The problem that follows the increase of dementia patients is the burden of caregivers caring for dementia patients. The purpose of this study was to examine the effects of horticultural therapy programs improving the quality of life and reducing the depression and burden of caregivers of the elderly with dementia. Methods: In this study, 19 caregivers of the elderly with dementia were selected, and the experiment was conducted by dividing the control group (n=9) and the experimental group (n=10) by random distribution. The experimental group was given eight horticultural therapy programs twice a week for a total of 4 weeks. Subjects were assessed using the depression(CES-D), quality of Life (WHOQOL-BREF), and care burden scales. The evaluation results were verified at a 95% significance level using descriptive statistics, the Mann-Whitney U test, and Wilcoxon signed-rank test. Results: In the case of depression, the control group's score tended to increase, and the experimental group's score appeared to decrease, but it was not a statistically significant change. In the quality of life, the control group was not statistically significant, but scores decreased overall. On the other hand, in the experimental group, the general quality of life increased significantly from 11.60 to 14.20 points (p = .02), and the total quality of life increased to a marginally significant level from 61.59 points to 68.85 points (p = .059). In the post-test of the total care burden score, a marginally significant difference was found between the control group (94.44 points) and the experimental group (82.50 points; p = .079). Conclusion: This study confirmed the applicability to reduce the burden of caregiving and improve the deterioration of quality of life of the caregivers. In particular, the results will serve as an opportunity to confirm accessibility in a new way to support the caregiver of dementia patients by demonstrating the applicability of horticultural therapy at a time when problems such as the burden of supporting the caregiver are emerging as social problems.

A STUDY ON THE SATISFACTION FACTORS OF THE DISABLED WHEN USING DENTAL CARE SERVICES (장애인의 치과의료서비스 이용 시 만족 요인에 관한 연구)

  • Cho, Hye Lim;Kim, Yung Jae;Yoon, Tai Young
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.9-21
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    • 2014
  • This study aims to help utilize the dental treatment institutions for the disabled and provide high quality of medical services in the future by identifying the satisfaction factors for the patients of the dental clinics for the disabled. As a study method, surveys were completed 200 patients who visited the dental hospital for the disabled. Among these, the surveys from 187 patients were statistically analyzed. The main findings of this study are as follow. Since the study showed that there were differences in the satisfaction factors between the disabled and non-disabled people, subsequent studies needs to be done to develop measuring tools to accurately accommodate the satisfaction factors of the disabled. In addition, as the low spatial accessibility in terms of distance and location was found in this study, more dental treatment institutions for the disabled are required. In the meantime, the survey results found that the most satisfactory aspect was the lower treatment cost compared to other clinics, and that the most important factor when choosing a clinic was also treatment. In addition, given the fact that the group that took a prosthetic treatment, which was non-insured treatment, showed higher satisfaction compared to the group that did not, it suggests that the economic burden plays an important role for the dental treatment of the disabled.

Thoracic and Cardiovascular Surgeons' Perception of the Concentration of Cardiovascular Operations in Seoul Metropolitan Area's Hospitals

  • Jeong, Hyo Seon;Lee, Kun Sei;Chee, Hyun Keun;Ahn, Hye Mi;Sim, Sung Bo
    • Journal of Chest Surgery
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    • v.49 no.sup1
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    • pp.53-59
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    • 2016
  • Background: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. Methods: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities. Results: Survey participants responded that South Korea needs governmental policies to alleviate the concentration of cardiovascular surgery patients in large metropolitan hospitals. Participants agreed that the freedom to choose medical institutions and improved accessibility to metropolitan hospitals due to advanced transportation systems were some of the causes for the concentration. A majority (98.7%) of respondents thought establishing thoracic and cardiovascular surgery centers in provinces was an appropriate solution to alleviate the concentration. Thoracic and cardiovascular surgery specialists were ranked as the number one group on which to focus development. Conclusion: Developing and carrying out policies to establish thoracic and cardiovascular surgery centers in provinces will alleviate the regional imbalance in available heart surgery services and an overall improvement in cardiovascular disease treatment in South Korea.